@article{article_1770811, title={Immunonutritional profiling for prognostic assessment in diffuse large B-cell lymphoma: an initial evaluation of the C-reactive Protein–Albumin–Lymphocyte (CALLY) Index}, journal={Journal of Health Sciences and Medicine}, volume={8}, pages={1112–1117}, year={2025}, DOI={10.32322/jhsm.1770811}, author={Pınar, İbrahim Ethem and Özkocaman, Vildan and Ersal, Tuba and Gürsoy, Vildan and Hunutlu, Fazıl Çağrı and Yiğit Ayhan, Elif and Özkalemkaş, Fahir}, keywords={Diffuse large B-cell lymphoma, CALLY Index, immunonutritional profiling, prognosis, International Prognostic Index, overall survival}, abstract={Aims: Diffuse large B-cell lymphoma (DLBCL) demonstrates wide heterogeneity, complicating risk stratification with conventional prognostic instruments, particularly the International Prognostic Index (IPI). The C-reactive Protein (CRP)-Albumin-Lymphocyte (CALLY) Index, an immunonutritional marker that integrates inflammation, nutritional status, and immune competence, has demonstrated prognostic relevance in solid tumors. The present analysis was designed to determine the clinical utility of the CALLY Index for prognostication in newly diagnosed DLBCL patients and to assess its added value when integrated with traditional prognostic scores. Methods: In this retrospective cohort, 112 patients presenting with newly diagnosed DLBCL and treated at Bursa Uludağ University between 2015 and 2019 were evaluated. The CALLY Index was calculated as (serum albumin × absolute lymphocyte count) / (CRP×10⁴). An optimal cutoff value of 0.78 was derived using log-rank testing and used to stratify patients into low (≤0.78) and high (>0.78) CALLY categories. Baseline clinical features were compared between groups. Kaplan-Meier curves and multivariable Cox proportional hazards modeling were applied to examine overall survival (OS). Multivariable analysis included IPI score and serum beta-2-microglobulin. Results: Cases in the low CALLY subgroup (68.8%) were significantly older, had poorer Eastern Cooperative Oncology Group performance, lower albumin, higher CRP, and more advanced disease (p <0.01 for all). They were also more frequently classified into higher-risk IPI categories (p=0.009). Median OS in the low CALLY group was 14.8 months, while the high CALLY group had not reached median OS at the end of follow-up (p=0.0009). Univariable analysis revealed that low CALLY (HR: 5.33, p=0.002) and high IPI score were associated with worse OS. In multivariable analysis, low CALLY remained an independent predictor of mortality (HR: 3.42, 95% CI: 1.16-10.08; p=0.025), even after adjusting for IPI and beta-2-microglobulin levels. Conclusion: The CALLY Index is an independent and clinically accessible prognostic biomarker in DLBCL. Its integration of inflammatory, nutritional, and immune parameters provides complementary prognostic information beyond traditional models such as the IPI. Given its cost-effectiveness and reliance on routine laboratory data, the CALLY Index may serve as a valuable tool in real-world prognostic assessment. These findings support prospective validation and exploration of its utility in dynamic risk models and personalized treatment strategies for DLBCL}, number={6}, publisher={MediHealth Academy Yayıncılık}