Pan-Immune-Inflammation Value and Bone Marrow Infiltration in Lymphoma: A Retrospective Cohort Analysis

Background Lymphoma, a prevalent hematologic malignancy, utilizes bone marrow infiltration (BMI) as a key prognostic indicator. However, reliable biomarkers for predicting BMI risk remain scarce. The pan-immune-inflammation value (PIV), an emerging systemic inflammatory metric in translational oncology, correlates with adverse outcomes in lymphoma but its specific association with BMI is unestablished. This study aimed to evaluate the PIV-BMI relationship in lymphoma patients. Methods In this retrospective cohort analysis, consecutive lymphoma patients diagnosed at The Third Affiliated Hospital of Sun Yat-sen University (January 2018-January 2024) were enrolled. Logistic regression modeled associations between PIV and BMI. Nonlinear relationships were explored using smooth curve fitting with threshold determination via inflection point analysis. Subgroup analyses assessed effect modification. Propensity score matching (PSM; 1:1) minimized selection bias and confounding. Results Consecutive lymphoma patients from The Third Affiliated Hospital of Sun Yat-sen University (diagnosed Jan 2018 - Jan 2024) formed this retrospective cohort. Logistic regression models assessed links between the Pan-Immune-Inflammation Value (PIV) and bone marrow infiltration (BMI). We explored potential nonlinear associations via smooth curve fitting, identifying thresholds with inflection point analysis. Subgroup analyses examined effect modification. Propensity score matching (PSM; 1:1) was then applied to address selection bias and confounding. Conclusions PIV demonstrates a significant inverse association with bone marrow infiltration in lymphoma, supporting its utility for clinical risk stratification. However, large prospective multicenter studies are needed to validate these findings and establish standardized PIV cut-offs for therapeutic guidance.