Effect of Shenmai injection combined with immunochemotherapy on the immune status and prognosis of elderly patients with diffuse large B-cell lymphoma

LIU Xian-gui; HUO Lan-fen; WANG Miao; LIANG Xiang-mei; WANG Zhi-fang; MENG Xiang-ling

doi:10.13820/j.cnki.gdyx.20242115

Abstract：Objective To investigate the effect of Shenmai Injection combined with the R-CHOP regimen on the immune status and prognosis of elderly patients with diffuse large B-cell lymphoma(DLBCL).Methods A total of 64 elderly patients diagnosed with DLBCL in the Department of Hematology at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to May 2023 were randomly divided into the observation group and the control group.The observation group received the standard R-CHOP regimen combined with Shenmai Injection,while the control group received the R-CHOP regimen alone.The two groups were compared for baseline Ann Arbor stage,IPI score,presence of B symptoms,cytokine levels,and immune status.After 4 cycles of treatment,the short-term effica-cy,adverse reactions,cytokine levels,and immune status of both groups were compared.The event-free survival(EFS)and progression-free survival(PFS)were followed up for 1 year.Results There were no statistically significant differ-ences in immune function and cytokine levels between the two groups before treatment(P>0.05).After 4 cycles of treat-ment,the total effective rate in the observation group was significantly higher than in the control group(90.63%vs.34.38%,P<0.01).Both groups showed a decrease in B cells,CD3+cells,CD4+cells,and CD4+/CD8+ratio,while CD8+cells increased,with significant differences(P<0.05).The observation group had higher levels of CD3+cells,CD4+cells,and CD4+/CD8+ratio,and lower CD8+cells compared to the control group(P<0.05),while no differ-ence was observed in B cells between the two groups.The observation group had lower levels of IL-6,IL-10,and TNF-α compared to the control group(P<0.01).The objective remission rate(CR+PR)in the observation group was higher than in the control group,though the difference was not statistically significant.Regarding adverse reactions,the observation group had significantly lower rates of infection,granulocytopenia,and cardiotoxicity compared to the control group(P<0.05).After 1 year of follow-up,the cumulative EFS was 11.40 months in the observation group versus 10.99 months in the control group(Log-Rank 0.525,P=0.469),with no significant difference.The median PFS was 11.11 months in the observation group versus 10.78 months in the control group(Log-Rank 0.838,P=0.360),with no significant difference.Conclusion Shenmai Injection combined with the R-CHOP regimen can enhance immune function after chemotherapy in DLBCL patients,improve clinical symptoms and traditional Chinese medicine syndromes,and reduce chemotherapy-related adverse reactions.This treatment may help improve long-term prognosis and is worthy of clinical promotion.