不同治疗策略对弥漫大B细胞淋巴瘤患者长期生存的影响.

Objective To explore the effect of different treatment strategies on the long-term survival of patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 117 DLBCL patients admitted to our hospital from April 2018 to April 2019 who had completed follow-up were selected and divided into group A (39 cases),group B (39 cases) and group C (39 cases). At the same time, patients were divided into survival group (96 cases) and death group (21 cases) according to the survival situation. Group A was treated with chop regimen, group B was treated with R-CHOP Regimen, and group C was treated with DA-R-EPOCH regimen. The clinical efficacy, adverse reactions and long-term survival of the three groups were compared, and the influencing factors of death in DLBCL patients were analyzed by COX regression model. Results After 4 cycles of treatment, the total effective rate of group C was 92. 31% (36/39),followed by group B[84. 62% (33/39) ] and group A[66. 67% (26/39) ],and the difference was statistically significant (P＜0. 05). During the treatment, there was no significant difference in the incidence of adverse reactions among the 3 groups (P＞0. 05). During the follow-up period, group C had the longest survival time[ (58. 08±6. 35) month] and the lowest mortality rate[10. 26% (4/39) ],followed by group B,group A had the shortest survival time and the highest mortality rate, and the difference were statistically significant (P＜0. 05). There were significant differences in Ann Arbor stage, Ki-67,International Prognostic Index (IPI) score and treatment scheme between the survival group and the death group (P＜0. 05). Ann Arbor stage (Ⅲ-Ⅳ stage),Ki-67 (＞80%),IPI score (＞2 points) and treatment plan (CHOP) were the independent risk factors of death in patients with DLBCL (HR＞1,P＜0. 05). Conclusion Both R-CHOP and DA-R EPOCH can effectively improve the clinical symptoms and prolong the survival of DLBCL patients without increasing the incidence of adverse reactions. At the same time, Ann Arbor stage, Ki-67,IPI score and treatment method are independent risk factors for death in DLBCL patients. [ABSTRACT FROM AUTHOR]