The clinical characteristics of 681 patients with diffuse large B-cell lymphoma / 中华血液学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To analyze clinical features and the differences of GCB and non-GCB phenotypes for diffuse large B-cell lymphoma (DLBCL) in different age groups, Ki-67 index and international prognostic index (IPI).</p><p><b>METHODS</b>Clinical data of 681 patients with DLBCL hospitalized in West China Hospital from January 2000 to December 2010 were retrospectively analyzed.</p><p><b>RESULTS</b>Of these DLBCL cases, the median age was 56 years old with a male predominance, 51.4% stage III-IV, 37.6% B symptoms, 30.2% IPI 3-5 scores, 49.8% from extranodal sites, 29.0% gastrointestinal tract infiltration, 38.3% low absolute lymphocyte count (ALC), 56.1% elevated serum lactate dehydrogenase (LDH) level, 83.0% elevated β(2)-microglobulin (β(2)-MG) level. B symptoms was associated with bone marrow involvement with the odds ratio 5.212 (95%CI 2.821 - 9.632, P = 0.000). Among 268 with DLBCL patients classified by Hans' classification, 28.4% were GCB and 71.6% non-GCB. The proportions of patients with HBsAg-positive, elevated serum LDH level and Bcl-2 positive expression in non-GCB group was higher than those in GCB group (P < 0.05). The differences between GCB and non-GCB DLBCL were not revealed in terms of age subgroups, Ki-67 expression status and IPI subgroups. The high (≥ 60%) Ki-67 group included more patients with extranodal site involvement compared with the low (< 60%) Ki-67 group (51.8% vs 38.7%, P = 0.008). The proportion of patents with low ALC in IPI 3-5 scores group was higher than in IPI 0-2 scores group (P = 0.000). The multivariate analysis showed that high IPI had statistically significant negative influence on survival (P = 0.000).</p><p><b>CONCLUSIONS</b>Most patients with DLBCL were middle-aged male from our data. The patients with primary nodal (PN) was almost equal to those with primary extranodal (PEN). The most frequent extranodal site was gastrointestinal tract. The non-GCB phenotype was significantly more common than GCB phenotype in this study, and the non-GCB group included more patients with HBsAg-positive and Bcl-2 positive expression. Low ALC was observed predominantly in the high risk group. IPI score was an independent prognostic indicator for survival.</p>