Clinical Analysis Of 170 Cases Of Diffuse Large B Cell Lymphoma

Objective To retrospectively analyze the clinical data of 170 patients with diffuse large B cell lymphoma(DLBCL)who were first diagnosed in Gansu Provincial People’s Hospital,to compare the efficacy of CHOP regimen and RCHOP regimen in DLBCL and the occurrence of adverse events during chemotherapy.And to explore the influence of different risk factors on the prognosis of DLBCL patients.Methods The clinical data of 170 DLBCL patients who were first diagnosed in Gansu Provincial People’s Hospital from June 2013 to June 2020 were collected,their general characteristics and the primary site of the disease were analyzed.136 patients who met the inclusion criteria were selected to compare the treatment effect of CHOP regimen and RCHOP regimen,and analyze the occurrence of adverse reactions during treatment;The Kaplan Meier method was used for survival analysis,and the relationship between various risk indicators and the prognosis of DLBCL was analyzed by univariate and Cox multivariate regression.Results 1.The median age of the 170 DLBCL patients was 57.5(9-88)years old,41 to70 years of age were the most prevalent age group of DLBCL,of which 51 to 60 years have the highest incidence;Including 91 males and 79 females,the incidence of females was slightly lower than that of males.The lesions originated in the lymph nodes accounted for47.65%,and the extra nodal lesions accounted for 52.35%.Among the extranodal patients,the most common lesions occurred in the gastrointestinal tract,followed by Weys ring and spleen.2.Compared the curative effect of patients who received CHOP regimen and RCHOP regimen chemotherapy,the results showed that the 3-year,5-year and overall survival rate of CHOP regimen were 71.93%,52.63% and 47.36%,respectively,while in the RCHOP regimen group were 88.60%,78.48%,and 75.95%,and the difference in two regimens was statistically significant(P<0.05).3.Both CHOP regimen and RCHOP regimen had mild to moderate bone marrow suppression,gastrointestinal reactions,allergies,abnormal liver function and cardiac events during treatment.And myelosuppression was the most common,the incidence of CHOP and RCHOP regimens were 31.57% and 36.71%,respectively;followed by gastrointestinal reactions,the incidence of two chemotherapy regimens was 24.56% and 26.58%;others such as allergic reactions,liver damage and the incidence of cardiotoxicity was low,and there was no significant difference in in adverse reactions between the two regimens.4.The results of survival analysis showed that the OS of patients age >60 years old was significantly lower than that age≤60 years old(P=0.02).Compared with the HBs Ag negative group,the OS of HBs Ag positive group was shorter(P=0.039).The OS of patients in the MYC/ Bcl-2/Bcl-6 co-expression group was significantly lower than that in the non-MYC/Bcl-2/Bcl-6 co-expression group(P=0.006).Patients with CD5 positive had a shorter OS than those with CD5 negative(P=0.015).The patient OS of Ann Arbor stage Ⅰ ～Ⅱ was better than the stage Ⅲ ～ Ⅳ(P = 0.007);Univariate analysis revealed that age,Ann Arbor stage,IPI score,HBs Ag,CD5 expression,and whether co-expression of MYC/BCL-2/BCL-6 were factors affected the outcome of DLBCL;Multivariate analysis discovered that Ann Arbor stage Ⅲ～Ⅳ and with the co-expression of MYC/BCL-2/BCL-6were independent indicators for the prognosis of DLBCL patients.Conclusion 1.The median age of the 170 DLBCL patients was 57.5(9-88)years old,and the incidence of females was slightly lower than that of males;the primary site is more common outside the lymph nodes,and the gastrointestinal tract is the most commonly involved site in the extranodal lymphatic DLBCL.2.For newly diagnosed DLBCL patients,the efficacy of the RCHOP regimen was significantly better than that of the CHOP regimen;mild to moderate adverse reactions would occur in both regimens,and there is no significant difference in the incidence between the two regimens.3.Age,Ann Arbor stage,IPI score,HBs Ag,CD5 expression,with the co-expression of MYC/BCL-2/BCL-6 were factors that affect the prognosis of DLBCL patients;while Ann Arbor stage and the co-expression of MYC/BCL-2/BCL-6 were independent indicators for the prognosis of DLBCL patients.