[The clinical characteristics of 681 patients with diffuse large B-cell lymphoma]

To analyze clinical features and the differences of GCB and non-GCB phenotypes for diffuse large B-cell lymphoma (DLBCL) in different age groups, Ki-67 index and international prognostic index (IPI).

Clinical data of 681 patients with DLBCL hospitalized in West China Hospital from January 2000 to December 2010 were retrospectively analyzed.

Of these DLBCL cases, the median age was 56 years old with a male predominance, 51.4% stage III-IV, 37.6% B symptoms, 30.2% IPI 3-5 scores, 49.8% from extranodal sites, 29.0% gastrointestinal tract infiltration, 38.3% low absolute lymphocyte count (ALC), 56.1% elevated serum lactate dehydrogenase (LDH) level, 83.0% elevated β(2)-microglobulin (β(2)-MG) level. B symptoms was associated with bone marrow involvement with the odds ratio 5.212 (95%CI 2.821 - 9.632, P = 0.000). Among 268 with DLBCL patients classified by Hans' classification, 28.4% were GCB and 71.6% non-GCB. The proportions of patients with HBsAg-positive, elevated serum LDH level and Bcl-2 positive expression in non-GCB group was higher than those in GCB group (P < 0.05). The differences between GCB and non-GCB DLBCL were not revealed in terms of age subgroups, Ki-67 expression status and IPI subgroups. The high (≥ 60%) Ki-67 group included more patients with extranodal site involvement compared with the low (< 60%) Ki-67 group (51.8% vs 38.7%, P = 0.008). The proportion of patents with low ALC in IPI 3-5 scores group was higher than in IPI 0-2 scores group (P = 0.000). The multivariate analysis showed that high IPI had statistically significant negative influence on survival (P = 0.000).

Most patients with DLBCL were middle-aged male from our data. The patients with primary nodal (PN) was almost equal to those with primary extranodal (PEN). The most frequent extranodal site was gastrointestinal tract. The non-GCB phenotype was significantly more common than GCB phenotype in this study, and the non-GCB group included more patients with HBsAg-positive and Bcl-2 positive expression. Low ALC was observed predominantly in the high risk group. IPI score was an independent prognostic indicator for survival.