Efficacy And Prognosis Of Immunochemotherapy To Diffuse Large B Cell Lymphoma

[Objective]A retrospective study of methods of R-CHOP compared with CHOP in thetreatment of newly diagnosed diffuse large B-cell lymphoma(DLBCL) patients withclinical efficacy, and to explore the BCL-6、CD10and ki–67expression andprognosis in patients with DLBCL.[Materials and methods]A total of83patients newly diagnosed DLBCL were enrolled from Janua-ry2006to December2010at two hospitals. The patients were divided into R-CHOP group and CHOP group. Among them32cases in group R-CHOP,using Rituximab combined with CHOP (Cyclophosphamide, epirubicin,vincristine,prednisone) scheme,51cases in group CHOP, with CHOP scheme. The twogroups were chemotherapy for6cycles, the interval of21days for1cycles,and according to the revised edition of lymphoma efficacy evaluation standards, evaluation of R-CHOP regimen and CHOP regimen in the initialtreatment of DLBCL patients with clinical efficacy; In addition, we detectedthe expression of BCL-6、CD10and ki–67protein by immunohistochemicalmethod and compared their expression with clinical relationship.[Results]1.Short-term efficacy: R-CHOP group complete remission rate and overallresponse rate higher than the CHOP group than in CHOP group, respectively75%vs54.2%, P=0.030;87.5%vs66.7%, P=0.034, short-term effect on the two programswere significant differences. 2. Long-term efficacy: R-CHOP group of5-year OS and PFS was significantlybetter in the CHOP group, respectively:47.9vs36.8months, P=0.025,39.3vs26.6months, the two programs in long-term effects are also significant differences.3. The expression of BCL-6and the efficacy: the positive expression of BCL-6protein was50.6%; in Short-term efficacy on BCL-6(+)/R-CHOP group and BCL-6(+)/CHOP group showed no significant difference (P>0.05), BCL-6(-)/R-CHOP group complete remission rate and BCL-6(-)/CHOP group also showedno significant difference (P>0.05). BCL-6(+) group of5years of OS and PFS wassignificantly associated with a better estimation than BCL-6(-) group,respectively:48.4vs30.3, P=0.001;37.9vs23.0, P=0.006. While BCL-6(+)/R-CHOP group and BCL-6(+)/CHOP5years of OS and PFS showed nosignificant difference (P>0.05); BCL-6(-)/R-CHOP group BCL-6(-)/CHOPgroup5years of OS and PFS also have no significant difference (P>0.05).4.The expression of CD10and the efficacy: The positive expression rate of CD10was36.1%; in short-term effect on CD10(+)/R-CHOP group and CD10(+)/CHOP group and CD10(-)/R-CHOP group and CD10(-)/CHOP group were notstatistically different (P>0.05). CD10(+) group of5years of OS and PFS wassignificantly associated with a better estimation than CD10(-) group, respectivelyfor47.9vs36.7P=0.036;40.5vs25.7, P=0.003. CD10(+)/R-CHOP group andCD10(+)/CHOP5years of OS and PFS showed no significant difference (P>0.05); but theCD10(-)/R-CHOP group5years of OS and PFS was significantlyassociated with a better estimation than CD10(-)/CHOP group, respectively for45.3vs30.0, P=0.013;35.8vs18.5, P=0.001.5. The expression of Ki-67and the efficacy: Ki-67protein expression rate of63.9%; in short-term effect on Ki-67(+)/R-CHOP group and Ki-67(+)/CHOPgroup showed no significant difference (P>0.05), Ki-67(-)/R-CHOP groupcomplete remission rate and Ki-67(-)/CHOP group also showed no significantdifference (P>0.05). Ki-67(+) group of5years of OS and PFS was significantlyassociated with a worse estimation than Ki-67(-)Group, respectively:32vs51.2, P=0.001;23.1vs44.1, P=0.000. While Ki-67(+)/R-CHOP group and Ki-67 (+)/CHOP5years of OS and PFS showed no significant difference (P>0.05); Ki-67(-)/R-CHOP group Ki-67(-)/CHOP group5years of OS and PFS also haveno significant difference (P>0.05).[Conclusion]1. When compared with standard CHOP alone, the addition of Rituximab tostandard CHOP regimen reduces the risk of treatment failure in patients with diffuselarge B cell lymphoma.R-CHOP in the treatment of newly diagnosed DLBCL patientswith short-term efficacy, long-term efficacy is superior to CHOP regimen. TheR-CHOP program can be used as initial treatment of DLBCL preferred scheme.2.In Cox regression DLBCL with BCL-6(+)﹑CD10(+) and Ki-67(-) patientshave better prognosis.