Efficacy of rituximab combined with conventional chemotherapy in treating patients with diffuse large B-cell lymphoma and influencing factors of recurrence

  Objective  To explore the clinical efficacy of rituximab combined with conventional chemotherapy in treating patients with diffuse large B-cell lymphoma (DLBCL), and analyze the influencing factors of recurrence.

  Methods  Clinical materials of 104 DLBCL patients from January 2018 to January 2021 were retrospectively analyzed, and all of them were conducted with rituximab combined with conventional chemotherapy. Therapeutic effect of rituximab combined with conventional chemotherapy was observed; according to the follow-up results, the patients were divided into recurrence group and remission group, and the influencing factors of recurrence were analyzed by multivariate Logistic regression model.

  Results  Of 104 patients with DLBCL, there were 65 cases (62.50%) with complete remission, 16 cases (15.38%) with partial remission, 6 cases (5.77%) with stable disease and 17 cases (16.35%) with relapsed or progressive disease, and the total effective rate was 77.88% (81/104). At 3 months of follow-up, 21 cases died, 37 cases were refractory or relapsed, and 46 cases were relieved. The positive rate of B symptoms, the neutrophil-to-lymphocyte ratio (NLR) and levels of β₂-microglobulin(β₂-MG), erythrocyte sedimentation rate (ESR), high-sensitivity C reactive protein (hs-CRP) and serum lactate dehydrogenase (LDH) in the recurrence group were significantly higher than those in the remission group, while the hemoglobin (HB), lymphocyte-to-monocyte ratio (LMR), plasma albumin (ALB) and high-density lipoprotein (HDL) were significantly lower than those in the remission group (P < 0.01). Multivariate Logistic regression analysis showed that B symptoms, Hb, NLR, LMR, β₂-MG, ESR, hs-CRP, ALB, LDH and HDL were the influencing factors of recurrence of DLBCL (P < 0.05).

  Conclusion  Rituximab combined with conventional chemotherapy can achieve a certain clinical efficacy in the treatment of patients with DLBCL, but there is still a high recurrence rate, and positive B symptoms, lymphocytes, inflammatory status and nutritional status are risk factors affecting the recurrence of DLBCL.