Clinical Characteristics And Correlation With Prognosis Of DLBCL With Bone Marrow Involvement And Chromosomal Abnormalities

Objective:To investigate the clinical characteristics of Diffuse Large B-cell Lymphoma(DLBC L)patients with bone marrow involvement and chromosome abnormalities,analyze the c orrelation between the degree of chromosome abnormality and prognosis,and further ana lyze the correlation between clinical characteristics and prognosis.This will enable early identification of high-risk patients and hence more aggressive and effective interventions.Methods:The clinical data of 88 patients diagnosed with DLBCL with bone marrow involvem ent and complete chromosomal findings in Shanxi Province Cancer Hospital from March2007 to October 2021 were retrospectively analyzed.The χ2 test was used to analyze the clinical characteristics,and the Kaplan-Meier method was used to plot the probabilities o f PFS and OS,and comparison between groups was performed by Log-rank test.Multiva riate analysis was conducted using Cox proportional risk model.P < 0.05 was considere d statistically significant.Results:1.Clinical characteristics: Of the 88 patients with DLBCL,male predominance(55patients,62.5%),the median age is 58(26-85)years old.All patients had bone marrow i nvolvement,all of them were Ann Arbor IV stage.81 patients(92.0%)had ≥2 extranodal involvement sites,62 patients(70.5%)had LDH higher than the upper limit of normal,47 patients(53.4%)had ECOG score ≥ 2,31 patients(35.2%)had B symptoms,and 25 pa tients(28.4%)had GCB type.31 patients(35.2%)had chromosome abnormalities,of wh ich 16(18.2%)had 1-2 chromosome abnormalities,and 15(17.0%)had ≥3 chromosome abnormalities(complex karyotype).2.Immunophenotyping: The positive detection rates of Bcl-2,Bcl-6,C-myc and Ki-67 ≥ 80% was high in patients with complex karyotypes,and most of them are double e xpressor lymphoma.3.Survival analysis: The median PFS of patients with normal chromosome was 14.4(0.1-113.5)months,the median OS was 24.7(0.1-179.9)months,and 29 patients(50.9%)died.The median PFS of patients with 1-2 chromosome abnormalities was 41.4(2.4-68.7)months,the median OS was 46.1(3.6-68.7)months,and 10 patients(62.5%)died.The m edian PFS of patients with complex karyotypes was 8.5(1.8-27.0)months,the median OS was 14.2(2.5-61.3)months,and 13 patients(86.7%)died.Univariate analysis showed th at double expression only had a significant adverse effect on OS.B Symptoms,higher L DH than the upper limit of normal,extranodal involvement sites ≥ 2,ECOG score ≥ 2,B cl-2 positive,complex karyotype had significant adverse effects on PFS and OS.Multiva riate analysis showed that age ≥ 60 years old,higher LDH than the upper limit of normal,C-myc positive and double expression were independent adverse prognostic factors for OS in DLBCL patients.ECOG score ≥ 2 and Bcl-2 positive were independent adverse pr ognostic factors for PFS and OS in patients with DLBCL.Conclusion:DLBCL with Bone Marrow Involvement and Chromosomal Abnormalities tends to occur in elderly men,with more than 2 extranodal involvement sites and higher LDH tha n the upper limit of normal.B symptoms,higher LDH than the upper limit of normal,ext ranodal involvement sites ≥ 2,ECOG score ≥ 2,Bcl-2 positive,and complex karyotype h ad significant adverse effects on PFS and OS.Among them,ECOG score ≥ 2 and Bcl-2 p ositive were independent adverse prognostic factors affecting PFS and OS.