The aim of the current study is to evaluate the prognostic value of anemia, an easy to estimate parameter in patients with diffuse large B-celllymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) immunochemotherapy. A total of 157 patients with newly diagnosed DLBCL treated with ≥ 1 cycle of R-CHOP were included. Hemoglobin level without red cell transfusion within seven days before initiation of treatment was chosen as a parameter of baseline cancer-induced anemia (CIA). To investigate the clinical significance of chemotherapy-induced anemia (CTIA) and its recovery after completion of treatment, 87 patients in complete remission for ≥ 6 months from the time of the last cycle of R-CHOP were grouped and analyzed separately. Patients with a CIA of hemoglobin < 10 g/dL showed inferior event-free and disease-free survival compared to those with hemoglobin ≥ 10 g/dL. This finding was observed irrespective of the status of pre-treatment bone marrow involvement. In multivariate analysis, hemoglobin < 10 g/dL was found to be an international prognostic index-independent prognostic factor. Risk of relapse was significantly higher for patients who were still anemic at six months after R-CHOP, compared to those who achieved complete recovery from CTIA within six months. This article is protected by copyright. All rights reserved.