“…However, no specific prognostic factors have been identified including the International Prognostic Index (IPI), because most patients were at low-or low-intermediate clinical risk and will be considered as low risk; other factors such as deep of invasion, tumor burden, lymph node invasion, and molecular profile have not been validated. [4][5][6][7][8][9][10][11][12][13][14][15] The use of combined treatments such as surgery, radiotherapy, and chemotherapy did not show any benefit in this setting of patients, [3][4][5][6][7][8][9][10][11] and the addition of rituximab is controversial; 4,5 in our experience, the addition of rituximab to CHOP chemotherapy does not improve outcome. 16 Some years ago, we performed a retrospective clinical study and found that patients with elevated serum levels of lactic dehydrogenase (LDH) and beta 2 microglobulin (B2M) (>2 of normal levels) have a worse prognosis, independent of other prognostic factors.…”