Considering that COO and MYC/BCL2 status may not influence the outcome among patients with early-stage DLBCL treated with R-CHOP regimen [26,27,28,29,30,31], other factors (internal or external microenvironmental factors) may drive the poor prognosis of early-stage nodal DLBCL located under the diaphragm. This evidence concerns the gene BCL2 and diffuse large B-cell lymphoma.