{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:11:13Z","timestamp":1783440673661,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Low baseline NK\u2010cell counts (NKCCs) in patients with diffuse large B\u2010cell lymphoma (DLBCL) are associated with a poor prognosis. The REMARC phase III trial (NCT01122472) showed that lenalidomide maintenance prolonged PFS in rituximab\u2013chemotherapy responders. We conducted a REMARC ancillary study analysing the impact of lenalidomide maintenance on the prognostic value of low NKCCs. Blood samples from 335 elderly French patients enrolled in the REMARC trial were analysed by flow cytometry to obtain NKCCs at diagnosis (<jats:italic>n<\/jats:italic> = 220), at randomization (<jats:italic>n<\/jats:italic> = 186) and\/or six months after randomization (<jats:italic>n<\/jats:italic> = 184). Baseline NKCCs &lt;\u2009100 cells\/\u03bcl were associated with shorter PFS and OS (HRs\u00a0=\u00a0[2.2 (1.4, 3.3), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001] and [2.8 (1.7, 4.5), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001], respectively), independently of aaIPI. In a competing risk analysis, low NKCCs at baseline were associated with a higher risk of relapse\/progression (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0025), but not of death without progression (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.33). Lenalidomide did not affect the prognosis value of low baseline NKCCs (<jats:italic>p<\/jats:italic> \u00a0=\u00a00.6349). Similar results were obtained for low NKCCs at randomization. Our results demonstrate that low NKCCs at baseline and post rituximab\u2013chemotherapy are robust prognostic factors in DLBCL and reveal that lenalidomide has no impact on this parameter. Other therapeutic strategies aiming at improving NK\u2010cell function could improve outcomes in DLBCL.<\/jats:p>","DOI":"10.1111\/bjh.18642","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T08:22:49Z","timestamp":1675671769000},"page":"256-266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lenalidomide maintenance fails to overcome the unfavourable prognosis of low NK\u2010cell counts in rituximab\u2013chemotherapy responsive elderly DLBCL patients: A LYSA group study"],"prefix":"10.1111","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7806-9687","authenticated-orcid":false,"given":"Asma","family":"Beldi\u2010Ferchiou","sequence":"first","affiliation":[{"name":"Biological Hematology and Immunology department, APHP, INSERM U 955 Hopital Henri Mondor  Creteil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Philippe","family":"Jais","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, APHP Univ Paris Descartes  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3131-3718","authenticated-orcid":false,"given":"Herv\u00e9","family":"Ghesquieres","sequence":"additional","affiliation":[{"name":"Hematology, Centre Hospitalier Lyon Sud PIERRE\u2010BENITE  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene Olivier","family":"Casasnovas","sequence":"additional","affiliation":[{"name":"Hematology, CHU Dijon Bourgogne and INSERM U 1231  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Tilly","sequence":"additional","affiliation":[{"name":"INSERM U918, Centre Henri Becquerel  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Fruchart","sequence":"additional","affiliation":[{"name":"Institut d'H\u00e9matologie de Basse Normandie, CHU Caen  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Morschhauser","sequence":"additional","affiliation":[{"name":"Clinical Hematology, Univ. 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