Clausen MR, Maurer MJ, Ulrichsen SP, et al. - Including patients from the Danish Lymphoma Registry (LYFO; N = 3,499) and from the Molecular Epidemiology Resource (MER; N = 1,225), Mayo Clinic and University of Iowa, researchers performed this inquiry to determine whether additional prognostic information over and above the NCCN-IPI could be provided by measuring pretherapeutic hemoglobin (Hgb) level in patients with diffuse large B-cell lymphoma. They described four gender-specific Hgb groups: below transfusion threshold, from transfusion threshold to below lower limit of normal, from lower limit of normal to the population mean, and above the mean. Hgb levels below the lower limit of normal were detected in nearly half of the patients. A direct correlation of an inferior overall survival with lower pretreatment Hgb was identified within the predefined groups, relative to patients with Hgb levels above the mean. In the MER, these results were confirmed. Findings of the multivariable analysis revealed the ability of lower pretreatment Hgb, even within the normal range but below the mean, to provide additional prognostic information over and above that offered by established indices such as the NCCN-IPI and the Charlson comorbidity index.