Clinical Features And Prognosis Analysis Of CD5-positive Diffuse Large B-cell Lymphoma

Objective:The study was conducted to analyze the clinicopathological characteristics and prognostic factors of CD5-positive diffuse large B-cell lymphoma(CD5~+DLBCL)and to assess the efficacy of first-line chemotherapy with R-CHOP in this cohort,with the aim of raising awareness of the disease,identifying high-risk patients and administering new therapies,thereby improving the poor prognosis of patients.Methods:Clinical information and follow-up data of 146 patients with DLBCL,including 17 CD5~+DLBCL and 85 CD5~-DLBCL,admitted to the Department of Haematology,The First Affiliated Hospital of Shantou University Medical College,February 2016 and June 2021,were collected and statistically analysed using SPSS23.0software.Differences between categorical data were assessed by the chi-square test.Both OS and PFS were analyzed by the Kaplan-Meier method and compared by log-rank tests.The influence of parameters on OS and PFS was analyzed using univariate or multivariate Cox regression.Results:(a).Patients with CD5~+DLBCL accounted for 16.6%of all DLBCL patients.Compared with CD5~-DLBCL group,CD5~+DLBCL group had more adcanced stage,more prone to bone marrow infiltration and HPS events,higher CNS-IPI score and high incidence of chromosome 19 abnormality(p<0.05).No statistical differences were found between the two group in age,sex,B-symptoms,lactate dehydrogenase,extra-nodal involvement,international prognostic index and cell of origin.(b).With a median follow-up of 23.6months(range,0.03-155.8months),The 2-year PFS for patients in the CD5~+DLBCL and CD5~-DLBCL groups were not reached and 24.4%(95%CI=2.7%-46.1%)(p<0.05);The 2-year OS for patients with CD5~+DLBCL and CD5~-DLBCL was 57.8%(95%CI=33.9%-81.7%)and 72%(95%CI=58.7%-85.3%),respectively(p<0.05).(c).Univariate survival analysis of 102 cases DLBCL found that shorter PFS was associated with CD5 positivity(HR=2.58,95%CI=1.02-6.55,p=0.04),HPS events(HR=28.95,95%CI=4.66-179.6,p=0.001)and high CNS-IPI score(HR=3.61,95%CI=1.45-9.03,p=0.005);while PS score>1(HR=2.92,95%CI=1.27-6.71,p=0.01),IPI>2(HR=2.70,95%CI=1.07-6.88,p=0.03),HPS events(HR=6.40,95%CI=1.75-23.38,p=0.005)and high CNS-IPI score(HR=4.08,95%CI=1.79-9.30,p=0.001)were associated with shorter OS.Multivariate survival analysis identified that HPS events(HR=15.11,95%CI=0.97-235.05,p=0.05)as an independent poor prognostic factor for PFS in DLBCL patients.(d).For CD5~+DLBCL patients,univariate analysis showed that shorter OS was associated with PS>1(HR=10.23,95%CI=1.022-85.68,p=0.03)and HPS events(HR=4.95,95%CI=1.07-22.90,p=0.04).Shorter PFS was associated with women(HR=10.76,95%CI=1.08-106.30,p=0.04),PS>1(HR=8.51,95%CI=0.99-73.03,p=0.05)and HPS event(HR=13.54,95%CI=1.36-135.2,p=0.02).Multivariate survival analysis did not identify adverse factors affecting PFS and OS in patients with CD5~+DLBCL.Conclusion:CD5~+DLBCL has a highly aggressive clinical and pathological profile.Survival and prognostic analyses indicated that CD5 is an unfavourable predictor of DLBCL,in addition,HPS event was found to be associated with the poor prognosis of patients with CD5~+DLBCL.