[Prognostic impact of bone marrow involvement (BMI) and therapies in diffuse large B cell lymphoma].
OBJECTIVE
To explore the prognostic impact of bone marrow involvement (BMI) and therapy in diffuse large B cell lymphoma (DLBCL).


METHODS
The clinical characteristics and prognosis of 83 DLBCL patients with or without BMI were retrospectively analyzed. The treatment outcome of standard CHOP regimen (CHOP group), intensive-dose regimen (intensive-dose group) and rituximab combined therapy (rituximab group) were compared.


RESULTS
The adverse prognostic factors including LDH elevation, ECOG score > or =2, higher IPI and aaIPI score, B symptom, hepatomegaly, splenomegaly, hemoglobin <110 g/L, platelet <100 x 10(9)/L and serum albumin <35 g/L were more prevalent in DLBCL patients with BMI than in those without BMI. Multivariate analysis showed that BMI was an independent prognostic factor of DLBCL. The 3-year OS and PFS rates in rituximab group were 78.1% and 64.3%, respectively, being statistically higher than that in CHOP group (23.6% and 21.8% respectively, P = 0.000 for both) and in intensive-dose group (33.3% and 25.7% respectively, P = 0.002 and 0.001, respectively). But no difference between the latter two groups (P = 0.411 and 0.694, respectively). For the patients with BMI, the 3-years OS and PFS in rituximab group (57.1% and 57.1%) were statistically higher than that in CHOP group (13.9% and 14.1%) and intensive-dose group (29.5% and 16.8%) (P = 0.029 and 0.012 respectively), respectively and also no difference in the latter two groups (P = 0.226 and 0.376 respectively). In the rituximab group, the 3-years OS and PFS were 86.7% and 67.3% respectively in patients without BMI, being higher than that in patients with BMI (57.1% and 57.1%), but the difference was not statistically significant (P = 0.645 and 0.965 respectively).


CONCLUSIONS
BMI is a negative independent prognostic factors of DLBCL patients. The rituximab combined chemotherapy can significantly improve the therapeutic effect of the DLBCL, and relieve the negative impact of BMI.
Yi
Shu-hua
SH
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China.
Xu
Yan
Y
Zou
De-hui
DH
An
Gang
G
Zhao
Yao-zhong
YZ
Qi
Jun-yuan
JY
Qiu
Lu-gui
LG
D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone