Prognostic Analysis Of Different Effect On Patients With Diffuse Large B-cell Lymphoma In Mid-term Evaluation

Objective:In this paper,we retrospectively analyzed the data of patients with diffuse large B-cell lymphoma(DLBCL)treated with R-CHOP regimen.The purpose is to explore different prognosis between the group of complete remission and the group that was not complete remission in mid-term evaluation.Methods:A total of 43 lymphoma patients were diagnosed as DLBCL from January 2010 to December 2016 in our study.The retrospective analysis included the general information,tumor staging,IPI,immunohistochemistry test,changes of leukocyte,erythrocyte,hemoglobin,platelets,albumin,lactate dehydrogenase,beta2-microglobulin,liver and kidney function before and after chemotherapy,treatment efficiency,survival rate.All these index and prognosis were analyzed between 2 groups.Results:There were 15 males and 9 females in the non-CR group,and 10 males and 9 females in the CR group(P=0.515).The average age was 57.62 ± 14.06 years old in the non-CR group,and 53.63 ± 13.60 years in the CR group(P=0.463).58.33% patients in the non-CR groupwere at clinical stage and ? ?,and 41.67% were at stage ? and ?.84.21% patients in the CR group were at stage and ? ?,and 15.79% were at stage ?and ?(P=0.033<0.05).As for IPI index,54.17% in the non-CR group were in the low-risk,4.17% in the low-middle-risk group,16.67% in the middle-high-risk group and 25% in the high-risk group.The low-risk group accounted for 57.89% of the CR group,the low-middle-risk accounted for 31.58%,the middle high risk accounted for 10.53%,and the high risk accounted for 0%(P=0.023<0.05).About immunohistochemistry,The number of GCB accounted for 8 people and non-GCB accounted for 12 people in the non-CR group.There were 9 people of GCB type and 9 people of non-GCB type in the CR group,with no difference between the two groups in Hans(P=0.536).There were 10 bcl-2 positive people and 3 negative in the non-CR group,and 10 positive people,2 negative in the non-CR group,with no difference between the two groups about bcl-2(P=0.998).There were higher expression levels of Ki-67 in non-CR group(79.25%)compared with CR group(68.33%)(P=0.043<0.05).There were no difference in WBC,HB,PLT,ALB,AST,ALT,CRE,LDH and ?2-MG between two groups before chemotherapy and mid-term evaluation.The LDH was 219U/L in CR group,251U/L in CR group,after finishing treatment,P=0.038<0.05.?2-MG was 2.07mg/L in the CR group and 2.91mg/L in the CR group after chemotherapy,P=0.032 < 0.05.WBC,HB,PLT,ALB,AST,ALT,CRE were no difference in two groups.After four courses of chemotherapy,the final treatment efficiency in the CR group was 88%,the non-CR group was 52%,and P=0.021<0.05.Due to truncated data,there was no difference between groups in Long-term survival rate.Conclusion:In this review,DLBCL patients with R-CHOP regimen were analyzed retrospectively.We exploredthe different prognosis between the group of complete remission and the group that was not complete remission in mid-term evaluation.The results showed that there was a high clinical grade,high IPI score,high expression of Ki-67,and high tumor load after mid-term evaluation in non-CRgroup,which showed the high level of LDH and ?2-MG.So the end of the evaluation of treatment efficiency was lower,the prognosis is relatively poorin non-CRgroup.