Dynamic Changes Of Lymphocyte Subsets Before And After Chemotherapy In Patients With Diffuse Large B-cell Lymphoma And Their Significance

ObjectiveDiffuse large B-cell lymphoma(DLBCL)is the most common non-Hodgkin’s lymphoma(NHL),and its incidence is increasing year by year.Although the lesions disappeared in many patients after undergoing the"standardized R-CHOP"regimen,there were still some cases with lesions that were difficult to treat due to the expansion of the lesion range.Malignant lymphoma is mainly caused by lymphocytes or lymphoid tissue malignant lymph nodes or node external lymphoid tissue malignant transformation,so in this article,through a retrospective analysis to newly diagnosed with CD20~+in patients with diffuse large B cell lymphoma patients,any correlation with different clinical pathological characteristics and the peripheral blood T/B/NK cells,The dynamic changes of lymphocyte subsets(CD3~+,CD4~+,CD8~+,CD19~+,CD4~+/CD8~+)in peripheral blood before and after chemotherapy and their relationship with the changes of patients’disease,progression-free survival and the occurrence of adverse reactions,and to explore the significance of dynamic changes of lymphocyte subsets.Methods Statistics and analysis of 56 patients who be diagnosed with CD20~+diffuse large B cell lymphoma from May 2018 to May 2020 in Provincial Hospital affiliated to Anhui Medical University as the research object,according to the initial CD3~+CD4~+/CD3~+CD8~+percentage is divided into the rise/normal group(group A)and lower group(group B),after four cycles of chemotherapy CD3~+CD4~+/CD3~+CD8~+percentage is divided into higher group(group C)and lower(group D),and the statistical number of cases and immune function in patients with different clinical special correlation analysis;After admission,all patients received R-CHOP chemotherapy,and the mid-term evaluation was conducted after four cycles of chemotherapy.Patients were followed up for changes in their conditions.Adverse reactions,such as anemia,thrombocytopenia,liver and kidney function impairment,were recorded in different patients.Follow-up time and progression-free survival time of patients with progression/recurrence were recorded.Results Approximately 30%of patients with DLBCL showed a decrease in initial CD4~+/CD8~+,and patients with initial CD4~+/CD8~+reduction had more cases of progression.(1)CD3~+and CD8~+increased and CD4~+/CD8~+decreased after treatment,and the difference was statistically significant(P<0.05);(2)The number of patients with progression after treatment in the initial CD4~+/CD8~+reduction group was more than that in the initial CD4~+/CD8~+increase group,and the difference was statistically significant(P<0.05);(3)The risk of thrombocytopenia in the CD4~+/CD8~+decreased group after 4 cycles of chemotherapy was higher than that in the CD4~+/CD8~+increased group after 4 cycles of chemotherapy,and the difference was statistically significant(P<0.05);(4)Whether the initial CD4~+/CD8~+increased in different Ann Arbor stages and LDH(P<0.05);but there were no significant differences among patients with different genders,ages,ECOG score,double expression or not,and whether patients with B symptoms were combined.Conclusion(1)The majority of patients with diffuse large B-cell lymphoma had no change in initial cellular immune function,but patients with reduced initial cellular immune function had more cases of progression during follow-up;(2)The cellular immune status of DLBCL patients changed significantly after treatment,and the evaluation of cellular immune function of patients is of high value for diagnosis and treatment.(3)Detection of peripheral blood immune cells can timely determine the immune status of patients in order to better guide the use of chemotherapy drugs,and can better prevent the occurrence of adverse reactions,which is of high significance for improving the long-term prognosis and quality of life of DLBCL patients.