[Clinical Study of Ibrutinib Combined with Venetoclax Regimen in the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma].

Abstract

Objective: To investigate the clinical efficacy of ibrutinib combined with venetoclax in the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), and to analyze the factors affecting efficacy and prognosis.

Methods: Clinical data of 62 R/R DLBCL patients admitted to our hospital from August 2017 to July 2022 were retrospectively analyzed. All patients were treated with ibrutinib combined with venetoclax. The clinical efficacy and drug safety were evaluated. The effects of clinical features on short-term efficacy and overall survival (OS) were analyzed.

Results: The objective response rate (ORR) of 62 patients was 48.39%. The extranodal lesions, intermediate-high/high risk of NCCN-IPI, intermediate-high/high risk of IPI, progression or recurrence time <12 months were the risk factors affecting the short-term efficacy of chemotherapy in R/R DLBCL patients (all P < 0.05). The most common adverse effect was neutropenia (75.19%), and the incidence of grade Ⅲ-Ⅳ neutropenia was 52.71%. The 1-year and 2-year OS rates of 62 patients were 48.51% and 31.56%, respectively, and the median OS time was 12 months. Multivariate analysis showed that objective remission after chemotherapy [HR =0.080 (95%CI: 0.028-0.235)] was a protective factor for OS in R/R DLBCL patients, and intermediate-high/high risk of NCCN-IPI [HR =4.828 (95%CI : 1.546-15.080)] was an independent risk factor affecting the prognosis of R/R DLBCL patients.

Conclusion: Ibrutinib combined with venetoclax can be used as an effective treatment regimen for R/R DLBCL, and NCCN-IPI can be used as a prognostic indicator. Objective remission after chemotherapy is beneficial for R/R DLBCL patients to achieve better OS.