Prognostic impact of smoking and alcohol consumption in male patients with diffuse large B-cell lymphoma: a multicenter retrospective study

PURPOSE: Previous studies have been inconsistent concerning the associations of smoking and alcohol consumption with the prognosis of diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the associations of smoking and drinking status with overall survival (OS) in male patients with DLBCL. METHODS: A total of 371 male patients with newly diagnosed DLBCL were retrospectively enrolled from eight medical centers. Smoking and drinking status were assessed as binary variables (yes or no). Inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for potential confounders. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess associations. RESULTS: Overall, 17.3% (n = 64) were smokers, and 12.7% (n = 47) reported alcohol consumption. After weighting, smoking was not associated with OS (HR = 1.192, 95% CI: 0.546-2.605, P = 0.665), nor was alcohol consumption (HR = 0.864, 95% CI: 0.174-4.288, P = 0.808). Subgroup analyses showed interactions between smoking and age (P for interaction = 0.003), and between drinking and EBV DNA status (P for interaction = 0.004). Sensitivity analyses using complete-case data and three-category exposure variables yielded consistent findings. CONCLUSIONS: In this multicenter cohort of male DLBCL patients, neither smoking nor alcohol consumption was associated with the prognosis of DLBCL. Among EBV-positive patients, alcohol use was associated with a trend toward poorer prognosis, highlighting the need for further research.