Analysis Of The Effect Of Separated (R) CHOP Regiment On Patients With Large B Cell Lymphoma In Old Age

Background and PurposeDiffuse large B-cell lymphoma(DLBCL)is the most common type of non-Hodgkin’s lymphoma and its incidence in China is also high.In recent years,the incidence of diffuse large B-cell lymphoma in the elderly has increased year by year.Patients over the age of 60 had the largest increase.Their diagnosis was that the median age of DLBCL was approximately 70 years.The(R)CHOP regimen is effective in the treatment of diffuse large B-cell lymphoma.It is still the first-line standard for clinical treatment and is also recommended for elderly patients.However,because elderly patients have more complications and complications,a variety of adverse reactions are likely to occur in the course of treatment,thus affecting the efficacy and even endangering the safety of life.At present,the treatment of diffuse diffuse large B-cell lymphoma has become the focus of attention of experts at home and abroad.To reduce the adverse effects of chemotherapy drugs and improve the safety of chemotherapy,experts are actively exploring new treatment options for elderly patients.They improved the(R)CHOP protocol by reducing the dose,using specific alternative drugs,and adding new biological agents.But so far,there is no accepted alternative that has a definite curative effect and a small side effect.This study collected 40 patients with diffuse large B-cell lymphoma 70-80 years old and divided the standard-dose(R)CHOP protocol into the first and eighth days of use.To investigate the efficacy and adverse reactions of segregated(R)CHOP regimen in 70-80 year-old diffuse large B-cell lymphoma patients,and to provide a new treatment strategy for the treatment of diffuse large B-cell lymphoma patients aged 70-80 years.Materials and MethodsTo collect 40 patients with diffuse large B-cell lymphoma at the age of 70-80 in the first oncology department of the First Affiliated Hospital of Zhengzhou University.There were 21 males and 19 females,with a median age of 73(70-79)years.According to the Ann-Arbor stage,16 cases of I-II stage and 24 cases of III-IV stage were included.There were 33 cases with ECOG 0-1 scores,7 cases with ECOG ≥ 2 points,17 cases with IPI score 0-2 points,and 23 cases with 3-5 points.There were 19 cases with elevated LDH,21 cases with normal LDH,29 cases with negative β2-MG,and 11 cases with β2-MG positive.There were 31 cases without B symptoms,9 cases with B symptoms,3 cases with bone marrow invasion,and 37 cases without bone marrow invasion.There were 26 cases with separate R-CHOP protocol and 14 cases with CHOP protocol.Inclusion criteria:(1)Age 70-80 years old;(2)Diagnosed as diffuse large B-cell lymphoma by more than 2 experienced professors of pathology;(3)Initial treatment without chemotherapy,radiotherapy or targeted therapy;(4)No chemotherapy contraindications(such as liver and kidney function damage,cachexia,etc.);(5)Non-double(triple)strike and double(triple)expression.Exclusion criteria:(1)Age less than 70 or greater than 80;(2)Pregnant,pregnant or lactating women;(3)Have received chemotherapy,radiotherapy or targeted therapy;(4)Patients with liver and kidney function damage,cachexia,etc.(5)Double(triple)blows and double(triple)patients;(6)Poor mental condition,unable to cooperate.Statistical methodSPSS20.0 was used to statistically analyze the data.Chi-square test was used to compare the rates.Kaplan-Meier method was used for survival analysis.P<0.05 was considered statistically significant.Results1.Recent efficacy:The ORR and DCR in 40 cases of separated(R)CHOP were 80.0%(32/40)and 82.5%(33/40)respectively,they are equivalent to GELA985 in the efficacy(P = 0.542,P= 0.385).In 40 patients,26 cases of patients were treated with R-CHOP,their ORR and DCR were 84.6%(22/26)and 84.6%(22/26)respectively,which are equivalent to GELA985 in the efficacy(P = 0.804,P= 0.901).14 cases of patients were treated with CHOP,their ORR and DCR were 71.4%(10/14)and 78.6%(11/14)respectively,which are equivalent to GELA985 in the efficacy(P = 0.821,P= 0.453).2.Long-term efficacy:2 years OS and PFS of the separated R-CHOP were 76.8% and 69.3% respectively,while GELA985 were 70.0% and 60.0% respectively.2 years OS and PFS of the separated CHOP were 61.1% and 22.9% respectively,while GELA985 were 57.0% and 41.6% respectively.3.Adverse reactions mainly include granulocyte reduction(Level I or above),level III or IV anemia,nausea and vomiting,constipation,neurotoxicity and fever.The incidence of nausea and vomiting,neurotoxicity and fever were lower than GELA985(P < 0.05),but the incidence of granulocyte reduction,level III or IV anemia,constipation were equivalent to GELA985(P >0.05).ConclusionIn 70-80 year old diffuse large B cell lymphoma patients,the efficacy of separated(R)CHOP is significant and the adverse reaction is light and tolerable,thus it is expected to be a feasible chemotherapy regiment for the elderly patients with diffuse large B cell lymphoma.