LYMPHOID TUMORS

Hodgkin’s Lymphoma: Analysis Results of Volgograd Regional Registry

LYMPHOID TUMORS , , , , , ,

KD Kaplanov1,2, NP Volkov1, TYu Klitochenko1, IV Matveeva1, AL Shipaeva1, MN Shirokova1, NV Davydova3, EG Gemdzhian4

1 Volgograd Regional Clinical Oncology Dispensary, 78 Zemlyachki str., Volgograd, Russian Federation, 400138

2 Volgograd Medical Scientific Center, 1G Rokossovskogo str., Volgograd, Russian Federation, 400081

3 Consultation and Diagnosis Polyclinic No. 2, 114A Angarskaya str., Volgograd, Russian Federation, 400081

4 National Medical Hematology Research Center, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Kamil Daniyalovich Kaplanov, MD, PhD, 78 Zemlyachki str., Volgograd, Russian Federation, 400138; e-mail: kamilos@mail.ru

For citation: Kaplanov KD, Volkov NP, Klitochenko TYu, et al. Hodgkin’s Lymphoma: Analysis Results of Volgograd Regional Registry. Clinical oncohematology. 2019;12(4):363–76 (In Russ).

DOI: 10.21320/2500-2139-2019-12-4-363-376

ABSTRACT

Background. The present paper discusses feasibility of first- and second-line therapies as well as the significance of different risk factors in the population of all patients with newly diagnosed Hodgkin’s lymphomas (HL) in a 14-year period based on the data of Volgograd regional registry.

Materials & Methods. During the period 2003 to 2017 the population registry of Department of Hematology of Volgograd Regional Clinical Oncology Dispensary included the data of all the patients with newly diagnosed HL (n = 622): 272 (44 %) men and 350 (56 %) women aged 18 to 84 years (mean age 38 years, median age 33 years). There were 97 (16 %) patients with early stages and without risk factors, 165 (27 %) patients with early stages and risk factors, 360 (59 %) patients with advanced stages, 308 (50 %) patients with toxic symptoms (stage B), and 179 (29 %) patients with bulky tumor lesions (≥ 10 cm). ABVD treatment regimen was administered in 190 (30.5 %) patients, increased-dose BEACO(D)PP in 39 (6 %) patients, BEACO(D)PP-14 in 159 (26 %) patients, standard BEACO(D)PP in 200 (32 %) patients, IVDG in 25 (4 %) patients, and other regimens in 9 (1.5 %) patients. The second-line treatment was administered in 120 (19 %) out of 622 patients. By the end of August 2018, the number of followed-up patients was 514 (83 %), 108 (17 %) patients had died. The prognostic value of the International Prognostic Score (IPS), PET, and other factors was assessed by means of Cox’s multivariate regression analysis. Pharmacoeconomic analysis of differences between options of first-line therapy was based on Markov model.

Results. In the group of patients with advanced HL stages treated with escalated BEACO(D)PP (the increased-dose regimen and BEACO(D)PP-14) 5- and 10-year overall survival (OS) was 83 % and 74 %, respectively, OS median was not reached. On standard BEACO(D)PP patients with advanced HL stages had OS median of 139 months (11.6 years) and 5- and 10-year OS of 68 % and 54 %, respectively (p = 0,012). In the group of patients with early stages and poor prognosis treated with escalated regimens BEACO(D)PP 5- and 10- year OS was 100 % and 90 %, respectively, in the combined group treated with ABVD and standard BEACO(D)PP it was 83 % and 75 % (p = 0.035). Replacement of procarbazine with dacarbazine in the standard and increased-dose BEACOPP regimens did not affect treatment efficacy. Markov analysis demonstrated the advantages of the escalated regimens for treatment of early stages with poor prognosis and advanced stages in terms of life years gained. Out of 7 IPS factors male sex, age ≥ 45 years, hemoglobin < 105 g/L, and albumin < 40 mg/L significantly impacted OS. Based on these data an adjusted prognostic index was suggested.

Conclusion. The advantage of the escalated strategy of first-line therapy in HL is reflected in survival parameters and is based on pharmacoeconomic evidence. The significance of some laboratory IPS risk factors can be reviewed; most obvious is increasing importance of PET for predicting the need for salvage therapy.

Keywords: Hodgkin’s lymphoma, BEACO(D)PP, ABVD, International Prognostic Score, survival analysis, pharmacoeconomics, Markov model, life years gained (LYG), incremental cost-effectiveness ratio (ICER).

Received: February 21, 2019

Accepted: September 17, 2019

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Expression of Adhesion Molecule CD56 in Tumor Plasma Cells in Bone Marrow as a Prognostic Factor in Multiple Myeloma

LYMPHOID TUMORS , , , ,

MV Firsova, LP Mendeleeva, AM Kovrigina, MV Solov’ev, NL Deineko, MYu Drokov, VG Savchenko

National Medical Hematology Research Center, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Maiya Valer’evna Firsova, MD, PhD, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; e-mail: firs-maia@yandex.ru

For citation: Firsova MV, Mendeleeva LP, Kovrigina AM, et al. Expression of Adhesion Molecule CD56 in Tumor Plasma Cells in Bone Marrow as a Prognostic Factor in Multiple Myeloma. Clinical oncohematology. 2019;12(4):377–84 (In Russ).

DOI: 10.21320/2500-2139-2019-12-4-377-384

ABSTRACT

Aim. To study immunohistochemical parameters of tumor plasma cells in bone marrow and to assess how the expression of adhesion molecule CD56 impacts overall survival (OS) of multiple myeloma (MM) patients.

Materials & Methods. The trial included 35 patients (19 men and 16 women) aged 23 to 73 years (with median age of 58 years) with newly diagnosed MM. At disease onset plasmacytoma was diagnosed in 21 patients. In all patients bone marrow core biopsy was performed followed by histologic and immunohistochemical (IHC) examinations. IHC examination was based on the panel of CD56, CD166, CXCR4, Ki-67, and c-MYC/CD138 antibodies. Kaplan-Meier survival curves and significance assessment by means of Cox’s F-Test were used.

Results. Expression mean values of most of studied markers (CD56, CXCR4, c-MYC, and Ki-67) in bone marrow of patients without plasmacytoma (n = 14) appeared to be higher than in patients with plasmacytoma at MM onset. Expression mean value is understood as percentage ratio of plasma cells expressing a studied marker to total cell count of tumor substrate. High expression of chemokine receptors (CXCR4), and adhesion molecules (CD56) probably inhibits plasma cell migration and impedes extramedullary tumor progression. Comparison of protein expression by tumor plasma cells in bone marrow in the groups with bone extramedullary plasmacytoma shows a distinct regularity referring to CD56 adhesion molecule. For example, CD56 expression is significantly (p < 0.05) lower in terms of the count of tumor plasma cells with marker expression in bone marrow of MM patients with extramedullary plasmacytoma compared with patients with bone plasmacytoma (1 ± 1 % vs. 65.71 ± 12.12 %). Comparison of MM patients’ OS depending on CD56 expression by tumor plasma cells in bone marrow showed that 4-year OS of patients with CD56 expression in bone marrow was significantly higher being 80 % vs. 38 % in the group with CD56 expression less than in 10 % of tumor cells.

Conclusion. Expression of adhesion molecule CD56 in tumor plasma cells in bone marrow can be regarded as a prognostic factor in MM. Probably, when at disease onset CD56 expression is identified in less than 10 % of tumor cells in bone marrow, more detailed additional examination of patients should be carried out to rule out extramedullary lesions in different organs and tissues.

Keywords: multiple myeloma, bone plasmacytoma, extramedullary plasmacytoma, bone marrow core biopsy, CD56.

Received: May 12, 2019

Accepted: September 2, 2019

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Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma

LYMPHOID TUMORS , , , ,

SV Samarina1, AS Luchinin1, NV Minaeva1, IV Paramonov1, DA D’yakonov1, EV Vaneeva1, VA Rosin1, SV Gritsaev2

1 Kirov Research Institute of Hematology and Transfusiology, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027

2 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

For correspondence: Svetlana Valer’evna Samarina, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027; Tel.: +7(912)732-47-56; e-mail: samarinasv2010@mail.ru

For citation: Samarina SV, Luchinin AS, Minaeva NV, et al. Immunohistochemical Subtype and Parameters of International Prognostic Index in the New Prognostic Model of Diffuse Large B-Cell Lymphoma. Clinical oncohematology. 2019;12(4):385–90 (In Russ).

DOI: 10.21320/2500-2139-2019-12-4-385-390

ABSTRACT

Aim. To develop an integrated prognostic model of diffuse large B-cell lymphoma (DLBCL) on the basis of immunohistochemical tumor subtype and parameters of International Prognostic Index (IPI).

Materials & Methods. Out of 104 DLBCL patients in the data base 81 (77.9 %) met the eligibility criteria. Median age was 58 years (range 23–83). All patients were treated with R-СНОР. The creation of overall survival (OS) prognostic model for DLBCL patients was based on machine learning with classification and regression trees. OS was analyzed using Kaplan-Meier method. Survival curves were compared by means of log rank test and hazard ratio (HR). Any test was considered significant if two-sided level of p < 0.05 was reached.

Results. Following the developed model three groups of patients were identified: the 1st group of low risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and GCB subtype); the 2nd group of intermediate risk (the combination of low, intermediate-low, and intermediate-high risks according to IPI and non-GCB subtype); the 3d group of high risk (irrespective of subtype). In the group of low risk (n = 26) 2-year OS during the monitoring period was 100 %. In the group of intermediate risk (n = 34) median OS was not reached, 2-year OS was 74 %, and expected 5-year OS was 68 %. In the group of high risk (n = 21) median OS was 25 months, 2-year OS was 46 %, and expected 5-year OS was 37 % (log rank p < 0.0001). HR calculated for the high-risk group compared with the low- and intermediate-risk groups was 5.1 (95% CI 2.1–12.1; p = 0.0003).

Conclusion. A new integrated system of DLBCL prognosis is suggested which includes IPI risk parameters and immunohistochemical subtype based on Hans algorithm. This prognostic system can be used in clinical practice for DLBCL patient stratification and risk-adapted therapy.

Keywords: diffuse large B-cell lymphoma, overall survival, prognosis, International Prognostic Index, machine learning.

Received: March 18, 2019

Accepted: August 27, 2019

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Experience with the Use of Thio/Mel Conditioning Regimen Prior to Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma

LYMPHOID TUMORS , , , ,

SV Gritsaev1, II Kostroma1, AA Zhernyakova1, IM Zapreeva1, EV Karyagina2, ZhV Chubukina1, SA Tiranova1, IS Martynkevich1, SS Bessmeltsev1, AV Chechetkin1

1 Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

2 Municipal Hospital No. 15, 4 Avangardnaya str., Saint Petersburg, Russian Federation, 198205

For correspondence: Ivan Ivanovich Kostroma, MD, PhD, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024; Tel.: +7(921)784-82-82; e-mail: obex@rambler.ru

For citation: Gritsaev SV, Kostroma II, Zhernyakova AA, et al. Experience with the Use of Thio/Mel Conditioning Regimen Prior to Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma. Clinical oncohematology. 2019;12(3):282–8 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-282-288

ABSTRACT

Background. In multiple myeloma (MM) treatment a single autologous hematopoietic stem cell transplantation (auto-HSCT) is preceded by conditioning regimens aimed at intensifying cytoreductive effect. In the course of ongoing search for combined conditioning regimens an attractive option proved to be thiotepa/melphalan combination.

Aim. Data analysis of a pilot study of the efficacy of conditioning regimens including administration of two alkylating agents (thiotepa and melphalan) with subsequent auto-HSCT.

Materials & Methods. 9 patients received 10 auto-HSCTs with conditioning regimen including administration of 250 mg/m2 of thiotepa on Day –5 and 140 mg/m2 of melphalan on Day –2. After auto-HSCT pegylated filgrastim was administered in 8 patients. Engraftment period was calculated on the basis of absolute neutrophil count ≥ 0,5 × 109/L and thrombocyte level ≥ 20 × 109/L. Regimen toxicity was assessed according to CTCAE v5.0. Survival rates were estimated by Kaplan-Meier curves.

Results. The use of thiotepa did not require administration of any additional drugs. The incidence of mucositis and enteropathy of grade 1–2 was 100 % and 70 %, respectively. Pyrexia was reported in 7 auto-HSCTs. Pneumonia occurred in 1 patient. The infusion of 1–3 doses of platelet concentrate (median of 2 doses) was required in all patients except for one. Donor erythrocytes were transfused to 3 patients. Engraftment was reported in all patients within the period of 10–14 days. Median hospitalization duration from Day 0 to hospital discharge was 16 patient-days. After auto-HSCT the quality of response improved in 6 out of 9 patients. MM progression was reported in one patient with complex karyotype. Further follow-up showed progression in 2 patients. By December 2018 median follow-up of 9 patients from the date of auto-HSCT was 9 months (range 3–20 months), median progression-free survival was 17 months, median overall survival was not reached.

Conclusion. Acceptable toxicity, improvement of response quality, and maintenance of it for up to 20 months allow to consider combined conditioning regimen Thio/Mel to be a possible alternative to the standard Mel200 regimen.

Keywords: multiple myeloma, autologous hematopoietic stem cell transplantation, conditioning regimen, thiotepa, melphalan.

Received: December 26, 2018

Accepted: May 25, 2019

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The Use of Ibrutinib in Refractory Chronic Lymphocytic Leukemia and in High-Risk Patients

LYMPHOID TUMORS , , ,

NV Kurkina1,2, EA Repina1, NN Mashnina2

1 NP Ogarev Mordovia National Research State University, 68 Bol’shevistskaya str., Saransk, Republic of Mordovia, Russian Federation, 430032

2 Republican Clinical Hospital No. 4, 32 Ul’yanova str., Saransk, Republic of Mordovia, Russian Federation, 430032

For correspondence: Nadezhda Viktorovna Kurkina, MD, PhD, 68 Bol’shevistskaya str., Saransk, Republic of Mordovia, Russian Federation, 430032; e-mail: nadya.kurckina@yandex.ru

For citation: Kurkina NV, Repina EA, Mashnina NN. The Use of Ibrutinib in Refractory Chronic Lymphocytic Leukemia and in High-Risk Patients. Clinical oncohematology. 2019;12(3):278–81 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-278-281

ABSTRACT

Despite advances in chemo-immunotherapy of chronic lymphocytic leukemia, a choice of therapy is a frequent challenge in patients with a refractory form of the disease, autoimmune hemolytic complications, and also in high-risk patients with cytogenetic changes. The use of ibrutinib, one of Bruton’s tyrosine kinase inhibitors, allows to overcome the resistance to anticancer therapy without adverse effects on patients’ quality of life.

Keywords: chronic lymphocytic leukemia, chemo-immunotherapy, ibrutinib, refractoriness, relapse.

Received: January 21, 2018

Accepted: May 10, 2019

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Rearrangement of Immunoglobulin Genes in Tumor Cells of Patients with Primary Mediastinal (Thymic) Large B-Cell Lymphoma

LYMPHOID TUMORS , , ,

YaK Mangasarova, YuV Sidorova, AU Magomedova, BV Biderman, EE Nikulina, AB Sudarikov, AM Kovrigina, SK Kravchenko

National Medical Hematology Research Center, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Yana Konstantinovna Mangasarova, MD, PhD, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(926)395-82-52; e-mail: v.k.jana@mail.ru

For citation: Mangasarova YaK, Sidorova YuV, Magomedova AU. Rearrangement of Immunoglobulin Genes in Tumor Cells of Patients with Primary Mediastinal (Thymic) Large B-Cell Lymphoma. Clinical oncohematology. 2019;12(3):271–7 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-271-277

ABSTRACT

Background. Primary mediastinal (thymic) large B-cell lymphoma (PMBCL) is a malignant tumor with large atypical lymphoid cells expressing post-germinal differentiation markers. Rearrangements of immunoglobulin genes in PMBCL are revealed in 30–65 % of cases. Immunoglobulin molecules, however, are expressed neither on the surface, nor in cytoplasm of tumor cells.

Aim. To assess cell clonality rate on the basis of rearrangements of immunoglobulin heavy/light chain genes; to determine rearrangement stability at the time of relapse development; to study the range of rearrangements and clonal relationship with primary tumor in metachronous development of mediastinal gray zone lymphoma.

Materials & Methods. The assessment of rearrangements of immunoglobulin heavy/light chain genes was based on molecular analysis of 29 primary tumor biopsies and 4 tissue samples with histologically and immunohistochemically verified relapses or metachronous lymphoma development.

Results. In 16 (55.2 %) out of 29 cases a rearrangement of immunoglobulin heavy chain genes was reported, in 7 (24.1 %) cases a rearrangement of light chain genes was identified, in 6 (20.7 %) cases no rearrangements of immunoglobulin heavy/light chain genes were found. On the basis of immunoglobulin gene analysis in 2 patients with early relapse a tumor clone was detected that was identical with the one identified at the onset of the disease. In 2 patients with complete remission a metachronous development of mediastinal gray zone lymphoma was reported, whereas molecular genetic analysis revealed a change/disappearance of initial clonal rearrangements of immunoglobulin genes.

Conclusion. Total detection rate of B-cell clonality in PMBCL was 79.3 %. Molecular genetic analysis confirmed that initial clonal rearrangements of immunoglobulin genes were preserved in early relapses, and invalidated tumor clonal relationship in a metachronous development of mediastinal gray zone lymphoma.

Keywords: primary mediastinal (thymic) large B-cell lymphoma, rearrangement of immunoglobulin heavy/light chain genes, polymerase chain reaction, metachronous development of lymphoma.

Received: November 2, 2018

Accepted: May 29, 2019

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REFERENCES

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TP53 Gene Mutations in Tumor Cells of Patients with Aggressive B-Cell Lymphomas

LYMPHOID TUMORS , , ,

AE Misyurina1, SK Kravchenko1, VA Misyurin2, AM Kovrigina1, AU Magomedova1, EA Baryakh3, FE Babaeva1, AV Misyurin4

1 National Medical Hematology Research Center, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

2 NN Blokhin National Medical Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

3 Municipal Clinical Hospital No. 52, 3 Pekhotnaya str., Moscow, Russian Federation, 123182

4 GenoTekhnologiya, 11 800-letiya Moskvy str., Moscow, Russian Federation, 127247

For correspondence: Anna Evgen’evna Misyurina, MD, PhD, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(909)637-32-49; e-mail: anna.lukina1@gmail.com

For citation: Misyurina AE, Kravchenko SK, Misyurin VA, et al. TP53 Gene Mutations in Tumor Cells of Patients with Aggressive B-Cell Lymphomas. Clinical oncohematology. 2019;12(3):263–70 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-263-270

ABSTRACT

Background. TP53 gene mutations impede cell apoptosis and lead to additional oncogenic events contributing to tumor progression.

Aim. To assess TP53 gene mutation rate in patients with high-grade B-cell lymphoma double-hit (HGBCL DH) and not otherwise specified (HGBL NOS); to analyse its relationship to disease prognosis.

Materials & Methods. Retrospective materials from medical records of 10 HGBL DH and 26 HGBL NOS patients were analyzed. Median follow-up was 26.5 months (range 0.6–160.9 months). Selection was based on the presence of available biological materials (paraffin blocks) for Sanger sequencing of TP53 gene from exon 5 to exon 8 (encoding DNA-binding domain of TP53 gene). FISH analysis of the tumor was performed in all patients to identify translocations involving c–MYC/8q24, BCL2/18q21, and BCL6/3q27 gene locus. To analyze differences between groups χ2 and Mann-Whitney tests were applied. Univariate event analysis (Kaplan-Meier and log-rank tests) and Cox regression analysis were used to assess the influence of molecular markers on the disease prognosis.

Results. TP53 gene mutations in lymphoma cells were found in 13 (36 %) out of 36 patients, 10/ (77 %) out of 13 mutations were pathogenic. In 8 out of 10 patients with TP53 mutations c–MYC/8q24 gene translocation was identified. Groups with wild (TP53-WT) and mutant (TP53-MUT) types of TP53 gene were similar in terms of main clinical characteristics. Patients with TP53-MUT in tumor cells showed worse 3-year overall survival (OS) compared with the group without TP53-MUT (30 % vs. 73 %; p = 0.026) as well as higher probability of disease progression in the period of 3 years (66 % vs. 15 %; p = 0.004). In multivariate analysis significant OS predictor proved to be the presence of TP53 mutation (p = 0.006). Relapse/progression probability was higher in combined cases of TP53 mutation and translocation involving c–MYC gene locus (p = 0.0003).

Conclusion. Translocation involving c–MYC gene along with TP53 gene mutation in tumor cells can serve as a criterion for dividing HGBL DH and HGBL NOS patients into different lymphoma relapse/progression risk groups.

Keywords: high-grade B-cell lymphoma double-hit, high-grade B-cell lymphoma not otherwise specified, TP53 mutation in tumor cells, translocation involving c–MYC gene locus.

Received: January 25, 2019

Accepted: June 3, 2019

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Primary Bone Lymphomas: Long-Term Results of a Prospective Single-Center Trial

LYMPHOID TUMORS , ,

AK Smol’yaninova, NG Gabeeva, VE Mamonov, SA Tatarnikova, LG Gorenkova, DS Badmadzhapova, AM Kovrigina, EG Gemdzhian, EE Zvonkov

National Medical Hematology Research Center, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Anna Konstantinovna Smol’yaninova, MD, PhD, 4a Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(495)612-23-61, +7(926)912-31-16; e-mail: annmo8@mail.ru

For citation: Smol’yaninova AK, Gabeeva NG, Mamonov VE, et al. Primary Bone Lymphomas: Long-Term Results of a Prospective Single-Center Trial. Clinical oncohematology. 2019;12(3):247–62 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-247-262

ABSTRACT

Background. Primary bone lymphomas (PBL) are rare extranodal lymphomas. In more than 90 % of cases they are reported as diffuse large B-cell lymphomas (DLBCL). At local (IE) stage of PBL the standard R-CHOP immunotherapy demonstrates efficacy over 90 %. If, however, such poor prognostic factors (PPF) as multiple bone lesions (IVЕ stage), increased lactate dehydrogenase (LDH) activity, B-symptoms, and large tumor mass are identified, R-CHOP efficacy tends to decrease. There is currently no optimal regimen for treatment of PBL patients with PPF. We suggest intensified multi-agent chemotherapy for this category of patients.

Aim. To assess long-term results of prospective single-center trial on the use of high-dose mNHL-BFM-90 program in patients with primary bone DLBCL and PPF.

Materials & Methods. The trial included 33 patients with primary bone DLBCL followed-up at the National Medical Hematology Research Center from 2006 to 2018. The median age of patients was 44 years (range 16–78 years). The spectrum of assessed data included main clinical, laboratory, X-ray and MRI tumor characteristics as well as survival rates and prognostic factors.

Results. PPF were identified in 29 (88 %) patients, out of them 20 (61 %) patients had an advanced stage (˃ IE), 20 (59 %) patients showed an increased LDH activity, B-symptoms were identified in 15 (45 %) patients, and large tumor mass was reported in 23 (71 %) patients. High-dose antitumor treatment (mNHL-BFM-90) was administered in 27 out of 33 patients. Overall and progression-free survival within the period of 5 years was 92 %. None of PPF significantly influenced survival rates.

Conclusion. The use of high-dose mNHL-BFM-90 program in PBL with poor prognosis achieves long-term remissions in 92 % patients. We recommend mNHL-BFM-90 as a therapy of choice for PBL patients with poor prognosis.

Keywords: primary bone lymphoma, diffuse large B-cell lymphoma, high-dose intensified multi-agent mNHL-BFM-90 program.

Received: January 25, 2019

Accepted: May 12, 2019

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A Case of Hairy Cell Leukemia Diagnosed Simultaneously with Lymphoplasmacytic Lymphoma by Anti-CD Antibody Microarray Method

LYMPHOID TUMORS , , , , ,

AN Khvastunova1,2, LS Al-Radi3, OS Fedyanina1,2, SA Lugovskaya4, SA Kuznetsova1,2

1 Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela str., Moscow, Russian Federation, 117997

2 Center for Theoretical Problems of Physicochemical Pharmacology, 4 Kosygina str., Moscow, Russian Federation, 119991

3 National Medical Hematology Research Center, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

4 Russian Medical Academy of Postgraduate Education, 2/1 Barrikadnaya str., Moscow, Russian Federation, 1125993

For correspondence: Alina Nikolaevna Khvastunova, PhD in Biology, 1 Samory Mashela str., Moscow, Russian Federation, 117997; Tel.: +7(495)287-65-70; e-mail: alina_shunina@mail.ru

For citation: Khvastunova AN, Al-Radi LS, Fedyanina OS, et al. A Case of Hairy Cell Leukemia Diagnosed Simultaneously with Lymphoplasmacytic Lymphoma by Anti-CD Antibody Microarray Method. Clinical oncohematology. 2019;12(3):243–6 (In Russ).

doi: 10.21320/2500-2139-2019-12-3-243-246

ABSTRACT

The paper deals with a combined case of hairy cell leukemia and lymphoplasmacytic lymphoma with IgMκ paraprotein secretion. The use of anti-CD antibody microarray enabled the simultaneous assessment of immunophenotype as well as morphological and cytochemical analysis. Small populations of hairy (3 % of total lymphocyte count) and plasma (2 %) cells including Mott cells (0.2 %) were found in the peripheral blood of a patient with leukopenia. The results obtained by the anti-CD antibody microarray method speeded up provisional diagnosis which was later confirmed by standard diagnostic methods.

Keywords: anti-CD antibody microarray, hairy cell leukemia, lymphoplasmacytic lymphoma, hairy cells, plasma cells, Mott cells.

Received: November 12, 2018

Accepted: May 2, 2019

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