Objective: To explore the correlation between peripheral blood B cell count and clinical features and prognosis of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).
Methods: The relationship of peripheral blood B cell count with clinical features, laboratory indexes and prognosis in 67 patients with newly diagnosed DLBCL was retrospectively analyzed.
Results: Patients were divided into low B-cell count group (B cell＜0.1×109/L, n=34) and high B-cell count group (B cell≥0.1×109/L, n=33) according to the median B cell count values. Compared with the high B cell count group, the low B cell count group had a higher proportion of patients with Lugano stage III-IV, elevated LDH, elevated β2-MG and IPI score 3-5 and increased CRP (P =0.033, 0.000, 0.023, 0.001, 0.033). The peripheral CD3+ and CD4+ cell counts of patients in the low B cell count group were significantly lower than those in the high B cell count group (P =0.010, 0.017). After initial treatment, overall response rate (ORR) and complete remission (CR) rate in high B cell count group were significantly higher than those in low B cell count group (P =0.032, 0.013). The median follow-up time of patients was 23(2-77) months, progression-free survival (PFS) and overall survival (OS) of patients in the high B cell count group were significantly better than those in the low B cell count group (P =0.001, 0.002). Univariate analysis showed that pretreatment low B cell count in the peripheral blood was associated with shortened PFS and OS (HR=4.108, P =0.002; HR=8.218, P =0.006). Multivariate analysis showed that low B cell count was an independent prognostic factor for shortened PFS (HR=3.116, P =0.037).
Conclusion: Decreased peripheral blood B cell count in newly diagnosed DLBCL patients is associated with high-risk clinical features and may affect the efficacy of immunochemotherapy, which is associated with poor clinical prognosis.
题目: 初诊弥漫大B细胞淋巴瘤患者外周血B细胞计数与临床特征及预后的相关性分析.
目的: 探讨外周血B细胞计数与初诊弥漫性大Ｂ细胞淋巴瘤（DLBCL）患者临床特征及预后的相关性。.
方法: 回顾性分析67例初诊DLBCL患者治疗前外周血B细胞计数与其临床特征、实验室指标、治疗疗效及预后的关系。.
结果: 按照B细胞计数中位值将患者分为低B细胞计数组（B细胞＜0.1×109/L，n=34）和高B细胞计数组（B细胞≥0.1×109/L，n=33）。与高B细胞计数组相比，低B细胞计数组中有更高比例的Lugano分期III-IV期、LDH升高、β2-MG升高及IPI评分3-5的患者（P 值分别为0.033、0.000、0.023、0.001），且CRP升高更多见（P =0.033）。低B细胞计数组的外周血CD3+和CD4+细胞计数显著低于高B细胞计数组（P =0.010，0.017）。高B细胞计数组患者初始治疗后总缓解率（ORR）及完全缓解（CR）率均显著高于低B细胞计数组（P =0.032, 0.013）。中位随访时间为23 (2-77)个月，高B细胞计数组患者的无进展生存（PFS）率及总生存（OS）率均明显优于低B细胞计数组（P =0.001，P =0.002）。单因素分析显示，初诊外周血低B细胞计数与PFS和OS缩短相关（HR=4.108, P =0.002；HR=8.218，P =0.006）。多因素分析显示，低B细胞计数是导致PFS缩短（HR=3.116, P =0.037）的独立预后因素。.
结论: 初诊DLBCL患者外周血B细胞计数降低与高危临床特征相关，并可能影响免疫化疗的疗效，与较差的临床预后有关。.
Keywords: diffuse large B-cell lymphoma; B cells; peripheral blood; prognosis.