malignant lymphoproliferative disorders

Treatment of Aggressive Non-Hodgkin’s Lymphomas in Pregnancy

AUTOIMMUNE THROMBOCYTOPENIA , ,

YaK Mangasarova1, AU Magomedova1, ES Nesterova1, LG Gorenkova1, FE Babaeva1, RG Shmakov2, SK Kravchenko1

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

2 VI Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, 4 Akademika Oparina str., Moscow, Russian Federation, 117997

For correspondence: Yana Konstantinovna Mangasarova, MD, PhD, 4 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, Magomedova AU, Nesterova ES, et al. Treatment of Aggressive Non-Hodgkin’s Lymphomas in Pregnancy. Clinical oncohematology. 2020;13(3):316–21 (In Russ).

DOI: 10.21320/2500-2139-2020-13-3-316-321

ABSTRACT

Background. The management of aggressive lymphomas in pregnancy depends on the time of diagnosis and immunomorphological variant of tumor. The rarity of aggressive lymphomas in pregnant women, the absence of consistent approaches to the treatment of such patients, the lack of data on physical growth of children as well as the incidence of newborns’ congenital and acquired pathology make this subject of vital importance.

Aim. To analyze the treatment results in patients with newly diagnosed aggressive lymphoma at different stages of pregnancy.

Materials & Methods. From 1993 to 2020 at the National Research Center for Hematology 74 pregnant women with lymphomas were treated. Aggressive tumors were detected in 17 (23 %) of them: primary mediastinal (thymic) large B-cell lymphoma (n = 14), anaplastic large-cell lymphoma ALK+ (n = 1), high-grade B-cell lymphoma, unspecified (n = 1), and diffuse large B-cell lymphoma (n = 1). The median age of patients was 30 years (range 21–37 years). The median pregnancy stage on the diagnosis of aggressive lymphoma was 21 weeks (range 11–32 weeks).

Results. In 1 case on the diagnosis of aggressive lymphoma at 11 weeks gestation dexamethasone 8 mg daily was administered up to the second trimester of pregnancy, afterwards the patient received polychemotherapy. On the diagnosis of aggressive lymphoma in the second (n = 13) and third (n = 2) trimesters of pregnancy the patients received polychemotherapy followed by delivery. In the third trimester of pregnancy delivery was performed with subsequent polychemotherapy in 1 patient. There were born 18 babies (1 pregnancy was multifetal): 8 girls and 10 boys.

Conclusion. As a result of the chosen tactics and the work of interdisciplinary team of doctors all patients, who completed the treatment, are followed-up in complete remission. All born babies, despite chemotherapy and perinatal complications, are alive and develop without abnormalities.

Keywords: malignant lymphoproliferative disorders, chemotherapy, primary mediastinal (thymic) large B-cell lymphoma, pregnancy.

Received: April 1, 2020

Accepted: June 22, 2020

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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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