Study Of Rituximab Combined Chemotherapy On Breg And IL-10 Changes In Patients With Newly Diagnosed Diffuse Large B-cell Lymphoma

Purpose: The purpose of this study is to detect newly diagnosed diffuse large B-cell lymphoma(DLBCL) patients before and after rituximab treatment of peripheral regulatory B cells(Bregs), interleukin-10(IL-10) levels. We are researching about the differences of regulatory B cells and interleukin-10 between newly diagnosed DLBCL patients and healthy control group,and discussing the role and significance of B-regulatory cells in DLBCL pathogenesis.Methods: We collected 20 cases of newly diagnosed DLBCL inpatient in the Second Hospital of Lanzhou University during December 2013 to January 2016. All patients were treated with containing rituximab(375 mg / m2) in the chemotherapy regimen of the treatment. We also collected 15 cases over the same period in our hospital examination of healthy subjects as control group. We used flow cytometry to detect the frequency of peripheral Breg cells in peripheral blood of patients with DLBCL before therapy, after one chemotherapy and control groups,and detected the secretion level of interleukin-10 with ELISA method.Results: 1.The proportion of DLBCL group before chemotherapy Breg was significantly higher than the normal control group(2.88 ± 0.58 vs 0.98 ± 0.42)%, the differences were statistically significant(P <0.01). The proportion of DLBCL group which treated with rituximab Breg was significantly lower than before chemotherapy(0.66 ± 0.43 vs 2.88 ± 0.58)%, the differences had remarkable statistically sense(P <0.01), DLBCL group after rituximab treatment and health normal control group(0.66 ± 0.43 vs 0.98 ± 0.42)%, had no significant difference(P> 0.05) in the control group. At different stages in DLBCL group, the proportion of Breg in the advanced stage was higher than that in the early stage(3.38 ± 0.45 vs 0.26 ± 2.47), the difference was statistically significant(P < 0.01). 2.The secretion levels of IL-10 in DLBCL group before chemotherapy was significantly higher than in the healthy control group(9.81 ± 2.07 vs 4.99 ± 1.36), there were statistic meaning between the differences(P <0.01). The secretion levels of IL-10 in DLBCL group which treated with rituximab was significantly lower than that before chemotherapy(3.94 ± 0.87 vs 9.81 ± 2.07), the differences did achieve apparent statistical significance(P <0.01), DLBCL group after rituximab treatment and healthy normal control groups(3.94 ± 0.87 vs 4.99 ± 1.36), there were no significant statistical difference(P> 0.05). At different stages in DLBCL group, the secretion level of IL-10 in advanced stage was higher than that in early stage(11.56 ± 1.13 vs 8.36 ± 1.43), and the difference was statistically significant(P < 0.01). 3.The DLBCL patients before rituximab therapy and after the treated with rituximab, the proportion of Breg and the secretion levels of IL-10 was positively correlated, we could get great statistical differences in this analysis( P <0.01). In early stage of DLBCL patients, the proportion of Breg and the secretion levels of IL-10 did not have correlation(P>0.05), in advanced stage, the proportion of Breg and the secretion levels of IL-10 were positively correlated, the difference was statistically significant(P < 0.01).Conclusion: 1.The proportion of Breg cells in DLBCL patients was increased, and the level of IL-10 was increased, which suggested that the imbalance of Breg cells is involved in the pathogenesis of DLBCL. 2.Rituximab therapy could down-regulate the expression of Breg cells and inhibited the production of IL-10, there was a positive correlation between them. 3.The proportion of Breg cells and IL-10 levels were positively correlated with both before and after treatment, suggesting that Breg may exert its negative regulation effect through the secretion of IL-10.