Analysis Of The Prognosis Of 88 Cases With Diffuse Large B Cell Lymphoma

Objective To analyse the influence factors on the prognosis of diffuse large B cell lymphoma patients in the first affiliated hospital of Guangxi Medical University. The effectiveness of CTOP and R-CTOP regimen were also observed.Methods Patients'elemental information was searched,who were newly diagnosed and had regularly treatment in this hospital from January 2004 to July 2010(age>17 years).The following up was made via telephone to confirm the condition of the patients.Date was analyzed to calculate complete remission (CR)rate , response rate(RR) and overall survival(OS) by SPSS17.0.Results1. Of the 88 patients,82 patients could be followed up by telephone.6 of them lost.The median follow-up time was 30 months(range,3～78months).2. 1, 2and 3 year survival rates: patients in stageⅠ,Ⅱwere 83.9% , 83.9% and 79% ,while stageⅢ,Ⅳwere59.6% , 47.4% and 44.6%.Patients who had a high level of serum LDH , B symptom or high International Prognostic Index score had a lower 3 year survival rates.3. Of the 88 patients,4 patients with bonemarrow involvement(LBMI) and 8 patients developed Secondary Central Nervous System Lymphom(aSCNSL). Both of then had a poor Prognosis .4. Complete remission (CR) rate and response rate(RR) in CTOP group was 54.7% and 85.9% respectively while in R-CTOP group was 79.2% and 91.9% respectively.There was no Statistically significant differences between RCTOP and CTOP group of the 3-year survival rates (69.2% VS 53.2,P=0.282).5. Six to eight cycles of R-CTOP had a higher 3-year survival rates than four or less four cycles (90.9% vs 48%,P=0.025).6. All the patients'predicted 3-year OS was 57%.No patient die if they were alive after three years of diagnosis during our follow up .Median survival time hasn't been achieved.Conclusion1. CR Was 79.2%in R-CTOP,being significantly higher than that of 54.7% in CTOP group.There Was no difference in RR and 3-year survival rates between the two groups . Six to eight cycles of R-CTOP may have a higher survival rates.2. Advanced stage,high level of serum LDH , B symptom and a high International Prognostic Index score were independent prognostic factors.3. patients of DLBCL who have advanced stage or high International Prognostic Index score at presentation More likely develop SCNSL . Both LBMI and SCNSL have a poor Prognosis .4. It is hardly relapse or develop in DLBCL patients who had CR and maintain CR for 3 years,and almost has Clinical cure.