Comparison Of The Efficacy Of R-CHOP Applies To Adult Males And Females Patients With DLBCL

BackgroundNon-Hodgkin’s lymphoma, referred as NHL, is a group of malignant solid tumours originating from lymphonodi and other lymphatic tissues and organs. It can be spread through lymph and blood circulation. About 20% among all the patients find their lesions outside of lymphonodi and the lesions often accumulate across one or more lymph node regions. The most common form of NHL is diffuse large B celllymphoma, also known as DLBCL, which captures nearly 1/3 of all the NHL cases. Recently, quite a few multicenter randomized controlled clinical studies proved that, the typical clinical treatment should be Rituximab combined with Cyclophosphamide, Doxorubicin Hydrochloride (Hydroxydaunomycin), Vincristine Sulfate (Oncovin) and Prednisone which is known as the R-CHOP approach. One of the well-known medicines that contain the active substance rituximab is MabThera. In this work, the safety and efficacy of R-CHOP approach for early-confirmed adult DLBCL patients will be measured and analyzed.Objectives(1) Compare the effectiveness of the chemotherapy using rituximab combined with CHOP for DLBCL patients with different ages and genders.(2)Monitor and analyze the influence of various factors including gender, age, LDH level, clinical stage, physical efficiency, IPI score and B symptoms, to the curative effect of R-CHOP.(3) Evaluate the internal association between different clinical parameters, e.g., the relativity between age and LDH level.MethodsRetrospective analyze the 73 initial visit DLBCL cases in Qilu Hospital of Shandong University from the year 2008 to 2012. Among all these patients, the largest and smallest ages are 80 and 15, respectively. They are divided into to two groups, young/middle aged and senior, based on whether being over 60 years old. The patients are further divided into high-risk and low-risk groups by applying IPI score, clinical stage, LDH level, physical efficiency and cumulative extranodal lymphoma. The curative effect of R-CHOP will be estimated for each patient after 6-8 treatment cycles and differences between different age and gender groups will be monitored and measured.ResultAmong all the 25 male patients in the young/middle aged group,16 had their conditions completed mitigated; 2 of them had a partial mitigation; 3 of them had a stabilized condition while there were also 3 recrudesce cases and 1 death. The overall effective rate is 84%. On the other hand, within the 19 female patients in the same group, 10 had their conditions completed mitigated; 3 had a partial mitigation; 2 of them had a stabilized condition while there were 4 recrudesce cases. The overall effective rate is 79%. The corresponding numbers for the 12 male patients in the senior group are 6 (completely mitigated),1 (partially mitigated),1 (stabilized),3 (recrudesce) and 1 (death). The overall effective rate is 67%. And for the 17 female patients, numbers are 8 (completely mitigated),2 (partially mitigated),1 (stabilized) and 6 (recrudesce). The overall effective rate is 65%. The result of the X2 inspection and analysis using SPSS 17.0 software shows that, within neither the young/middle aged nor the senior group, does the difference of effectiveness between two genders have any statistical significance.It’s showed that the effectiveness for patients with B symptoms, higher LDH level or being in clinical stage Ⅲ-Ⅳ is less significant (P<0.05).ConclusionThe therapeutic regimen of rituximab combined with CHOP (Cyclophosphamide, Doxorubicin Hydrochloride (Hydroxydaunomycin), Vincristine Sulfate (Oncovin) and Prednisone) shows safety to some extent when used for treatment of DLBCL. In this study, no significant difference was found between the effectiveness of R-CHOP for young/middle aged female and male patients. The same fact stood for the senior group, i.e., R-CHOP showed no different effectiveness for female and male patients. The conclusion is that gender cannot be viewed as a key factor of the effectiveness of R-CHOP. It’s a result that having B symptoms, high LDH level and being in clinical stage Ⅲ-Ⅳ are considered as adverse factors for the effectiveness of R-CHOP and they do show statistical significance to some extent. The result of the correlation analysis in the SPSS17.0 indicated that there were no direct relation between age and the LDH level.