Impact of immunochemotherapy on prognostic factors in diffuse large B-cell lymphoma patients / 中国实验血液学杂志

ABSTRACT

The international prognostic index (IPI) has been established as one of the best predictors of outcome, and several different immunologic subtypes have been established as independent predictors of diffuse large B-cell lymphoma (DLBCL). This study was aimed to reassess and re-evaluate the useful value of these prognostic predictors in patients treated with immunochemotherapy. A retrospective analysis of clinical records of immuno-chemotherapeutic (rituximab + CHOP, R-CHOP) and route chemotherapeutic (CHOP) groups was carried out. Standard two-step method of immunohistochemical staining was used to assess the expression of CD10, MUM-1, BCL-6 and BCL-2. The different classification models (Han's algorithm and Muris model) were performed for patients with DLBCL according to the immunohistochemical staining results in both R-CHOP and CHOP regimen groups. Then the data of remission and overall survival rate in different groups were analyzed to investigate the effect of these prognostic factors. Total 126 de novo DLBCL patients were collected in this study, including 51 patients with treatment of R-CHOP and the other 75 patients with treatment of CHOP. The results showed that the R-CHOP group had higher complete remission rate (68.8) than CHOP group (58.7). The patients with IPI score ≤ 2 had significantly higher overall response rate and overall survival rates than the patients with IPI scores > 2 in both groups. The survival rates of different subtypes in Han's and Muris models were not different from each other in R-CHOP group, but were obvious different from each other in CHOP group. It is concluded that IPI is still effective and predictive for identification of different risk groups. Immunochemotherapy can improve the remission and overall survival rate of DLBCL, but weaken the effect of outcome predictor.