LYMPHOID TUMORS

Malignant Lymphoproliferative Disorders with Anemia: Changes of Quality of Life in Patients Treated with Donor Red Blood Cell Transfusions and Recombinant Erythropoietin

LYMPHOID TUMORS , , , , , , , ,

S.S. Bessmeltsev1, N.A. Romanenko1, N.A. Potikhonova1, S.A. Tiranova1, M.N. Zenina1, A.E. Romanenko2, L.Yu. Zhiguleva1, K.M. Abdulkadyrov1

1 Russian Scientific Research Institute of Hematology and Transfusiology under the Federal Medico-Biological Agency, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024

2 St. Olga Children Hospital, 2 Zemledelcheskaya str., Saint Petersburg, Russian Federation, 194156

For correspondence: Stanislav Semenovich Bessmel’tsev, DSci, Professor, 16 2-ya Sovetskaya str., Saint Petersburg, Russian Federation, 191024; Tel.: +7(812)717-58-57; e-mail: RNIIHT@mail.ru

For citation: Bessmel’tsev SS, Romanenko NA, Potikhonova NA, et al. Malignant Lymphoproliferative Disorders with Anemia: Changes of Quality of Life in Patients Treated with Donor Red Blood Cell Transfusions and Recombinant Erythropoietin. Clinical oncohematology. 2015;8(4):368–378 (In Russ).

DOI: 10.21320/2500-2139-2015-8-4-368-378

ABSTRACT

Aim. To evaluate the quality of life of anemic patients with malignant lymphoproliferative disorders after red blood cells transfusion and administration of human recombinant erythropoietin agents.

Methods. The efficacy was assessed based on evaluation of clinical data, lab test findings and quality of life (QoL) parameters using the FACT-An questionnaire. Red blood cells transfusions (RBCsT) were prescribed to anemic patients with malignant lymphoproliferative disorders (LPD) (n = 54) with initial Hb levels of 7.0 ± 0.16 g/dl. After red blood cells transfusion (Me = 3 Units) the Hb level increased up to 9.31 ± 0.12 g/dl. Human recombinant erythropoietin agents (EPO) were prescribed to LPD patients (n = 77) with initial Hb levels of 8.84 ± 0.14 g/dl.

Results. A positive response with a ³ 2.0 g/dl increase of Hb levels was observed in 52 (67.5 %) of 77 patients. The Hb level in responsive patients increased up to 12.31 ± 0.24 g/dl. Statistically significant QoL changes were observe according to «Physical well-being», «Emotional well-being», «Functional well-being», and «Anemia» scales. After EPO-therapy, significant changes were found according to «Physical well-being» and «Anemia» scales. A comparative analysis of QoL in both groups of patients demonstrated maximum changes according to the «Physical well-being» scale (from 12.9 ± 0.7 to 11.0 ± 0.8 points after RBCsT, p < 0.001; from 11.6 ± 0.7 to 9.6 ± 0.7 points on EPO, p < 0.02) and the «Anemia» scale (from 41.1 ± 2.0 to 34.2 ± 2.2 points after RBCsT, p < 0.001; from 34.5 ± 1.7 to 30.1 ± 1.6 points on EPO; p < 0.001).

Conclusion. Therefore, RBCsT and EPO therapy may significantly increase the Hb levels and improve QoL. However, the QoL of LPD patients on EPO proved to be better than that after RBCsT, because it had been possible to achieve normal and stable Hb levels.

Keywords: anemia, malignant lymphoproliferative disorders, erythropoietin, recombinant erythropoietin, donor’s red blood cells, red blood cell transfusions, quality of life, FACT-An questionnaire, «Anemia» scale.

Received: May 13, 2015

Accepted: October 12, 2015

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Modern Aspects of Diagnosis and Treatment of Complicated Forms of Non-Hodgkin’s Lymphomas of Small and Large Intestine

LYMPHOID TUMORS , , , ,

OA Malikhova, AO Tumanyan, VA Shalenkov, AG Malikhov, YuP Kuvshinov, GV Ungiadze

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

For correspondence: Ol’ga Aleksandrovna Malikhova, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-43-27; e-mail: malikhova@inbox.ru

For citation: Malikhova OA, Tumanyan AO, Shalenkov VA, et al. Modern Aspects of Diagnosis and Treatment of Complicated Forms of Non-Hodgkin’s Lymphomas of Small and Large Intestine. Clinical oncohematology. 2015;8(2):129–35 (In Russ).

ABSTRACT

Background & Aims. Lymphomas constitute 5 to 10 % of gastrointestinal tumors and most of them are non-Hodgkin’s lymphomas (NHLs). They constitute 30–45 % of all extranodal NHLs. Primary involvement of the gastrointestinal tract is observed in 2/3 of patients. The objective of this study is to determine clinical and morphological features and treatment outcomes of complicated forms of NHLs of the small and large intestine.

Methods. NHLs of the small and large intestine were studied in 189 patients treated in the N.N. Blokhin Russian Cancer Research Center within the period of 1985–2010. Large intestine involvement was observed in 64 patients and small intestine involvement in 125 patients.

Results. Surgical interventions for ileus, bleeding or perforation of a hollow organ were performed in 92 patients with primary or secondary involvement of the small and large intestine (48.7 %). The intestine involvement was primary in 58.9 % of cases and secondary in 41.0 % of cases.

Conclusion. Complications of gastrointestinal NHLs deteriorate the overall survival rate. Patients with small or large intestine involvement require a special approach to diagnosis and treatment because of a high risk of surgical complications.

Keywords: lymphoma, small intestine, large intestine, oncohematology, non-Hodgkin’s lymphomas.

Received: January 30, 2014

Accepted: February 12, 2015

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Endoscopic and Endosonographic Criteria of Ulcerative Forms of Gastric Non-Hodgkin’s Lymphoma

LYMPHOID TUMORS , ,

OA Malikhova1, IV Poddubnaya2, AO Tumanyan1, YuP Kuvshinov1, GV Ungiadze1

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

2 Russian Medical Academy of Postgraduate Education, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Ol’ga Aleksandrovna Malikhova, DSci, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-43-27; e-mail: malikhova@inbox.ru

For citation: Malikhova OA, Poddubnaya IV, Tumanyan AO, et al. Endoscopic and Endosonographic Criteria of Ulcerative Forms of Gastric Non-Hodgkin’s Lymphoma. Clinical oncohematology. 2015;8(1):54–61 (In Russ).

ABSTRACT

Background. At present, the use of a standard visual endoscopy and X-ray methods alone for examination of gastric lesions does not meet oncologists’ requirements. Although these techniques are still used as basic and primary test methods for examination of the digestive tract, a comprehensive endoscopic and endosonographic (EUS) diagnostics is playing a leading role in evaluation of the nature of injuries in the upper gastrointestinal tract.

Objective. The objective of this study is to establish endoscopic and EUS criteria for diagnosing of the ulcerative form of non-Hodgkin’s lymphomas of the stomach.

Methods. In order to evaluate the potential of the complex endoscopic diagnosis of ulcerative form of non-Hodgkin’s lymphoma of the stomach, 37 patients were examined over the period from 2007 to 2009. All patients underwent intracavitary scanning after video-assisted gastroscopy with zoom at narrow-spectrum UV light, and then a tumor biopsy was performed.

Results. We established endoscopic criteria of gastric ulcerative NHL: in 18 (48.6 %) cases the ulcerative defect looks like a deep chronic callous peptic ulcer. A shallow polygonal-shaped ulcerative defect surrounded by unchanged mucosa is another form of non-Hodgkin’s lymphoma found in 11 (29.7 %) patients within the frames of this study. Another form of the disease is the evolution of nodular or plaque-like type registered in 8 (21.6 %) patients. Ulcerative gastric NHL was diagnosed by scanning in 6 (13.0 %) patients.

Conclusions. EUS criteria for non-Hodgkin’s gastric lymphoma: echography demonstrated hollow organ defects in gastric ulcers. It should also be noted that in case of NHL, there is evident thickening of the submucous membrane up to 6–7 mm along the edge of ulcer, which extends beyond visually detected borders of the ulcerative defect for more than 50 mm.

Keywords: non-Hodgkin’s gastric lymphomas, endosonography, endoscopy.

Received: October 14, 2014

Accepted: October 27, 2014

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REFERENCES

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MYC and BCL2 Protein Expression in Patients with Diffuse Large B-cell Lymphoma

LYMPHOID TUMORS , , , ,

AE Misyurina1, AM Kovrigina1, EA Baryakh1, VA Misyurin2, SK Kravchenko1, AV Misyurin2, TN Obukhova1, SM Kulikov1, AN Kopylov2, AU Magomedova1, EG Gemdzhyan1, AI Vorob’ev1

1 Hematology Research Center under the Ministry of Health of the Russian Federation, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

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

For correspondence: Anna Evgen’evna Misyurina, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(909)637-32-46; e-mail: anna.lukina1@gmail.com

For citation: Misyurina AE, Kovrigina AM, Baryakh EA, et al. MYC and BCL2 Protein Expression in Patients with Diffuse Large B-cell Lymphoma. Clinical oncohematology. 2015;8(1):44–53 (In Russ).

ABSTRACT

Objective. The objective of this study is to analyze the incidence and the role of MYC and BCL2 protein expression in patients with diffuse large B-cell lymphoma (DLBCL) and to compare data of histological, immunohistochemical, genetic, and moleculobiological analyses with clinical characteristics.

Methods. 62 patients with confirmed diffuse large B-cell lymphoma (DLBCL) were enrolled in the study; they underwent treatment according to the original modified protocol NHL-BFM-90 ± R in the Hematology Research Center under the Ministry of Health of the Russian Federation. A reference group consisted of 13 DLBCL patients who underwent СНОР-like ± R therapy. In all observations, histological and immunohistochemical tests were performed in archived biopsy samples of a tumor tissue or a lymph node (paraffin blocks) using BCL2 (clone 124, Dako) and MYC antibodies (clone Y69, Epitomics). Based on C.P. Hans’s algorithm (2004), GCB and non-GCB immunohistochemical subtypes of DLBCL were determined. Standard cytogenetic tests (n = 22) and FISH analysis (n = 52) were performed in this study in order to determine locus translocation of с-MYC gene, IgH gene, t(8;14)(q24;q32), BCL2 gene, t(14;18)(q32;q21). Quantitative RT-PCR on paraffin tumor/node biopsy samples was also performed to evaluate the number of mRNAs of с-MYC and BCL2 genes.

Results. MYC expression was found in 24 (39 %) of 62 DLBCL patients and BCL2 in 36 (58 %) of 62 patients (threshold values were 40 % and 50 % of tumor cells, respectively). MYC/BCL2 coexpression was diagnosed in 15 (24 %) of 62 DLBCL patients. 4 (27 %) of 15 patients with MYC/BCL2 coexpression had a GCB-subtype of DLBCL, 73 % patients with MYC/BCL2 coexpression were diagnosed with non-GCB subtype of DLBCL (p < 0.02). c-MYC rearrangement was found in two cases (3 %), one of them had a MYC protein expression score more than 40 %. 10 (19 %) patients had one or more additional signal from 8q24 locus of c-MYC gene. We didn’t find any correlation between the presence of additional signals from c-MYC gene locus and the level of immunohistochemical expression of MYC protein ³ 40 % (p < 0.05). BCL2 gene rearrangement was detected in one case; it was accompanied by BCL2 protein immunohistochemical expression ³ 50 %. BCL2 amplification was observed in 17 (40 %) patients. There was a correlation between the amplification of BCL2 gene and immunohistochemical expression of BCL2 protein (threshold value was ³ 50 % of positive cells) (p = 0.0053). There was a direct correlation between the amount of mRNAs and MYC protein (correlation coefficient 0.86; p < 0.0001). There was no correlation between the level of BCL2 gene expression and the amount of protein (correlation coefficient 0.14; p = 0.57). Four-year overall survival for DLBCL patients treated with m-NHL-BFM-90 ± R was 71 % (in patients without MYC/BCL2 coexpression) vs 57 % (in patients with MYC/BCL2 coexpression) (p = 0.39). The probability of relapse or progression of DLBCL was significantly higher in patients with MYC/BCL2 coexpression, than in patients without MYC/BCL2 coexpression (65 % vs 15 %; p = 0.0029).

Conclusions. The MYC/BCL2 coexpression is observed mainly in DLBCL patients with non-GCB immunohistochemical subtype of the disease. The MYC/BCL2 coexpression is vital for prediction of the risk of relapses/progression of the disease in patients receiving an intensive chemotherapy according to the m-NHL-BFM-90 ± R protocol. Taking into account a relatively stable structure of the protein substrate, the obtained data may become a basis for development of a diagnostic immunohistochemical algorithm for stratification of DLBCL patients.

Keywords: DLBCL, intensive therapy, MYC/BCL2 coexpression, immunohistochemistry, unfavorable prognostic factor.

Received: November 8, 2014

Accepted: November 11, 2014

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High-Dose Chemotherapy for Grade 3B Relapsed Follicular Lymphoma with Deletions of Loci of BCL6 (3q27) and TP53 (17p13) Genes: Case Report and Literature Review

LYMPHOID TUMORS , ,

EE Zvonkov, NG Gabeeva, MV Firsova, EV Moiseeva, VV Troitskaya, LA Kuz’mina, TN Obukhova, AM Kovrigina, EN Parovichnikova, VG Savchenko

Hematology Research Center under the Ministry of Health of the Russian Federation, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Nelli Georgievna Gabeeva, PhD, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(495)612-48-10; e-mail: dr.gabeeva@gmail.com

For citation: Zvonkov EE, Gabeeva NG, Firsova MV, et al. High-Dose Chemotherapy for Relapsed Follicular Lymphoma Grade 3B with Deletions of Loci of BCL6 (3q27) and TP53 (17p13) Genes: Case Report and Literature Review. Clinical oncohematology. 2015;8(1):36–43 (In Russ).

ABSTRACT

Background. The article describes a rare case of grade 3В follicular lymphoma (FL) with a nodular-diffuse growth; it also presents a literature review. Grade 3В follicular lymphoma with a nodular-diffuse growth is a rare lymphoid neoplasm, and no optimal therapeutic strategies have been developed for it. In addition to the absence of the classic t(14;18), combined deletions of 17p13 (TР53 gene locus) and 3q27 (BCL6 gene locus) are observed in a very few cases. This combination may negatively affect the FL prognosis. The unique ability of bendamustine to induce ТР53-independent apoptosis offers new opportunities for the high-dose chemotherapy of lymphomas.

Objective. To evaluate efficacy and tolerance of the ВеЕАМ conditioning regimen using high-dose bendamustine followed by autologous HSCT in a patient with 3B FL relapse and combined 17p13 and 3q27 deletion.

Methods. A 58-year-old man was diagnosed with 3B grade FL. After 8 R-CHOP courses and a two-year maintenance therapy with Rituximab, he developed a generalized enlargement of lymph nodes, and a neoplasm in left liver lobe. A liver biopsy confirmed the relapse of grade 3B FL with a nodular-diffuse growth and a high Ki-67 level (60 %). Cytogenetic analysis identified 17p13 and 3q27 deletions.

Results. Four courses of anti-relapse therapy were performed (2 — DHAP and 2 — ICE). PET scanning showed a complete regression in lymph nodes, whereas the size of the focus in the liver and the rate of accumulation of radiopharmaceuticals in it remained unchanged. ВеЕАМ conditioning regimen (bendamustine 600 mg) followed by autologous HSCT were performed. 46 days after the autologous HSCT, the tumor focus in the liver was PET-negative. The remission retained for 10 months.

Conclusions. Further study of the efficacy of high-dose bendamustine in the therapy of aggressive lymphoid tumors with TP53 mutation seems promising.

Keywords: follicular lymphoma, TP53-independent apoptosis, bendamustine.

Received: October 24, 2014

Accepted: October 27, 2014

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Efficacy and Toxicity of Therapy for Patients with Intermediate-Risk Hodgkin’s Lymphoma: Results of Multicenter Randomized Study

AUTOIMMUNE THROMBOCYTOPENIA, LYMPHOID TUMORS , , ,

IA Kryachok1, AA Amdiev2, IB Titorenko1, EM Aleksik1, EO Ul’yanchenko1, OI Novosad1, ES Filonenko1, MI Kasich2, MYa Kiseleva2

1 National Cancer Institute, 33/43 Lomonosova str., Kyiv, Ukraine, 03022

2 V.M. Efetov Crimean National Clinical Oncology Dispensary, 49a Bespalova str., Simferopol, Russian Federation, 295023

For correspondence: Alim Anvarovich Amdiev, 49a Bespalova str., Simferopol, Russian Federation, 295023; Tel.: +38(0652)60-22-09; e-mail: amdiev@gmail.com

For citation: Kryachok IA, Amdiev AA, Titorenko IB, et al. Efficacy and Toxicity of Therapy for Patients with Intermediate-Risk Hodgkin’s Lymphoma: Results of Multicenter Randomized Study. Clinical oncohematology. 2015;8(3):281–6 (In Russ).

ABSTRACT

Objective. To study the efficacy and toxicity of various treatment schemes for patients with intermediate-risk Hodgkin’s lymphoma (HL).

Methods. This article presents an analysis of the immediate results of complex treatment of 103 intermediate-risk HL patients (stage IIA and IIB with one or more unfavorable prognostic factors), who have been treated at the National Cancer Institute (Kyiv) and the Crimean Oncology Dispensary (Simferopol) from 2009 to 2014 (study group). Patients were divided into two study groups and treated with 6xBEACOPP-esc or 2xBEACOPP-esc + 4xABVD, followed by radiotherapy on the affected areas at a dose of 30–36 Gy in both groups. The control group included 53 patients who received treatment according to the 6xABVD scheme, followed by radiotherapy on the affected areas at a dose of 30–36 Gy over the period from 2000 to 2008. The immediate efficiency of the therapy, as well as its toxicity was evaluated.

Results. The study results demonstrated that treatment of the intermediate-risk HL patients that included 6xBEACOPP-esc and 2xBEACOPP-esc + 4xABVD proved to be an effective approach. Overall immediate efficacy of 2xBEACOPP-esc + 4xABVD protocol with subsequent radiation therapy was 95.83 %, and that of the 6xBEACOPP-esc was 96.36 %, which was significantly higher than the efficacy in the control group (83.02 %; p < 0.05). The toxicity level of the therapy was lower in the 2xBEACOPP-esc + 4xABVD group than that in the 6xBEACOPP-esc group (63.19 % and 83.03 %, respectively, p < 0.001).

Conclusion. Treatment of patients with intermediate-risk HL with 2xBEACOPP-esc + 4xABVD is comparable to that with 6xBEACOPP-esc, but it demonstrates a better toxicity profile.

Keywords: Hodgkin’s lymphoma, chemotherapy, efficacy, toxicity.

Received: March 31, 2015

Accepted: May 31, 2015

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Role of TGF-b1 Gene Polymorphism in Development of Multiple Myeloma

LYMPHOID TUMORS , ,

AA Pavlova1, LN Bubnova1, YuV Sokolova1, EV Karyagina2, SS Bessmel’tsev1, IE Pavlova1

1 Russian Scientific 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 citation: Pavlova AA, Bubnova LN, Sokolova YuV, et al. Role of TGF-b1 Gene Polymorphism in Development of Multiple Myeloma. Clinical oncohematology. 2015;8(3):274–80 (In Russ).

ABSTRACT

Background & Aims. Multiple myeloma (MM) is a hematological malignancy characterized by uncontrolled proliferation of the clonal plasma cells. Studies showed that the TGF-b1 cytokine induces growth of the tumor clone in MM. The aim of this study was to detect single nucleotide polymorphisms (SNP) of the TGF-b gene (codon 10, codon 25) associated with the development of MM and to determine risks of the bone disease development in residents of the Northwest Russia.

Methods. 43 patients with MM were examined (mean age: 69.2 ± 9.0 years). Patients were divided into two groups: the 1st group with severe osteolytic bone lesions and the 2nd one with signs of osteoporosis and solitary foci of lysis. The control group consisted of 40 healthy donors (mean age: 49.8 ± 10.1 years).

Results. The study demonstrated that MM was associated with TGF-b1 codon 25 CC genotype and TGF-b1 codon 10/codon 25 T/C haplotype. However, the TGF-b1 codon 25 GG genotype can be considered a marker of resistance to development of MM. Osteoporosis was associated with the TGF-b1 codon 25 GG genotype, whereas the TGF-b1 codon 25 GC was detected more frequently in patients with severe osteolytic bone lesions.

Conclusion. The obtained results indicate that individual genotypes and haplotypes of TGF-b1 are involved in the formation of predisposition to development of multiple myeloma.

Keywords: multiple myeloma, cytokines, TGF-b1, single nucleotide polymorphisms.

Received: February 9, 2015

Accepted: May 30, 2015

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REFERENCES

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Multiple Myeloma: 7-Year Experience of Applying Targeted Therapy in Novosibirsk and Its Results

LYMPHOID TUMORS , ,

T.I. Pospelova1, N.V. Skvortsova1, I.N. Nechunaeva2

1 Novosibirsk State Medical University, 52 Krasnyi pr-t, Novosibirsk, Russian Federation, 630091

2 Municipal Hospital No. 2, 21 Polzunova str., Novosibirsk, Russian Federation, 630051

For correspondence: Nataliya Valer’evna Skvortsova, PhD, associate professor, 52 Krasnyi pr-t, Novosibirsk, Russian Federation, 630091; Tel.: +8(383)279-94-06; e-mail: nata_sk78@mail.ru

For citation: Pospelova T.I., Skvortsova N.V., Nechunaeva I.N. Multiple Myeloma: 7-Year Experience of Applying Targeted Therapy in Novosibirsk and Its Results. Klin. Onkogematol. 2015;8(3):267–73. (In Russ.)

ABSTRACT

Objective. To evaluate results of the 7-year experience in treatment of multiple myeloma (MM) with proteasome inhibitor (bortezomib) in the Novosibirsk Municipal Hematological Center.

Methods. 199 MM patients treated in the Novosibirsk Municipal Hematological Center over the period from July, 2006, till December, 2014, were enrolled in the study. The median age of patients was 68 years (varied from 36 to 81). 98 patients received bortezomib as the first line therapy and 101 patients as the second line.

Results. The overall response rate of the first line therapy was 78.5 %; at that, 25 % of patients achieved a complete and almost complete remission. The median time to achieve response was 72 days. With the progression or refractory MM, the efficacy of bortezomib as a part of a combined antitumor therapy was 68.3 %. Bortezomib proved to be effective when its administration was resumed by patients who had received bortezomib and other components of the combined regimen previously (overall response: 68.4 %). The median overall survival rate has not been achieved, and 7-year survival rate was 70 %. Adverse events of bortezomib were predictable and manageable; the most relevant of them included gastrointestinal and hematologic disorders, fatigue, and peripheral neuropathy.

Conclusion. Bortezomib is a highly effective drug, which plays an important role in the treatment of MM as the first and subsequent line therapies; its administration results in significant increase in patients’ overall survival.

Keywords: multiple myeloma, effectiveness of treatment, bortezomib, overall survival.

Received: February 16, 2015

Accepted: May 28, 2015

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  13. Бессмельцев С.С., Карягина Е.В., Стельмашенко Л.В. и др. Бортезомиб (Велкейд) в комбинации с дексаметазоном в лечении рефрактерных/рецидивирующих форм множественной миеломы у пожилых больных. Онкогематология. 2010;2:40–5.
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  17. Blade J, Samson D, Reece D, et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Br J Haematol. 1998;102(5):1115–23. doi: 10.1046/j.1365-2141.1998.00930.x.
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    [Pospelova TI, Skvortsova NV, Nechunaeva IN. Results of treatment of multiple myeloma with bortezomib. Onkogematologiya. 2009;2:35–41. (In Russ)]
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Video-Assisted Laparoscopic Surgeries in Lymphomas Diagnostics

LYMPHOID TUMORS , , ,

I.G. Komarov1,2, S.S. Stepanenkova3, M.I. Komarov2

1 Surgical Unit No. 2, N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

2 Subdepartment of Oncology, Russian Medical Academy of Postgraduate Education, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

3 Subdepartment of Oncology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: I.G. Komarov, DSci, Professor, N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel: +7(499)324-12-70; e-mail: komarovig@mail.ru

For citation: Komarov I.G., Stepanenkova S.S., Komarov M.I. Video-Assisted Laparoscopic Surgeries in Lymphomas Diagnostics. Klin. Onkogematol. 2014; 7(4): 540–550 (In Russ.).

ABSTRACT

The article describes application of modern minimally invasive surgical technologies in oncohematology. The history of the video-assisted surgery is presented. Modern opportunities of the video-assisted laparoscopic surgery in diagnosing of malignant lymphoproliferative disorders were described. The main tools and the equipment, stages of intervention and technique used in video-assisted surgery are briefly described. Indications and contraindications for laparoscopic interventions are presented.

Keywords: lymphoma, diagnosis, video-assisted surgery, laparoscopy.

Accepted: September 17, 2014

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REFERENCES

  1. Hatzinger M., Fesenko A., Sohn M. The first human laparoscopy and NOTES operation: Dimitrij Oscarovic Ott (1855–1929). Urol. Int. 2014; 92(4): 387–91.
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  8. Vacchio R., MacFayden B.V., Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000; 42(1): 87–90.
  9. Кобаладзе М.Г. История развития эндоскопии. История науки и техники. 2004; 5: 18–23. [Kobaladze M.G. History of endoscopic surgery. Istoriya nauki i tekhniki. 2004; 5: 18–23. (In Russ.)]
  10. Himal H.S. Minimal invasive (laparoscopic) surgery. Surg. Endosc. 2002; 16(12): 1647–52.
  11. Mettler L. From air insufflation to robotic endoscopic surgery: a rocky road. J. Minim. Invasive Gynecol. 2011; 18(3): 275–83.
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Effects of Antitumor Chemotherapy and Radiation Therapy on Thyroid Gland in Hodgkin’s Lymphoma Patients during Follow-up Observations

LYMPHOID TUMORS , , ,

S.V. Shakhtarina, A.A. Danilenko, V.V. Pavlov, V.S. Parshin, O.V. Timokhina, G.A. Simakova

Medical Radiological Research Center under the Ministry of Health of the Russian Federation, 4 Koroleva str., Obninsk, Kaluga Oblast, Russian Federation, 249036

For correspondence: A.A. Danilenko, PhD, Senior scientific worker 4 Koroleva str., Obninsk, Kaluga Oblast, Russian Federation, 249036; Tel: +7(48439)9-31-01; e-mail: danilenko@mrrc.obninsk.ru

For citation: Shakhtarina S.V., Danilenko A.A., Pavlov V.V., Parshin V.S., Timokhina O.V., Simakova G.A. Effects of Antitumor Chemotherapy and Radiation Therapy on Thyroid Gland in Hodgkin’s Lymphoma Patients during Follow-up Observations. Klin. Onkogematol. 2014; 7(4): 533–539 (In Russ.).

ABSTRACT

This paper presents data on Hodgkin’s lymphoma (HL) patients who developed a second tumor — thyroid cancer — after therapy. The cohort includes 1789 patients (1177 women and 612 men) who were treated between 1968 and 1997 in the Medical Radiological Research Center, Obninsk (Russia) with radiotherapy alone or chemo-radiotherapy involving irradiation of supradiaphragmatic nodal areas (including cervico-supraclavicular lymph nodes) and spleen with the total tumor dose (TTD) up to 40 Gy. The total observation period was 18949 person/years. Thyroid cancer was registered in 9 women and 1 man. The expected (standardized) incidence of thyroid cancer was calculated with regard for gender, age, and in accordance with incidence rates for Russian population. For the cohort of 1177 women treated for HL (with 13 032 person/year follow up) the expected incidence was 1.15, while the actual incidence was 9 cases. The relative risk was 7.81 (95% CI: 3.47–13.9). For the cohort of 612 men (with 5917 person/year follow up) the expected incidence of thyroid cancer was 0.11, while the actual one was 1 case. The relative risk was 9.09 (95% CI: 0–0.44). Structural (sonographic, morphological) and functional changes in thyroid gland were studied in 335 HL patients treated with radiotherapy alone or chemo-radiotherapy (including irradiation of cervico-supraclavicular lymph nodes) at TTD of 40, 30, 20 Gy who received therapy between 1970 and 2010 and remained in continuous remission throughout the follow-up period. Nodular masses were found in thyroids of 72 (21.5 %) patients; decreased echogenity of thyroid tissue in 36 (10.7 %) patients; cysts in 21 (6.2 %); and thyroid cancer in 3 (0.9 %) patients. Functional changes were only seen in thyroids of patients (n = 316) who were given cervico-supraclavicular irradiation. Subclinical hypotheriosis was found in 72 (22.8 %), and the clinical one in 5 (1.6 %) patients; elevated antibody levels were found in 80 (25.3 %) patients. Decreased incidence of structural and functional thyroid changes was seen (p < 0.05) with decreased TTD during irradiation of the cervico-supraclavicular area.

Keywords: Hodgkin’s lymphoma, thyroid gland, hypothyroidism, thyroid cancer.

Accepted: September 10, 2014

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REFERENCES

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