Overcoming Resistance in Relapsed Anaplastic Large-Cell Lymphoma, ALK-Positive (Literature Review and Clinical Experience)

YuE Vinogradova1, NG Chernova2

1 IM Sechenov First Moscow State Medical University, 8 bld. 2 Trubetskaya Str., Moscow, Russian Federation, 119991

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

For correspondence: Yuliya Eikhenovna Vinogradova, MD, PhD, 8 bld. 2 Trubetskaya str., Moscow, Russian Federation, 119991; Tel.: +7(495)609-14-00, +7(916)195-68-57; е-mail: jvinogr@gmail.com

For citation: Vinogradova YuE, Chernova NG. Overcoming Resistance in Relapsed Anaplastic Large-Cell Lymphoma, ALK-Positive (Literature Review and Clinical Experience). Clinical oncohematology. 2019;12(2):179–84.

DOI: 10.21320/2500-2139-2019-12-2-179-184


ABSTRACT

Peripheral T-cell lymphomas (PTCL) are characterized by unfavorable prognosis and poorer survival in comparison with B-cell lymphomas. Probability of remission on first-line PTCL therapy is not higher than 60 % with high relapse rate. Long-term remission in PTCL relapses/progression cases typically fails to be achieved. The present article provides literature review and the authors’ own clinical experience in the management of anaplastic large-cell lymphoma, ALK-positive with primary skin and soft tissue lesions in an 65-year old female patient. After NHL-BFM-90 intensive chemotherapy the first 5,5-year complete remission was achieved in this patient. Afterwards a СНОР therapy-resistant relapse was identified. Chemotherapy-resistance of tumor was successfully overcome by adding of epigenetic drugs to cytostatic antitumor therapy. The duration of second complete remission is 3 years. Oncohematological diseases with either initial chemotherapy-resistance or the resistance acquired during antitumor therapy are most efficiently treated by various drug combinations including monoclonal antibodies, epigenetic drugs, and cytostatic therapy.

Keywords: anaplastic large-cell lymphoma, ALK-positive, skin involvements, resistance associated with relapse, epigenetic drugs.

Received: July 26, 2018

Accepted: January 15, 2019

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

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

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

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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T-cell lymphomas: therapeutic possibilities for a limited choice

V.A. Doronin

N.N. Blokhin Russian Cancer Research Center, RAMS, Moscow, Russian Federation


ABSTRACT

Peripheral and cutaneous T-cell lymphomas (PTCLs and CTCLs) are a group of distinct non-Hodgkin’s lymphomas (NHLs) with wide variation of molecular and genetic features, symptom patterns, and clinical manifestations. The diversity and rarity of these hematological disorders make clinical studies difficult, and treatment is improving slower than in more common B-cell NHLs. Thus, no standard therapies have been established for T-cell lymphomas so far. Treatment is often conducted within the frame of clinical trials. This article offers perspectives regarding the tailoring of treatment for patients with PTCL and CTCL. Novel therapies are also discussed.


Keywords: T-cell lymphomas, peripheral T-cell lymphoma, not otherwise specified, angioimmunoblastic T-cell lymphoma, anaplastic large cell lymphoma, cutaneous T-cell lymphomas.

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