Abstract:
AIM:To characterize a group of patients with B-cell lymphoma (BCLU) unclassified that is intermediate between diffuse large B-cell lymphoma and Burkitt's lymphoma, to identify poor prognostic factors, and to evaluate therapeutic efficiency in patients with BCLU. SUBJECTS AND METHODS:Twenty-five patients with BCLU were examined. Double-hit lymphoma (DHL) was diagnosed in 8 (32%) patients. According to the Ann-Arbor classification of lymphoma, its stages II, III, and IV were diagnosed in 3 (12%), 2 (8%), and 20 (80%) patients, respectively. MYC rearrangement was observed in 11 (48%) out of 23 patients: single-hit lymphoma in 3 patients and DHL in 8 (BCL2+/MYC+ in 6 cases and BCL6+/MYC+ in 2). The expression of с-MYC (cut off ≥40%) was revealed in 17 (74%) out of 23 patients; that of BCL2 (cut off ≥50%) was detected in 14 (58%) out of 24 patients; coexpression of both proteins was seen in 12 (52%) out of 23 patients. The DHL group showed a correlation between the rearrangement of the BCL2+/MYC+ genes and the expression of MYC and BCL2 proteins in 5 out of 6 patients. Taking into account the heterogeneity of the entire patient group, DHL and non-DHL subgroups were considered separately. Both subgroups were comparable by clinical characteristics. BCLU patients younger than 60 years of age received treatment according to the LB-M-04 ± rituximab; those aged 60 or older had CHOP-like regimens ± rituximab. Autologous stem cell transplantation (auto-SCT) was performed in 5 patients belonging to a high-risk group. RESULTS:The 3-year overall survival (OS) was 62% and the 3-year event-free survival (EFS) was 51%. The 3-year OS was lower for the DHL group than that for the non-DHL group (43 and 75%, respectively). CONCLUSION:In the DHL group, both OS and EFS are significantly lower (the risk of poor outcome, including death, is higher) than those in the non-DHL group. It is conceivable that intensified chemotherapy with auto-SCT increases treatment results in patients with BCLU; however, a larger number of observations are needed to obtain valid data. :Цель исследования. Охарактеризовать группу больных неклассифицируемой В-клеточной лимфомой (ВНЛ), занимающей промежуточное положение между диффузной В-крупноклеточной лимфомой (ДВККЛ) и лимфомой Беркитта (ЛБ), выделить факторы неблагоприятного прогноза и оценить эффективность терапии больных ВНЛ. Материалы и методы. Обследовали 25 больных ВНЛ. 'Double-hit' лимфома (DHL) диагностирована у 8 (32%) больных. Согласно классификации Ann-Arbor II стадия заболевания диагностирована у 3 (12%) больных, III - у 2 (8%), IV - у 20 (80%). Перестройка локуса гена MYC наблюдалась у 11 (48%) из 23 пациентов: 'single-hit' - у 3, DHL - у 8 (у 6 BCL2+/MYC+, у 2 BCL6+/MYC+). Экспрессия с-MYC (пороговый уровень ≥40%) выявлялась у 17 (74%) из 23 больных, экспрессия BCL2 (пороговый уровень ≥50%) - у 14 (58%) из 24, коэкспрессия обоих белков - у 12 (52%) из 23. В группе DHL корреляция перестройки генов BCL2+/MYC+ и экспрессии белков BCL2+/MYC+ наблюдалась у 5 из 6 пациентов. Учитывая гетерогенность общей группы пациентов, подгруппы больных DHL и non-DHL рассматривали отдельно. Обе группы были сопоставимы по клиническим характеристикам. Больным ВНЛ моложе 60 лет проводили терапию согласно протоколу ЛБ-М-04 ± ритуксимаб, пациентам старше 60 лет - CHOP-подобными курсами ± ритуксимаб. Трансплантацию аутологичных стволовых клеток крови (ауто-ТСКК) выполняли 5 больным, относящихся к группе высокого риска. Результаты. 3-летняя общая выживаемость (ОВ) составила 62%, 3-летняя бессобытийная выживаемость (БСВ) - 51%. 3-летняя ОВ для группы больных c DHL оказалась ниже, чем у больных non-DHL, - 43 и 75% соответственно. Заключение. Как ОВ, так и БСВ у пациентов c DHL существенно ниже (а риск неблагоприятного исхода, включая смерть, выше), чем у пациентов группы non-DHL. Возможно, интенсификация терапии c ауто-ТСКК повышает эффективность лечения пациентов с ВНЛ, однако для получения достоверных данных необходимо большее количество наблюдений.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Baryakh EA,Misyurina AE,Kovrigina AM,Obukhova TN,Gemdzhyan EG,Vorobyev VI,Mangasarova YK,Polyakov YY,Magomedova AU,Klyasova GA,Misyurin VA,Yatsyk GA,Shevelev AA,Kostina IE,Vorobyev AI,Kravchenko SKdoi
10.17116/terarkh201587877-85subject
Has Abstractpub_date
2015-01-01 00:00:00pages
77-85issue
8eissn
0040-3660issn
2309-5342journal_volume
87pub_type
杂志文章abstract::The paper is devoted to the characterization of the spectrum of lipoproteins (LP) including the determination of the content of apoproteins AI and B by quantitative "rocket" immunoelectrophoresis in 75 male patients aged 40 to 59 with normal body mass, with types I and II diabetes mellitus, in the state of compensatio...
journal_title:Terapevticheskii arkhiv
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更新日期:1987-01-01 00:00:00
abstract::The paper analyzes the literature showing that there is not only a phylogenetic relationship, but also a functional one between visceral diseases and oral health. It gives data on the unity of the occurrence of somatic and dental diseases. There is evidence for cause-and-effect relationships between them, which arise ...
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abstract:AIM:To evaluate the practical efficiency of the diagnostic algorithms for enterohemorrhagic escherichiasis, which are laid down by the current normative documents of the Russian Federation. SUBJECTS AND METHODS:The investigators estimated the prevalence of enterohemorrhagic Escherichia coli (EHEC) infection in childre...
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abstract::As many as 56 healthy women and 45 women of reproductive age, suffering from essential hypertension (EH) were examined for the effect of ovarian cycle phases on vegetative regulation of central hemodynamics and pharmacodynamic effects of hemiton. The healthy persons in the phase of proliferation (I) and secretion (III...
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abstract::The paper discusses current approaches to diagnosing in an internal medicine clinic and to improving diagnostic tactics. It gives prospects for training physicians in current diagnostic approaches in the framework of the continuing medical education system. ...
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abstract::As many as 195 patients with rheumatoid arthritis (RA) were examined for the clinical characteristics of the disease course depending on the presence or lack of antibodies to DNA or of antinuclear factor (ANF). Provided the patients' blood serum contained antibodies to DNA and ANF, RA was noted to run a graver course ...
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更新日期:1990-01-01 00:00:00
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更新日期:1995-01-01 00:00:00
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doi:
更新日期:1995-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,meta分析
doi:
更新日期:2014-01-01 00:00:00
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doi:
更新日期:1990-01-01 00:00:00
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更新日期:1997-01-01 00:00:00
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更新日期:2013-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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doi:
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doi:
更新日期:2004-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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