Prognostic Factors Analysis Of 59 Patients With Diffuse Large B-cell Lymphoma

Objective To evaluate the prognostic factors of the patients with diffuse large B-cell lymphoma(DLBCL) and analyze the efficacy of rituximab in the patients with different immunological subtypes by summarize the clinical characteristics and overall survival rates of them.Methods The clinical data of 59 patients who were newly diagnosed DLBCL in the 2nd hospital affiliated of Fujian Medical University from January 2006 to December 2014 was collected. According to the Hans standard, the data was divided into two groups(group A with the germinal center subtype and group B with the non-germinal center subtypes). Univariate and multivariate analysis were used to analyze the clinical data by the means of Kaplan-Meier estimate, Log-rank test and Cox regression model. The statistical factors of the clinical data included patients’ gender, age, LDH level, albumin level, Hepatitis B virus(HBV) infection status, the expression of BCL-6 and MUM1 protein, IPI scores, risk stratification, ECOG physical ability scores, Ann Arbor stage, Hans immunological subtypes, treatment, and the survival time of theses patients. Additionally, Chi-Square test and Fisher’s exact probability method were used to analyze the effect of rituximab.Results In a total of 59 patients were identified, which including 39 men and 20 women aged from 18 to 89 years old(median age was 56 years old).The median duration of follow-up time was 18(1-107) months. And the results of the collected data were displayed as the follows: 1. Univariate analysis showed that age, LDH level, albumin level, the expression of BCL-6 and MUM1 protein, IPI scores, risk stratification, Ann Arbor stage, Hans immunological subtypes, treatment were significantly relating to the prognosis of DLBCL(p<0.05) while gender, Hepatitis B virus(HBV) infection status, ECOG physical ability scores were not relating to the prognosis of DLBCL(p>0.05). 2. Multivariate analysis showed Hans immunological subtypes, IPI scores and treatment were independent prognostic factors of DLBCL(p<0.05). 3. Rituximab combined with CHOP regiment could improve the recentrespond rate and overall survival rate of patients with DLBCL, especially in those with the non-germinal center subtype(p<0.05). 4. With the prophylactic anti-virus therapy a week before chemotherapy, the HBV carriers accompany with DLBCL had a low incidence of liver damage(p < 0.05).Conclusion 1. Immuno-phenotype of non-germinal center subtype, IPI scores(especially those with 4-5 score) and treatment(those use CHOP scheme without rituximab) were the independent risk factors of prognosis in patients with DLBCL. 2. The application of rituximab could improve the respond rate and overall survival rate of patients with DLBCL. 3. With the prophylactic anti-virus therapy a week before chemotherapy in HBV carriers accompany with DLBCL, the incidence of liver damage decreased and the severity of it became lower.