Analysis of Relevant Factors of Refractory and Relapse DLBCL Treated by Rituximab Combined with CHOP/EPOCH Regimen

Abstract

To analyze the efficacy of rituximab combined with CHOP/EPOCH regimen for treatment of diffuse large B-cell lymphoma（DLBCL） patients, and to explore the high risk factors of refractory and relapsed patients. The clinical data of 72 patients with de novo DLBCL from December 2012 to December 2018 in the Department of Hematology, Zhongda Hospital Affiliated to Southeast University were retrospectively analyzed. The remission rate of DLBCL patients treated by rituximab combined with CHOP/EPOCH was analyzed, and survival analysis was conducted to explore the risk factors influencing refractory recurrence. 45 cases among 72 patients achieved complete remission (CR), 11 cases achieved partial remission (PR), the total remission rate was 77.78%. 25 cases (34.2%) refractory and relapsed. Single factor analysis showed that the B symptoms, low Hb, high NLR, low MLR, high β2-MG, high ESR, high hs-CRP, high LDH, low ALB, low HDL were high risk factors of refractory and relapsed DLBCL. Multivariate Logistic analysis showed B symptoms, low Hb, high β2-MG, high ESR, and high hs-CRP were significantly related with refractory relapse. Survival analysis showed that OS of refractory and relapsed group was significantly worse than that in remission group. In addition, OS of patients with B symptoms, anemia, low LMR, high β2-MG, high hs-CRP, high LDH, low ALB and low HDL was significantly worse than that of control group. The remission rate of DLBCL patients treated by rituximab combined with CHOP/EPOCH regimen is high, but about one third of the patients still show refractory and relapsed. B Symptoms, anemia, high β2-MG, ESR and hs-CRP are the independent prognostic factors.