二线方案治疗98例复发难治弥漫大B细胞淋巴瘤的疗效及预后分析

OBJECTIVE: To evaluate the efficacy and prognostic factors of second-line regimens for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). METHODS: A retrospective analysis was performed in 98 patients with relapsed/refractory DLBCL who were treated with salvage regimens in Rui Jin Hospital from July 2004 to June 2016. Overall response rate (ORR) was evaluated after all treatment finished. Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate by Cox proportional hazards models. RESULTS: There were 60 males and 38 females with a median age of 55.5 (15–77) years. 48 (49.0%) patients responded to chemotherapy, and 32 (32.7%) patients achieved complete remission (CR). Factors affecting ORR were progression disease or refractory/relapse status less than 12 months after diagnosis (χ(2)=5.878, P=0.015), IPI intermediate-high/high risk (χ(2)=5.930, P=0.015) and NCCN-IPI intermediate-high/high risk (χ(2)=4.961, P=0.026). No significance difference was observed in ORR between germinal-center B-cell type (GCB) and non-GCB (χ(2)=0.660, P=0.417). One-year and 2-year OS rates were 51.0% and 31.5%, with median OS at 13.17 months, respectively. Multivariate analysis indicated NCCN-IPI intermediate-high/high risk[HR=2.176 (95%CI 1.338–3.538), P=0.002] and response to chemotherapy [HR=0.273 (95%CI 0.165–0.452), P<0.001] were independent prognostic factors for survival. CONCLUSION: NCCN-IPI is a valid predictor of outcome for patients with relapse/refractory DLBCL. Response to chemotherapy is an independent prognostic factor for better survival.