To Investigate The Clinical Characteristics Of Patients With Diffuse Large B-cell Lymphoma And The Factors Related With The Rituximab Effect

Objective :To investigate the clinical characteristics of patients with diffuse large B-cell lymphoma and the factors related with the rituximab effect. Method:We carried out a study on 49 diffuse large B-cell lymphoma patients who have used the rituximab therapy in combination with chemotherapy in the Sino-Japanese Friendship Hospital of Jilin University from January 2010 and December 2015. we analyze the general clinical feature in the 49 patients with different risk stratification, and also discusse the relationship between the degree of the CD3+tumor infiltrating lymphocytes and the rituximab effect stastically. Results:1.Patients with different risk stratification need different treatment course to reach PR by using rituximab together with chemotherapy,IPI score is higher, the more number of courses required to achieve PR, P = 0.0002, the difference was statistically significant. The IPI score is related with the absolute lymphocytes in peripheral blood, blood β2-microglobulin levels and serum globulin levels, P values were 0.04,0.024,0.035. But there is no significant correlation between the level of Ki-67 proliferation index、the hepatitis B infection and the IPI score, P values are 0.593,0.884.2. The absolute lymphocyte <1.0 × 109 / L in patients with diffuse large B-cell lymphoma occurred in patients with abnormal LDH levels, P = 0.001. And there is no significant difference between different absolute lymphocytes group in sex, age, stage of lymphoma, β2-microglobulin levels, extranodal sites, P values are 0.505,0.499,0.176,0.797, 0.131.3.There is no significant correlation between the β2-microglobulin levels and the treatment courses to reach PR, P = 0.361. Only the age is related with different β2 microglobulin levels,P = 0.001, the numble of patients with a higher abnormalβ2 microglobulin level are more occured in age >60 years than in patients ≤60 years. And there is no significant difference between the β2-microglobulin levels in sex, lymphoma stage, the serum LDH levels, extranodal involvement of extranodal sites, P values were 0.555,0.214,0.406,0.074.4.The degree of the CD3+tumor infiltrating lymphocytes in the 16 diffuse large B-cell lymphoma patients have no significant difference between the survival and death patients in a 2-year follow-up, P = 0.8627. And there are no significant correlation between the degree of CD3 + T cell infiltration,and IPI score, Ann Arbor stage, P values are 0.968, 0.324. Conclusion:1.The higher IPI scores of diffuse large B-cell lymphoma patients are,the more rituximab in combination with chemotherapy treatment courses are need to achieve PR, but the β2-microglobulin levels and ki-67 levels do not affect treatment courses to achieve PR. There are significantly differences between the different risk groups in the absolute lymphocytes in peripheral blood, blood β2-microglobulin levels, serum globulin levels,the absolute lymphocytes in peripheral blood <1.0 × 109 / L, the abnormally elevated blood β2-microglobulin levels,and serum globulin levels often occure in patients with higher IPI scores.2.Diffuse large B-cell lymphoma patients with absolute lymphocytes in peripheral blood <1.0 × 109 / L also have abnormally elevated serum LDH levels, and the prognosis of these patients are often poor.3.The numble of diffuse large B-cell lymphoma patients with a higher abnormalβ2 microglobulin level are more occured in age >60 years than in patients ≤60 years, together with a poor prognosis.4.There is no significant difference between the degree of the CD3+tumor infiltrating lymphocytes and the rituximab effect in the 16 diffuse large B-cell lymphoma patients. Also there is no significant correlation between the degree of CD3 + T cell infiltration,and IPI score, Ann Arbor stage.