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The presence of tumor-associated macrophages (TAMs) may influence the progression of lymphoma and expression of HLA-DR. We retrospectively studied causes of newly diagnosed DLBCL to examine the clinical relevance of HLA-DR expression and TAMs. Methods: We retrospectively reviewed 36 patients who had newly diagnosed DLBCL, underwent flow cytometry (FCM) of lymphoma cells, and were treated with R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) at Kanagawa Cancer Center in Japan from 2004 to 2010. HLA-DR expression on lymphoma cells was evaluated by FCM and patients were divided into those with or without HLA-DR bright cells. TAMs in lymphoma tissue were evaluated by immunohistochemistry of CD68 as a marker http://www.selleckchem.com/products/ABT-263.html of macrophages and CD163 as a marker of M2 TAMs which have been reported the relationship to worse prognosis in some tumors and patients were divided into those with CD68��CD163 or CD163>CD68. We then compared HLA-DR expression and TAM status with the clinical features and prognosis. Results: The median follow-up time was 3.1 years. Three-year overall survival (OS) was respectively 100% versus 69.6% (95% confidence interval http://www.selleck.cn/products/Erlotinib-Hydrochloride.html [CI]: 52.0-93.2) in patients with or without HLA-DR bright status (P=0.012), while it was 94.4% (95% CI: 84.4-100.0) versus 72.7% (95% CI: 50.6-100.0) in patients with CD68��CD163 TAMs or CD163>CD68 TAMs (P=0.017). HLA-DR status was an independent factor influencing progression-free survival (PFS) according to http://www.selleckchem.com/products/MK-2206.html multivariate analysis. There was no relationship between HLA-DR and TAM status. However, DLBCL patients could be classified into 4 groups by their HLA-DR and TAM patterns, and the prognosis of patients with HLA-DR not bright and CD163>CD68 TAMs was much worse than that of the others (3-year OS: 40.0% [95% CI: 13.7-100.0] versus 95.7% [95% CI: 87.7-100.0] [P