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[Relationship between clinopathological features and outcome of rituximab treatment for diffuse large B-cell
Hong-Yu Zhang1, Zhong-Zhen Guan, Bo Wang
1Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Insights
Rituximab plus chemotherapy improves response rates in diffuse large B-cell lymphoma (DLBCL). Advanced stage, high LDH, relapsed disease, bulky disease, and negative Bcl-2 expression are unfavorable prognostic factors for this immunochemotherapy.
Area of Science:
- Hematology
- Oncology
- Immunotherapy
Background:
- Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
- Rituximab, an anti-CD20 monoclonal antibody, is a key component in DLBCL treatment.
- Understanding factors influencing rituximab treatment outcomes is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the relationship between clinopathological features and the outcome of rituximab treatment in DLBCL patients.
- To identify prognostic factors that predict response to rituximab-based immunochemotherapy.
Main Methods:
- Retrospective analysis of 69 DLBCL patients treated with rituximab and chemotherapy.
- Evaluation of clinopathological factors including age, stage, lactate dehydrogenase (LDH) levels, and bulky disease.
- Immunohistochemical detection of anti-/pro-apoptotic proteins (Bcl-2, Bax, Survivin) and correlation with treatment efficacy.
Main Results:
- Rituximab plus chemotherapy demonstrated high overall response rates (90.7%) and complete remission rates (69.8%) in previously untreated DLBCL.
- Advanced stage, elevated serum LDH, poor physical status, and bulky disease were identified as unfavorable factors.
- Bcl-2 overexpression correlated with better treatment efficacy, while Bax and Survivin expression showed no significant correlation.
Conclusions:
- Immunochemotherapy with rituximab improves response and complete remission rates in DLBCL without significant increase in toxicity.
- Identifying unfavorable prognostic factors such as advanced stage, high LDH, relapsed disease, bulky disease, and negative Bcl-2 expression aids in predicting treatment outcomes.
Objective:
To investigate the relationship of clinopathological features and outcome of rituximab treatment for diffuse large B-cell lymphoma (DLBCL).
Methods:
Sixty-nine patients with DLBCL received intravenous infusion of rituximab in combination with different chemotherapy regimens have been retrospectively analyzed. The influencing factors such as age, stage, serum level of lactate dehydrogenase (LDH) and bulky disease were analyzed retrospectively in terms of the response. The anti-/ pro-apoptosis proteins were detected by immunohistochemistry (SP methods). The correlation of protein expression with efficacy of rituximab treatment was also analyzed.
Results:
In the patients with previously untreated aggressive B-NHL, the combination of rituximab with chemotherapy achieved an overall response rate (ORR) of 90.7% and CR of 69.8%, while in the patients with relapsed disease, that was 80.8% (ORR) and 30.8% (CR). The disease stage (P = 0.046), serum lactate dehydrogenase (LDH) (P = 0.024), physical status (P = 0.009) and bulky disease (P = 0.013) were found to be unfavorable factors for the immunochemotherapy. The treatment efficacy in the patients with Bcl-2 overexpression was better than that in cases with negative one. No correlation of the bax and survivin expression with immunochemotherapy efficacy was observed.
Conclusion:
The immunochemotherapy regimen (rituximab plus chemotherapy) can improve the response rate and CR rate without significant increase in toxicity in patients with diffuse large B-cell lymphoma. The advanced stage, high serum LDH level, relapsed disease, bulky disease and negative Bcl-2 expression are unfavorable factors affecting the therapeutic efficacy.
