Abstract:
AIM:To evaluate the efficiency and toxicity of the intensive Burkitt's lymphoma (BL) therapy protocol BL-M-04. SUBJECTS AND METHODS:A total of 70 patients diagnosed with BL, including 45 men and 25 women whose age was 15 to 62 years (median age 31 years), were followed up in 2003 to 2014. Stage I (according to S. Murphy) was diagnosed in 4 (5.7%) patients; II in 9 (12.9%), III in 25 (35.7%), IV in 11 (15.7%), and Burkitt's leukemia in 21 (30%). There were tumor involvements of the bone marrow and central nervous system in 23 (32.9%) and 15 (21.4%) patients, respectively. B symptoms were detected in 56 (80%) patients; enhanced lactate dehydrogenase (LDH) activity was found in 50 (78.1%) out of 64 patients; moreover, in 34 (56.2%) out of 64 patients, LDH activity was more than twice as high as the reference values. The median LDH activity was 2398 (238-20,300) U/I. Acute renal failure at disease onset was identified in 17 (24.2%) patients; chemotherapy was initiated in 8 patients during renal replacement therapy. The treatment was performed using the BL-M-04±R protocol (4 successive blocks of A-C-A-C±R). Six blocks of A-C-A-C-A-C with rituximab has been carried out in patients with bone marrow involvement since 2011. RESULTS:Sixty-two (89%) patients achieved complete remission. At this time, 6 patients died from therapy complications during remission induction; 2 patients were observed to have disease progression; 3 developed disease recurrence (2 patients had early recurrence; 1 patient developed recurrence 2 years after treatment). Five-year overall survival (OS) was 85%; 5-year relapse-free survival (RFS) was 95%. The Cox multivariate regression analysis revealed that Burkitt's leukemia and bone marrow involvement were independent factors that influenced OS and RFS. The poor somatic status (3-4 ECOC scores versus 0-2 scores) proved to be statistically significant for OS rather than RFS. CONCLUSION:Despite the optimistic results obtained by our study group, there is a need to further improve BL treatment protocols and to elaborate novel approaches to therapy particularly for older patients and patients with Burkitt's leukemia. :Лимфома Беркитта (ЛБ) является одной из наиболее агрессивных В-клеточных лимфом и характеризуется преимущественно экстранодальной локализацией опухоли, частым вовлечением в опухолевый процесс костного мозга (КМ) и центральной нервной системы (ЦНС). Отличительной чертой ЛБ является высокая пролиферативная активность опухолевых клеток (Ki-67 ~100%) и наличие перестройки гена c-MYC в область тяжелых или легких цепей иммуноглобулина. Цель исследования. Оценка эффективности и токсичности интенсивного протокола терапии лимфомы Беркитта ЛБ-М-04. Материалы и методы. С 2003 по 2014 г. наблюдали 70 больных с диагнозом ЛБ: 45 мужчин и 25 женщин в возрасте от 15 до 62 лет, медиана возраста 31 год. I стадия заболевания по S. Murphy диагностирована у 4 (5,7%) больных, II - у 9 (12,9%), III - у 25 (35,7%), IV - у 11 (15,7%), лейкоз Беркитта - у 21 (30%). У 23 (32,9%) пациентов отмечено вовлечение в опухолевый процесс костного мозга, у 15 (21,4%) больных - ЦНС. В-симптомы выявлялись у 56 (80%) пациентов, повышение активности лактатдегидрогеназы (ЛДГ) - у 50 (78,1%) из 64, при этом у 34 (56,2%) из 64 отмечено повышение активности ЛДГ более чем в 2 раза по сравнению с референсными значениями. Медиана активности ЛДГ составила 2398 (238-20 300) ед/л. Острая почечная недостаточность в дебюте заболевания определялась у 17 (24,2%) больных, у 8 химиотерапия начата на фоне терапии, замещающей функцию почек. Лечение проводили по протоколу ЛБ-М-04±R, (4 последовательных блока А-С-А-С±R). С 2011 г. больным с поражением КМ проводили 6 блоков А-С-А-С-А-С с ритуксимабом. Результаты. Полная ремиссия заболевания достигнута у 62 (89%) больных. При этом 6 пациентов умерли от осложнений терапии в период индукции ремиссии, у 2 наблюдалась прогрессия заболевания, у 3 развился рецидив заболевания (у 2 ранний, у 1 через 2 года после завершения лечения). 5-Летняя общая выживаемость (ОВ) составила 85%, 5-летняя безрецидивная выживаемость (БРВ) - 95%. При проведении многофакторного регрессионного анализа Кокса выявлено, что лейкоз Беркитта и поражение КМ являются независимыми факторами, влияющими на ОВ и БРВ. Плохой соматический статус (оценка по шкале ECOG 3-4 балла по сравнению с 0-2 баллами) оказался статистически значимым для ОВ, но не для БРВ. Заключение. Несмотря на оптимистичные результаты, полученные нашей исследовательской группой, необходимы дальнейшее совершенствование протоколов лечения ЛБ, разработка новых подходов к терапии, особенно у пациентов старшей возрастной группы, и больных лейкозом Беркитта.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Baryakh EA,Tyurina NG,Vorobyev VI,Gemdzhyan EG,Mangasarova YK,Klyasova GA,Kovrigina AM,Obukhova TN,Zvonkov EE,Vernyuk MA,Chervontseva AM,Polyakov YY,Misyurina АЕ,Valiev TT,Zherebtsova VA,Magomedova AU,Galstyan GM,Yatskodoi
10.17116/terarkh20158774-14subject
Has Abstractpub_date
2015-01-01 00:00:00pages
4-14issue
7eissn
0040-3660issn
2309-5342journal_volume
87pub_type
社论abstract:AIM:To investigate the link between the hypoglycemia (registrated accurately by the professional Continuous Glucose Monitoring CGM; severe hypoglycemia at home) and the hetero-/homozygote carriage of single nucleotide polymorphisms (SNP) of cytochrome systems geneCYP2C9(rs1799853CYP2C9*2 иrs1057910CYP2C9*3) at the pati...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.10.000530
更新日期:2020-11-24 00:00:00
abstract::The authors assessed the time course of the S-T segment in 12 standard and monitor ECG leads and the time course of MB CPK fraction activity and Mg blood concentration in 34 patients with acute myocardial infarction. After the detection of thrombotic occlusion of the coronary artery they received thrombolytic therapy ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:AIM:The aim of our study was to assess the prevalence of contrast-induced acute kidney injury (CI-AKI) in patients with stable coronary artery disease (CAD) receiving optimal medical treatment with indications to coronary angiography and intraarterial administration of contrast agents. MATERIALS AND METHODS:1023 patie...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.09.000751
更新日期:2020-10-14 00:00:00
abstract:AIM:To examine effects of endotheline-1 (ET-1) and nitric oxide (NO) on endothelium-dependent mechanisms of vascular tonicity regulation in patients with chronic cardiac failure (CCF) of FC I-IV (NYHA). MATERIAL AND METHODS:Vascular reactions of 94 patients with CCF of FC I-IV were examined according to D.S. Celermaje...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:AIM:To study morphofunctional status of neutrophilic polymorphonuclear leukocytes (NPNL) in patients with chronic autoimmune thyroiditis (CAIT). MATERIAL AND METHODS:The morphofunctional status of NPNL was investigated with vital computer phasic morphometry (CPM) in 25 patients (24 females and 1 male, mean age 45.4 +/...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract::The content of steroid hormone receptors was measured in 22 men with mammary gland carcinoma. The content of estrogen receptors appeared high in both primary tumor and cancer metastasis. It was not dependent on the process extent or patients' age. In some cases the tumor remained "receptor-positive" after preoperative...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:AIM:To evaluate the clinical and economic feasibility of pharmacogenetic testing (PGT) for dabigataran etexilate administration in the treatment of atrial fibrillation (AF) without valve in comparison with tactics without pharmacogenetic testing. MATERIALS AND METHODS:The pharmacoeconomic model was done using generali...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2019.08.000379
更新日期:2019-08-15 00:00:00
abstract::The efficacy of pulse therapy in combination with hemosorption or plasmapheresis, pulse therapy without extracorporeal treatment and methotrexate has been compared for 40 patients with rheumatoid arthritis (RA) with extra-articular manifestations. All kinds of intensive treatment were effective. Extracorporeal methods...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:AIM:To define optimal time for transplantation of bone marrow (TBM) in children with hematological malignancies. MATERIALS AND METHODS:20 allogenic TBMs were performed in children with acute myeloblastic leukemia (6 patients, 2 of them in recurrence), acute lymphoblastic leukemia (7 patients, 4 of them in recurrence),...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:AIM:To study the urinary excretion of the molecular factors regulating angiogenesis, such as vascular endothelial growth factor type A (VEGF-A), thrombospondin 1 (THBS1), and angiopoietin 2 (ANGPT2), versus that of the urinary markers of renal injury and fibrogenesis, such as neutrophil gelatinase-associated lipocalin ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201587675-82
更新日期:2015-01-01 00:00:00
abstract::Altogether 44 patients with amyloidosis (7 with primary, 24 with secondary and 13 with hereditary associated with periodic disease) and different stages of renal impairment and 32 patients with chronic glomerulonephritis (CGN) (14 with the latent and 18 with the nephrotic form) were examined for chemotactic properties...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Results of clinical, psychological and psychophysiological examinations of 136 patients with mild essential hypertension indicate that psychorelaxation therapy is more effective in patients with a higher level of BP response to emotional stress and a shorter period of BP recovery after stress. Those patients had a mod...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::To study humoral antistreptococcal immunity, 29 patients with acute glomerulonephritis (AGN), 211 patients with chronic glomerulonephritis (CGN) and 30 healthy donors were examined. According to EIA, blood sera of the indicated groups demonstrated antibodies (AB) to structural components of Streptococcus--A-polysaccha...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:AIM:The aim of the study is to study the state of the immunological and hormonal background in patients with non-hospital pneumonia (NP) - liquidators of the accident at the Chernobyl nuclear power plant (ChNPP) after treatment. MATERIALS AND METHODS:Patients with NP were divided into 2 groups of liquidators of the Ch...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2019.03.000115
更新日期:2019-03-30 00:00:00
abstract::Using RIA, 188 patients with acute pneumonia were examined over time for the blood ACTH, cortisol, TTH, T3 and T4 content as well as for T4/T3, TTH/T3 and TTH/T4 correlations. Under discussion are causes, approaches to the prevention and correction of the hormonal disorders revealed in the pituitary-adrenal system in ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The authors analyze indications, technique and results of 143 laparoscopies in blood diseases and diseases with hematological symptoms; evidence obtained at combined and separate hepatic and splenic biopsies (55, 84 and 1 patients, respectively). Trepan biopsy was preferred to other biopsies. The technique proposed by...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Basing on their psychophysiological, immunological and clinical findings, the authors emphasize the role of chronic infection, occupational hazards, adaptation to new climatic and social environment in pathogenesis of neurocirculatory asthenia (NA). The disease is also associated with sensitization to streptococcus, a...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::A study was made of the presence of antinuclear antibodies to Ro, La, nDNA, RNP and Sm in 18 patients with Sjögren's disease (SD) and in 13 patients with Sjögren's syndrome (SS). Anti-Ro and/or anti-La were revealed in 12 SD patients (67%) and in 3 SS patients (23%, P less than 0.05) only. Anti-nDNA and anti-RNP were ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Analysis of the cooperative work of district internists and cardiologists of the polyclinics with special reference to the management of patients with coronary heart disease (CHD) has demonstrated that if their activities are interrelated, the scope of diagnostic studies and the rate of drug treatment adequacy signifi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To study the association of adiponectin gene G276Т (ADIPOQ) polymorphism with the development of metabolic syndrome (MS) in ethnic Kyrgyz patients. MATERIAL AND METHODS:A total of 171 patients with MS (a study group) and 117 patients without MS (a comparison group) were examined. MS was defined on the basis of the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh2015871085-90
更新日期:2015-01-01 00:00:00
abstract::The paper reviews the main problems of vaccine prophylaxis of adult infectious diseases, including the organization of adult vaccination within the national calendar of immunization and that as indicated by epidemics. It gives data on vaccine-controlled adult infectious morbidity. The problems of the training of medic...
journal_title:Terapevticheskii arkhiv
pub_type: 社论
doi:
更新日期:2010-01-01 00:00:00
abstract::The article provides an overview of current views on the involvement of the liver, gallbladder, and pancreas in patients with overweight and obesity. It considers the general issues of the pathogenesis of these conditions, their clinical features and diagnostic methods. :В статье приводится обзор современных взглядов...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh2017891128-133
更新日期:2017-01-01 00:00:00
abstract::The paper is concerned with the results of investigation of water-electrolyte equilibrium in 72 patients with liver cirrhosis. Regulatory disorder of the stability of volume of intravascular liquid was shown manifesting itself in a loss of ability to react by raising the natriuretic factor (NUF) production and enhance...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::The short- and long-term results of embolization of the splenic artery are analyzed in 143 patients with different diseases of the blood system. Two methods of splenic artery occlusion have been examined: one-stage total and staged embolization of the splenic artery. The course of the postembolization period is consid...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To study effects of carvedilol and atenolol and their combination with fosinopril on heart rhythm variability (HRV, clinicofunctional status and quality of life in postmyocardial infarction patients with moderate chronic cardiac failure (CCF). MATERIAL AND METHODS:An 8-week randomized open study enrolled 50 male p...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2004-01-01 00:00:00
abstract:AIM:To evaluate the short-term efficacy of the nonselective endothelin receptor antagonist bosentan in the treatment of pulmonary hypertension (PH) associated with diffuse connective tissue diseases (CTD), as well as its effect on survival in both monotherapy and in combination with other PH-specific agents. SUBJECTS ...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:UNLABELLED:To study prevalence of polyresistance (PR) among the strains of Helicobacter pylori isolated from patients with chronic gastritis, gastroduodenal ulcer and gastric cancer in Georgia. Material and methods. Biopsies of gastric mucosa and resection material were studied in 206patients with gastroduodenal zone d...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:AIM:to define a role of hemostatic disorders in the pathogenesis of Astrakhan rickettsial fever (ARL). SUBJECTS AND METHODS:Platelet functional activity and plasma hemostatic parameters were studied in 89 patients of moderate ARL. RESULTS:The clinical manifestations of hemostatic disorders at the height of ARL were c...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::Peripheral blood erythrocytes of patients with bronchial asthma (BA) and preasthma (PA) were investigated using the following methods: 1) the radiochemical method--the level of specific binding of beta-adrenergic ligands; 2) direct erythrocytometry--erythrocyte diameter; 3) the cytochemical method (paraldehyde fuchsin...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:To study hypotensive effectiveness and organ-protective properties of telmisartan in patients with essential hypertension (EH). MATERIAL AND METHODS:The trial enrolled 33 patients with EH of stage II, blood pressure (BP) elevation of the first and second degree, with ultrasound-diagnosed left ventricular (LV) hype...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2008-01-01 00:00:00