Abstract:
Introduction: Diffuse large B-cell lymphomas account for almost a third of all non-Hodgkin's lymphomas. The advent of Rituximab has changed the prognosis of patients, demonstrating improved survival regardless of age and initial prognostic factors. The main objective of our study is to evaluate the different clinico-biological markers as prognostic factors of therapeutic response to RCHOP in diffuse large-cell B lymphoma. Methodology: This is a retrospective, descriptive, and analytical study carried out in the Internal Medicine and Onco-Hematology Department at the Hassan II University Hospital in Fez, covering a hospital series. This study is spread over 4 years, from January 2018 to December 2021. Results: The number of patients was 153, with a mean age of 56.16 years and a standard deviation of +/- 16.81 years. The F/H sex ratio was 1.12. Seventy-one patients presented with a tumor syndrome, mainly peripheral adenopathy. Fifty-three percent of patients had B symptoms. According to the Ann-Arbor classification, 61% of patients had extensive stages (III-IV) versus 39% who had localized stages (I-II). The IPI score was low in 25.5%, low intermediate in 36.6%, high intermediate in 36.8%, and high in 11.2%. Progression was marked by a 64% rate of good therapeutic response. Overall survival at 2 years was 77%. To explain this evolution, we studied the various parameters (clinical features, blood count abnormalities, lactate dehydrogenase levels, albuminemia, inflammatory syndrome) as factors influencing response, taking into account other factors such as age, disease stage, disease location, and diagnostic delay. At the end of this analysis, we found that the presence of a bulgy mass, monocytosis, and localized stage at the start of the disease were parameters significantly associated with a higher remission rate. In multivariate analysis, an association was found between the presence of monocytosis, time to diagnosis, and a good response to the RCHOP protocol. Conclusion: Extremely important advances have been made in the identification of prognostic features in diffuse large B-cell lymphoma. Our study has identified new factors that may improve the prognosis of this disease. These results warrant further research. In this context, we note the interest in larger multicenter studies.
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