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Addition of rituximab to a CEOP regimen improved the outcome in the treatment of non-germinal center immunophenotype diffuse large B cell lymphoma cells with high Bcl-2 expression

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Abstract

Diffuse large B cell lymphoma (DLBCL) cells can be sub-classified into germinal center B cells (GCB) and non-GCB immunophenotypes. In the present study, we treated 161 newly diagnosed DLBCL patients with cyclophosphamide, epirubicin, vincristine, and prednisolone (CEOP) regimen with or without rituximab, and retrospectively investigated DLBCL sub-classifications combined with assessment of B cell lymphoma 2 (Bcl-2) expression level for their utility in the prediction of clinical efficacy. Survival analyses showed that non-GCB patients treated with R-CEOP regimen had significantly higher 5-year OS rates than the CEOP group (P = 0.033), while no statistically significant difference was observed between R-CEOP and CEOP treatments in GCB patients (P = 0.317). Prognosis was poorest for high Bcl-2 expressing non-GCB subgroup patients treated with CEOP, compared with Bcl-2 negative non-GCB CEOP patients (P = 0.044). In the R-CEOP group, Bcl-2 expression had no significant effect on prognosis for both GCB and non-GCB patients. The addition of rituximab to CEOP chemotherapy negates the adverse prognostic influence of Bcl-2 protein expression on overall survival in non-GCB DLBCL.

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Acknowledgments

We would like to apologize to our colleagues in the field whose work may not have been cited owing to space considerations. This study was carried out in collaboration with the hematologists and pathologists. We appreciate all of their efforts and expertise. We would like to express our thanks to the Tissue Microarray Laboratory at Department of Pathology, the People’s Hospital of Xinjiang Uygur Autonomous Region for their technical guidance and support: Zhenzhu Sun, Xiaoping Hu, Lijuan Wang, Wenjing Pu, Aini Waer, Tu Ba, Yingchun Wang.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Hematology, The People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Ürümqi, 830001, China

    Yan Li, Maimaitili Yimamu, Xiaomin Wang, Xiaoyan Zhang, Min Mao, Ling Fu, Aihemaitijiang Aisimitula, Yuling Nie & Qin Huang

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  1. Yan Li
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  2. Maimaitili Yimamu
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  3. Xiaomin Wang
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Correspondence to Xiaomin Wang.

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Li, Y., Yimamu, M., Wang, X. et al. Addition of rituximab to a CEOP regimen improved the outcome in the treatment of non-germinal center immunophenotype diffuse large B cell lymphoma cells with high Bcl-2 expression. Int J Hematol 99, 79–86 (2014). https://doi.org/10.1007/s12185-013-1472-z

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  • DOI: https://doi.org/10.1007/s12185-013-1472-z

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