A Observation On Efficacy Of Different Chemotherapy Regimens For Newly Diagnosed Patients With Diffuse Large B Cell Lymphoma

Objective:To analyse the therapeutic efficacy,survival and side effects between different chemotherapy Regimes for the treatment of newly diagnosed patients with DLBCL by retrosp-ective studies.Materials and methods:A total of 76 newly diagnosed cases with DLBCL which were diagnosed from May 2002 to December 2009 were enrollted from our hospital.The patients were divided into two groups: 29 received Rituximab plus CHOP(Cyclophosphamide, epirubicin ,vincristine ,prednisone)and 47received CHOP alone. The cycle was repeated every 21 days. The therapeutic efficacy and side effects of RCHOP and CHOP regimens were evaluated according to the revised response criteria for lymphoma after 6 chemotherapy cycles. Inaddition , we detected the expression of Bcl-2 of the Seventy-six cases by themethods of immunohistochemistry and compared the correlation of the efficacy and the expression of Bcl-2. We did the statistics analysis with x2 test,Fisherexact probabilities and multifacto-corrlation by SPSS17.0 sofeware. P<0.05 hasstatistic significance.Results:1.Short-term efficacy: 22 had a complete remission (CR) (75.9%) ,5 had a partial remission(PR)(17.3%), 1 had a stable disease (SD) (3.4%) and 1 had a progressive disease (PD) (3.4%) in R-CHOP group, and the overall response rate was 93.1%(27/29).While 25 had a complete remission (CR) (53.2%) ,10 had a partial remission(PR)(21.3%), 5 had a stable disease (SD) (10.6%) and 7 had a progressive disease (PD) (14.9%) in CHOP group the overall response rate was 74.5%(35/47). There was statistically significant difference in the short-term efficacy between R-CHOP group and CHOP group. 2. Long-term efficacy:The estimated mean OS in R-CHOP group was longer than in CHOP group(32.9 months vs 26.9 months, P=0.040) and also in the estimated mean PFS(27.3 months vs 20.4 months, P=0.031).There was statistically significant difference in the estimated mean OS and PFS between two groups.3. The expression of Bcl-2 and the efficacy: the overall response rate for R-CHOP and CHOP were ,respectively, 94.7%(18/19) and 75.0%(27/36)( P=0.037) in BCL-2(+) patients and 70%(7/10) and 63.3%(7/11)( P=1.000) in BCL-2(-) patients. R-CHOP was significantly associated with a better estimated mean overall suvival than CHOP in BCL-2(+) patient(33.0 months vs 25.6 months, P=0.044). In BCL-2(-) patients there was no statistically significant difference (32.9 months vs 26.9 months, P=0.700).4.Side effects: The major adverse events in R-CHOP group were infusion-related responses which could be well tolerated. there was no statistically significant difference in hematological adverse reactions and and other non-hematologic adverse reactions between two groups.Conclusion:1. R-CHOP was significantly associated with a better short-term efficacy and long-term efficacy than CHOP.R-CHOP can be recommended as the first-choice regimen for the treatment of Newly Diagnosed patients with DLBCL.2.Rituximab could improve the efficancy of BCL-2 positive patients.3. The major adverse events in R-CHOP group were infusion-related responses which could be well tolerated. there was no statistically significant difference in hematological adverse reactions and and other non-hematologic adverse reactions between two groups..