LYMPHOID TUMORS

Role of Positron-Emission Tomography in Prognosis of Outcomes of High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation in Hodgkin’s Lymphoma

LYMPHOID TUMORS , , ,

VG Potapenko1,2, NB Mikhailova1, BI Smirnov4, IA Skorokhod2, DA Chaginskaya2, VV Ryabchikova2, IA Samorodova2, EI Podol’tseva2, VV Ipatov3, IV Boikov3, VN Semelev3, DA Gornostaev3, TG Potapenko5, TG Kulibaba5, NV Medvedeva2, BV Afanas’ev1

1 Academician IP Pavlov First St. Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

2 Municipal Hematological Center, Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

3 SM Kirov Military Medical Academy, 6 Akademika Lebedeva str., Saint Petersburg, Russian Federation, 194044

4 VI Ul’yanov (Lenin) St. Petersburg State Electrotechnical University LETI, 5 Professora Popova str., Saint Petersburg, Russian Federation, 197376

5 St. Petersburg State University, 7/9 Universitetskaya nab., Saint Petersburg, Russian Federation, 199034

For correspondence: Vsevolod Gennad’evich Potapenko, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022; Tel: +7(812)230-19-33; е-mail: potapenko.vsevolod@mail.ru

For citation: Potapenko VG, Mikhailova NB, Smirnov BI, et al. Role of Positron-Emission Tomography in Prognosis of Outcomes of High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation in Hodgkin’s Lymphoma. Clinical oncohematology. 2016;9(4):406–12 (In Russ).

DOI: 10.21320/2500-2139-2016-9-4-406-412

ABSTRACT

Aim. To perform a comparative analysis of the prognostic significance of positron-emission tomography (PET) with other prognostic factors of the efficacy of high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with Hodgkin’s lymphoma.

Methods. Data on 84 patients with Hodgkin’s lymphoma receiving treatment over the period from October 2007 till November 2015 were analyzed. The median age was 26.6 years (range: 10–62). The median follow-up was 25 months (range: 1–81 months). The prognostic significance of sex, response to the initial chemotherapy, time to relapse, second-line chemotherapy regimen type, B-symptoms, tumor size (>5 cm in cases of relapse prior to the HDCT), serum LDH and albumin levels, CT findings, the number of chemotherapy lines, conditioning regimen before the auto-HSCT, and the metabolic activity before the HDCT (PET1, n = 82) and after auto-HSCT (PET2, n = 57) was analyzed.

Results. The two-year overall (OS) and event-free (EFS) survival rates were 70.6 % and 58.7%, respectively. Prognosis was the worst in patients with CT-confirmed lymphoma progression by the initiation of HDCT. In the presence of a CT-response, the PET status of lymphoma has a prognostic significance. The 2-year OS and EFS rates of PET1-negative and PET1-positive patients were 82 % vs. 62 % (p = 0.056) and 74 % vs. 44 % (p = 0.003), respectively. In PET2-negative and PET2-positive patients, the OS and EFS rates were 90 % vs. 65 % (p = 0.013) and 72 % vs. 52 % (p = 0.014), respectively. From the prognostic point of view, PET2 findings prevailed over PET1 findings. The multivariate analysis confirmed only PET2 significance for OS prediction.

Conclusion. The tumor sensitivity to the chemotherapy assessed by the CT is the most important prognostic factor. In case of a positive CT dynamics, the achievement of PET1 or PET2 negativity before or after HDCT/auto-HSCT is a favorable prognostic factor. The worst prognosis was observed in patients with tumor metabolic activity before or after HDCT/auto-HSCT.

Keywords: positron-emission tomography (PET), Hodgkin’s lymphoma, high-dose chemotherapy, auto-HSCT.

Received: June 23, 2016

Accepted: August 29, 2016

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Brentuximab Vedotin: New Possibilities for Treatment of Relapses and Refractory Hodgkin’s Lymphomas

LYMPHOID TUMORS , , ,

EA Demina

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

For correspondence: Elena Andreevna Demina, DSci, Professor, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel: +7 (499)324-90-89; e-mail: drdemina@yandex.ru

For citation: Demina EA. Brentuximab Vedotin: New Possibilities for Treatment of Relapses and Refractory Hodgkin’s Lymphomas. Clinical oncohematology. 2016;9(4):398–405 (In Russ).

DOI: 10.21320/2500-2139-2016-9-4-398-405

ABSTRACT

The concept of total curability of Hodgkin’s lymphoma was introduced as early as in 1970s. However, 10–30 % of patients develop relapses; in addition, resistant tumors cannot be excluded. A high-dose chemotherapy with autologous hematopoietic stem cell transplantation is a modern treatment standard for relapses and refractory Hodgkin’s lymphomas. However, long-term remissions are achieved only in a half of these patients. The toxicity of effective first-line treatment regimens and insufficient effectiveness of regimens prescribed for relapses and refractory disease are the reason for further search of new therapeutic options for this malignant tumor. Invention of an immunoconjugate, brentuximab vedotin, became one of the new steps in the treatment of Hodgkin’s lymphomas. This review presents data on the pharmacological properties of the drug, the mechanism of the anti-tumor effect, as well as results of large international, randomized clinical trials.

Keywords: brentuximab vedotin, Hodgkin’s lymphoma, relapse, treatment.

Received: June 14, 2016

Accepted: June 17, 2016

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Non-Hodgkin’s Lymphomas in Children: 25-Year Clinical Experience

LYMPHOID TUMORS , , , , , ,

TT Valiev, AV Popa, AS Levashov, ES Belyaeva, NS Kulichkina, BV Kurdyukov, RS Ravshanova, GL Mentkevich

Scientific Research Institute of Pediatric Oncology and Hematology, NN Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Timur Teimurazovich Valiev, DSci, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel: +7(499)324-98-69; e-mail: timurvaliev@mail.ru

For citation: Valiev TT, Popa AV, Levashov AS, et al. Non-Hodgkin’s Lymphomas in Children: 25-Year Clinical Experience. Clinical oncohematology. 2016;9(4):420–37 (In Russ).

DOI: http://dx.doi.org/10.21320/2500-2139-2016-9-4-420-437

ABSTRACT

Background & Aims. Current polychemotherapeutic protocols based on differentiated and risk-adopted approaches permitted to consider non-Hodgkin’s lymphomas (NHL) potentially curable diseases although they had been considered fatal previously. The aim of this study is to summarize and analyze outcomes of NHL therapy over a 25-year period.

Methods. 246 patients were enrolled in the study. They were treated in the department of chemotherapy of hemoblastoses in the Scientific Research Institute of Pediatric Oncology and Hematology under the NN Blokhin Russian Cancer Research Center over the period of 25 years: from April 1, 1991, till June 1, 2016. B-NHL-BFM 90/95 protocols and a modified B-NHL-BFM 95 protocol (with rituximab) were used for B-cell NHLs (n = 130). Patients with lymphocytic leukemia (n = 75) were treated using ALL-mBFM 90/95 and ALL IC-BFM 2002 protocols. 21 patients with anaplastic large cell lymphomas (ALCL) received treatment according to the B-NHL-BFM 90/95 protocol, and 20 patients received the НИИ ДОГ-АККЛ-2007 protocol.

Results. Taking into account clinical and immunological characteristics of ALCL, the authors invented an original НИИ ДОГ-АККЛ-2007 protocol. Special attention was paid to potential modification of standard treatment regimens for B-cell NHL by adding rituximab. The article demonstrates the evolution in prescription of rituximab for B-cell NHL and possibilities for reduction of the total number of polychemotherapy cycles for late-stage tumors without deterioration of treatment outcomes.

Conclusion. The obtained results permit to conclude that introduction of achievements of oncoimmunology, molecular biology, and cytogenetics will become the basis for further modification of existing treatment options for NHL.

Keywords: Burkitt lymphoma, diffuse large B-cell lymphoma, anaplastic large-cell lymphoma, primary mediastinal (thymic) large B-cell lymphoma, T- and B-cell lymphoblastic lymphomas, treatment, children.

Received: June 12, 2016

Accepted: June 17, 2016

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Factors Affecting Course and Outcome of Chronic Lymphocytic Leukemia: Data from Hematological Hospitals of Krasnoyarsk Region

LYMPHOID TUMORS , , , ,

VI Bakhtina1,2, IV Demko2, AN Narkevich2, DS Gushchin3

1 Regional Clinical Hospital, 3а Partizana Zheleznyaka Str., Krasnoyarsk, Russian Federation, 660022

2 Professor VF Voyno-Yasenetsky Krasnoyarsk State Medical University, 1 Partizana Zheleznyaka Str., Krasnoyarsk, Russian Federation, 660022

3 Norilsk Inter-District Hospital No. 1, Solnechnyi pr-d, 7a Norilsk, Russian Federation, 663300

For correspondence: Varvara Ivanovna Bakhtina, 1 Partizana Zheleznyaka Str., Krasnoyarsk, Russian Federation, 660022; Tel: +7(923)357-57-77; е-mail: doctor.gem@mail.ru

For citation: Bakhtina VI, Demko IV, Narkevich AN, Gushchin DS. Factors Affecting Course and Outcome of Chronic Lymphocytic Leukemia: Data from Hematological Hospitals of Krasnoyarsk Region. Clinical oncohematology. 2016;9(4):413–419 (In Russ).

DOI: http://dx.doi.org/10.21320/2500-2139-2016-9-4-413-419

ABSTRACT

Background & Aims. B-cellular chronic lymphocytic leukemia (CLL) is a disease with heterogeneous clinical manifestations and biological characteristics. The age of 70 % of patients is more than 65 years by the date of the diagnosis; most of them have several comorbidities. The aim of the study is to identify factors affecting the survival, as well as to determine causes of mortality in CLL patients (according to data from hematological hospitals of Krasnoyarsk Region).

Methods. In order to identify the most significant factors affecting the course and the outcome of CLL, a retrospective analysis of data on patients who died in hematological hospitals was carried out. 45 cases with the lethal outcome were registered within six years. All patients were under hematologist’s supervision after diagnosing the disease, and they were followed throughout the treatment period up to the lethal outcome.

Results. Тhe overall and progression-free survival depended, first of all, on the type of the first line therapy and its efficacy. The progression of the underlying disease and infectious complications became the main reason of the lethal outcome in CLL patients.

Conclusion. Most patients received ineffective treatment as first line therapy. The analysis of the comorbidities showed that a more effective chemotherapy could be performed with achievement of longer complete remissions.

Keywords: chronic lymphocytic leukemia, oncohematological diseases, comorbidities, survival, treatment.

Received: May 16, 2016

Accepted: June 17, 2016

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Role of Positron-Emission Tomography in Prognosis of Outcomes of High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation in Hodgkin’s Lymphoma

LYMPHOID TUMORS , , ,

VG Potapenko1,2, NB Mikhailova1, BI Smirnov4, IA Skorokhod2, DA Chaginskaya2, VV Ryabchikova2, IA Samorodova2, EI Podol’tseva2, VV Ipatov3, IV Boikov3, VN Semelev3, DA Gornostaev3, TG Potapenko5, TG Kulibaba5, NV Medvedeva2, BV Afanas’ev1

1 Academician IP Pavlov First St. Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

2 Municipal Hematological Center, Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

3 SM Kirov Military Medical Academy, 6 Akademika Lebedeva str., Saint Petersburg, Russian Federation, 194044

4 VI Ul’yanov (Lenin) St. Petersburg State Electrotechnical University LETI, 5 Professora Popova str., Saint Petersburg, Russian Federation, 197376

5 St. Petersburg State University, 7/9 Universitetskaya nab., Saint Petersburg, Russian Federation, 199034

For correspondence: Vsevolod Gennad’evich Potapenko, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022; Tel: +7(812)230-19-33; е-mail: potapenko.vsevolod@mail.ru

For citation: Potapenko VG, Mikhailova NB, Smirnov BI, et al. Role of Positron-Emission Tomography in Prognosis of Outcomes of High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation in Hodgkin’s Lymphoma. Clinical oncohematology. 2016;9(4):406–12 (In Russ).

DOI: http://dx.doi.org/10.21320/2500-2139-2016-9-4-406-412

ABSTRACT

Aim. To perform a comparative analysis of the prognostic significance of positron-emission tomography (PET) with other prognostic factors of the efficacy of high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with Hodgkin’s lymphoma.

Methods. Data on 84 patients with Hodgkin’s lymphoma receiving treatment over the period from October 2007 till November 2015 were analyzed. The median age was 26.6 years (range: 10–62). The median follow-up was 25 months (range: 1–81 months). The prognostic significance of sex, response to the initial chemotherapy, time to relapse, second-line chemotherapy regimen type, B-symptoms, tumor size (>5 cm in cases of relapse prior to the HDCT), serum LDH and albumin levels, CT findings, the number of chemotherapy lines, conditioning regimen before the auto-HSCT, and the metabolic activity before the HDCT (PET1, n = 82) and after auto-HSCT (PET2, n = 57) was analyzed.

Results. The two-year overall (OS) and event-free (EFS) survival rates were 70.6 % and 58.7%, respectively. Prognosis was the worst in patients with CT-confirmed lymphoma progression by the initiation of HDCT. In the presence of a CT-response, the PET status of lymphoma has a prognostic significance. The 2-year OS and EFS rates of PET1-negative and PET1-positive patients were 82 % vs. 62 % (p = 0.056) and 74 % vs. 44 % (p = 0.003), respectively. In PET2-negative and PET2-positive patients, the OS and EFS rates were 90 % vs. 65 % (p = 0.013) and 72 % vs. 52 % (p = 0.014), respectively. From the prognostic point of view, PET2 findings prevailed over PET1 findings. The multivariate analysis confirmed only PET2 significance for OS prediction.

Conclusion. The tumor sensitivity to the chemotherapy assessed by the CT is the most important prognostic factor. In case of a positive CT dynamics, the achievement of PET1 or PET2 negativity before or after HDCT/auto-HSCT is a favorable prognostic factor. The worst prognosis was observed in patients with tumor metabolic activity before or after HDCT/auto-HSCT.

Keywords: positron-emission tomography (PET), Hodgkin’s lymphoma, high-dose chemotherapy, auto-HSCT.

Received: June 23, 2016

Accepted: August 29, 2016

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Brentuximab Vedotin: New Possibilities for Treatment of Relapses and Refractory Hodgkin’s Lymphomas

LYMPHOID TUMORS , , ,

EA Demina

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

For correspondence: Elena Andreevna Demina, DSci, Professor, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel: +7 (499)324-90-89; e-mail: drdemina@yandex.ru

For citation: Demina EA. Brentuximab Vedotin: New Possibilities for Treatment of Relapses and Refractory Hodgkin’s Lymphomas. Clinical oncohematology. 2016;9(4):398–405 (In Russ).

DOI: http://dx.doi.org/10.21320/2500-2139-2016-9-4-398-405

ABSTRACT

The concept of total curability of Hodgkin’s lymphoma was introduced as early as in 1970s. However, 10–30 % of patients develop relapses; in addition, resistant tumors cannot be excluded. A high-dose chemotherapy with autologous hematopoietic stem cell transplantation is a modern treatment standard for relapses and refractory Hodgkin’s lymphomas. However, long-term remissions are achieved only in a half of these patients. The toxicity of effective first-line treatment regimens and insufficient effectiveness of regimens prescribed for relapses and refractory disease are the reason for further search of new therapeutic options for this malignant tumor. Invention of an immunoconjugate, brentuximab vedotin, became one of the new steps in the treatment of Hodgkin’s lymphomas. This review presents data on the pharmacological properties of the drug, the mechanism of the anti-tumor effect, as well as results of large international, randomized clinical trials.

Keywords: brentuximab vedotin, Hodgkin’s lymphoma, relapse, treatment.

Received: June 14, 2016

Accepted: June 17, 2016

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Acute Leukemias: Immunophenotypic Differences between Blast Cells and Their Nonneoplastic Analogues in Bone Marrow

LYMPHOID TUMORS , , ,

АM Popov1, ТYu Verzhbitskaya2,3, LG Fechina2, AV Shestopalov1,4, SA Plyasunova1

1 Dmitrii Rogachev Federal Scientific Clinical Centre of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela str., Moscow, Russian Federation, 117997

2 Regional Children’s Hospital No. 1, 32 Serafimy Deryabinoi str., Yekaterinburg, Russian Federation, 620149

3 Institute of Medical Cell Technologies, 22a Karla Marksa str., Yekaterinburg, Russian Federation, 620026

4 N.I. Pirogov Russian National Research Medical University, 1 Samory Mashela str., Moscow, Russian Federation, 117997

For correspondence: Aleksandr Mikhailovich Popov, PhD, 1 Samory Mashela str., Moscow, Russian Federation, 117997; Tel.: +7(495)287-65-70; e-mail: uralcytometry@gmail.com

For citation: Popov AM, Verzhbitskaya TYu, Fechina LG, et al. Acute Leukemias: Immunophenotypic Differences between Blast Cells and Their Nonneoplastic Analogues in Bone Marrow. Clinical oncohematology. 2016;9(3):302-13 (In Russ).

DOI: http://dx.doi.org/10.21320/2500-2139-2016-9-3-302-313

ABSTRACT

Flow cytometry immunophenotyping of bone marrow tumor blasts is one of the principal methods used for acute leukemia (AL) diagnosing. Normal lymphopoietic and myelopoietic progenitors have very similar antigenic profile with leukemic cells, thus, making the AL diagnosing more difficult. Genetic disorders resulting in formation of a tumor clone contribute to development of an immunophenotype that differs from normal cells. Aberrant expression of markers detected in AL blast cells alone forms a so-called leukemia-associated immunophenotype. The leukemia-associated immunophenotype detection by multicolor flow cytometry permits distinguishing between normal and neoplastic cells. This requires simultaneous assessment of many markers on the same cells, which is possible only if multicolor flow cytometry with well-designed and well-established antibodies panels is used. Moreover, correct interpretation of the cell population location on dot plot requires adequate cytometer setup, standardized sample preparation and enough experienced personnel. That is why correct immunophenotyping is often possible only in large laboratories performing reference immunophenotyping within the frames of multicenter trials.

Keywords: acute leukemias, flow cytometry, antigenic expression, immunophenotype.

Received: February 19, 2016

Accepted: March 16, 2016

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Clinical Significance of Immunophenotyping of Bone Marrow Cells in Multiple Myeloma

LYMPHOID TUMORS , , , , ,

OYu Yakimovich, OM Votyakova, NV Lyubimova, NN Tupitsyn

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Oksana Yur’evna Yakimovich, graduate student, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-28-54; e-mail: ronc_ramn@mail.ru

For citation: Yakimovich OYu, Votyakova OM, Lyubimova NV, Tupitsyn NN. Clinical Significance of Immunophenotyping of Bone Marrow Cells in Multiple Myeloma. Clinical oncohematology. 2016;9(3):296-301 (In Russ).

DOI: 10.21320/2500-2139-2016-9-3-296-301

ABSTRACT

Aim. To analyze the relationship between expression of aberrant CD45, CD19, CD56 markers on the plasma cells and clinical and laboratory findings and prognostically significant parameters in patients with multiple myeloma (MM).

Methods. This scientific research includes data on clinical investigation and immunophenotyping of bone marrow cells obtained from 64 MM patients treated in the N.N. Blokhin Russian Cancer Research Center over the period from 2004 to 2015. The three-color flow cytometry was performed using a direct immunofluorescence technique (CD38-PerCP, CD138-FITC monoclonal antibodies) and PE-conjugated monoclonal antibodies against CD45, CD19, and CD56.

Results. Comparison of average values of the total count of plasma cells, the number of plasmablasts, proplasmacyte and mature plasma cells (according to the myelogram) and comparison of these data with the level of expression of the CD19 marker demonstrated a significant relationship between the CD19 negative immunophenotype and both a higher level of the total count of plasma cells and immature plasma cells. There also was a significant correlation between the CD19 negative immunophenotype and a higher level of C-reactive protein, which is significant prognostic factor in MM. In addition, there was a significant relationship between the CD19 negative phenotype and a higher percentage of young neutrophils in blood, i.e. with a more frequent “left shift”. The CD56 negative phenotype is associated with plasmablastic morphology of plasma cells and with the presence of plasma cells in the peripheral blood. Plasma cell leukemia is more common in patients with СD56 negative phenotype of myeloma cells. The CD45 negative immunophenotype was associated with a higher level of k-type FLCs, Bence-Jones proteinuria and with a higher serum creatinine, than in the cases of CD45 positive phenotype.

Conclusion. The study of the immunophenotype of plasma cells in MM has important scientific and practical significance and requires further study.

Keywords: multiple myeloma, aberrant immunophenotype of malignant plasma cells, CD45, CD19, and CD56 markers, clinical and laboratory parameters.

Received: March 17, 2016

Accepted: April 1, 2016

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REFERENCES

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Pathomorphological Diagnosis of Splenic Diffuse Red Pulp Small B-Cell Lymphoma

LYMPHOID TUMORS , , ,

AM Kovrigina, SM Korzhova, LS Al’-Radi, UL Dzhulakyan, BV Biderman, IA Yakutik, AB Sudarikov

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

For correspondence: Alla Mikhailovna Kovrigina, DSci, Professor, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: 7(495)612-61-12; e-mail: kovrigina.alla@gmail.com

For citation: Kovrigina AM, Korzhova SM, Al’-Radi LS, et al. Pathomorphological Diagnosis of Splenic Diffuse Red Pulp Small B-Cell Lymphoma. Clinical oncohematology. 2016;9(3):287-95 (In Russ).

DOI: 10.21320/2500-2139-2016-9-3-287-295

ABSTRACT

Background. Unclassifiable splenic B-cell lymphoma/leukemia is a rare and poorly studied disorder introduced in the WHO classification of hematopoietic and lymphoid tissue malignancies for the first time in 2008. This type of lymphoma requires differential diagnosing between hairy cell leukemia-variant (HCL-V) and splenic diffuse red pulp small B-cell lymphoma (SDRPL).

Aim. To develop criteria for diagnosis of SDRPL by comparison of bone marrow biopsies (BMB) and surgical specimens of the spleen.

Methods. In the Department of Morbid Anatomy of the Hematology Research Center, preoperative BMBs and surgical specimens of the spleen (2013–2015) were compared in 71 patients (men/women ratio 1:2.6, age range 44–81, median age 58 years) using morphological and extended immunohistochemical studies. Sanger sequencing and PCR assay were carried out to analyze the mutational status of IgHV and to identify mutations in MAP2K1, NOTCH, BRAF.

Results. SDRPL was diagnosed in 5 (7 %) of 71 patients. In 2 groups of patients (with normal and high WBC count), the morphological features of spleen tissue were similar to those of a neoplastic substrate of HCL-V. The immunohistochemical assay demonstrates monomorphic expression of CD20 and DBA.44 and heterogeneous expression of CD11c, TRAP, CD103, CD123 in all cases. In none of the 5 cases, expression of CD25, CD27, Cyclin D1, Annexin-1 was found. In bone marrow (unlike HCL and HCL-V), predominantly interstitial and intravascular scant CD20+ lymphoid infiltration (4 of 5 cases) was found without detectable nucleoli in nuclei of small lymphoid cells. In 1 case, there was a combined lymphoid infiltration: CD20+ microfocal-interstitial infiltration with an intravascular component. No persistent molecular mutations in the spleen tissue specimens were found.

Conclusion. SDRPL is diagnosed in 7 % of splenic B-cell lymphomas. It is a rare disorder, whose verification requires an integrated approach taking into account clinical and laboratory data, results of flow cytometry, cytological, morphological, extended IHC and molecular biological studies.

Keywords: immunohistochemistry, splenic diffuse red pulp small B-cell lymphoma, splenectomy, bone marrow biopsy.

Received: April 28, 2016

Accepted: April 29, 2016

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ЛИТЕРАТУРА

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Modern Aspects of Diagnosis and Treatment of Anaplastic Large Cell Lymphoma in Children (Literature Review)

LYMPHOID TUMORS , , ,

AS Levashov1, TT Valiev1, AM Kovrigina2, AV Popa1, GL Mentkevich1

1 N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

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

For correspondence: Andrei Sergeevich Levashov, scientific worker, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(916)233-05-75; e-mail: andreyslevashov@mail.ru

For citation: Levashov AS, Valiev TT, Kovrigina AM, et al. Modern Aspects of Diagnosis and Treatment of Anaplastic Large Cell Lymphoma in Children (Literature Review). Clinical oncohematology. 2016;9(2):199–207 (In Russ).

DOI: 10.21320/2500-2139-2016-9-2-199-207

ABSTRACT

Anaplastic large cell lymphoma (ALCL) includes different types of the disease that are heterogeneous according to clinical, morphological, immunological, cytogenetic and molecular biological features. The review demonstrates not only main clinical and morphoimmunological characteristics of ALCL, but also presents data about expression and prognostic significance of STAT3, pSTAT3tyr705, and survivin (transcription factor). It demonstrates the value of defining the minimal disseminated disease (the minimal disseminated disease is evaluated using the PCR test before initiation of the treatment, and the minimal residual disease is evaluated during the treatment and after its completion), and clinical and molecular biological prognostic factors are also identified. There is still no a standard therapeutic regimen for pediatric ALCL patients. However, the following therapeutic protocols are considered most effective: NHL-BFM 90/95, CCG5941, SFOP-LM 89/91, UKCCSG, ALCL99-Vinblastine, POG АРО 9315, AIEOP LNH-92/97. Treatment outcomes are presented in this paper. Particular attention is paid to different molecular biological markers that allow further improvement of patients’ stratification in risk groups and possible use of target medications (multikinase inhibitors and monoclonal antibodies) improving the therapy outcomes.

Keywords: anaplastic large cell lymphoma, diagnosis, treatment, children.

Received: February 3, 2016

Accepted: February 10, 2016

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