Anemia at diagnosis (baseline) is a potential adverse prognostic factor for no response to chemotherapy in addition to the standard risk factors. OBJECTIVE: The purpose of this study was to identify factors associated with baseline anemia and to determine risk factors associated with no response to CHOP chemotherapy in IGNHL patients. METHODS: A historical case series sample of 591 patients diagnosed between 1993 and 1999, and treated in 12 practice sites with CHOP chemotherapy was used. Baseline anemia was defined as a hemoglobin (Hb) value < 12 g/dl at baseline. Multiple logistic regression was used to determine factors associated with baseline anemia and model its relationship with response [no response (NR) versus partial response (PR) and complete response (CR)]. RESULTS: Anemia was present in 193/546 (35.3%) patients. Baseline Hb values were not available for 45 patients. Multiple logistic regression showed that baseline anemia was significantly associated with elevated LDH (OR; 95%CI) (OR=2.74; 1.66-4.50), presence of B symptoms (OR=2.16; 1.22-3.83), stage III-IV (OR=1.81: 1.10-2.93), male gender (0.42: 0.25-0.69), and large cell diffuse (OR=2.05; 1.19-3.54) or immunoblastic (3.99; 1.78-9.02) histologic types. No significant interactions existed between any of the variables included in this model. Multiple logistic regression (predicting NR versus CR/PR) showed that the presence of baseline anemia (OR=2.29; 1.10-4.74) controlling for elevated LDH, advanced Stage III-IV, and age greater than or equal to 60, was a significant risk factor for NR to CHOP chemotherapy. CONCLUSION: The results support previous findings of the high prevalence of, and risk factors associated with, baseline anemia prior to CHOP chemotherapy. Baseline anemia was a significant risk factor for NR to CHOP chemotherapy, even after controlling for age, stage, and LDH. We conclude that additional studies with a comprehensive set of known risk factors validating this relationship between baseline anemia and response to CHOP chemotherapy are warranted.