диффузная В-крупноклеточная лимфома

Неходжкинские лимфомы у детей: 25 лет терапии

ЛИМФОИДНЫЕ ОПУХОЛИ , , , , , ,

Т.Т. Валиев, А.В. Попа, А.С. Левашов, Е.С. Беляева, Н.С. Куличкина, Б.В. Курдюков, Р.С. Равшанова, Г.Л. Менткевич

НИИ детской онкологии и гематологии ФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» Минздрава России, Москва, Каширское ш., д. 24, Российская Федерация, 115478

Для переписки: Тимур Теймуразович Валиев, д-р мед. наук, Каширское ш., д. 24, Москва, Российская Федерация, 115478; тел.: +7(499)324-98-69; e-mail: timurvaliev@mail.ru

Для цитирования: Валиев Т.Т., Попа А.В., Левашов А.С. и др. Неходжкинские лимфомы у детей: 25 лет терапии. Клиническая онкогематология. 2016;9(4):420–37.

DOI: 10.21320/2500-2139-2016-9-4-420-437

РЕФЕРАТ

Актуальность и цели. Современные программы полихимиотерапии, в основе которых лежит дифференцированный риск-адаптированный подход, позволили рассматривать неходжкинские лимфомы (НХЛ), ранее считавшимися фатальными, как потенциально излечимые заболевания. Цель настоящей работы — обобщение и анализ результатов лечения НХЛ за 25-летний период.

Методы. В исследование включено 246 больных, проходивших лечение в отделении химиотерапии гемобластозов НИИ ДОГ ФГБУ «РОНЦ им. Н.Н. Блохина» МЗ РФ за 25 лет: с 1.04.1991 по 1.06.2016 г. При В-клеточных НХЛ (n = 130) использовались программы B-NHL-BFM 90/95, а также модифицированная программа B-NHL-BFM 95 (включен ритуксимаб). Больным лимфобластным лейкозом (n = 75) лечение проводилось по протоколам ALL-mBFM 90/95 и ALL IC-BFM 2002. При анапластической крупноклеточной лимфоме (АККЛ) 21 больной получил лечение по протоколу B-NHL-BFM 90/95, 20 — по программе НИИ ДОГ-АККЛ-2007.

Результаты. С учетом клинико-иммунологических особенностей АККЛ авторами был разработан оригинальный протокол НИИ ДОГ-АККЛ-2007. Особое внимание уделялось возможности модификации стандартных программ лечения НХЛ из зрелых В-клеток (В-НХЛ) путем включения ритуксимаба. Показана эволюция в назначении ритуксимаба при В-НХЛ и возможность редукции общего числа блоков полихимиотерапии при поздних стадиях опухоли без снижения результатов лечения.

Заключение. Полученные данные позволяют считать, что внедрение достижений онкоиммунологии, молекулярной биологии и цитогенетики станет основой последующей модификации существующих программ терапии НХЛ.

Ключевые слова: лимфома Беркитта, диффузная В-крупноклеточная лимфома, анапластическая крупноклеточная лимфома, первичная медиастинальная (тимическая) В-крупноклеточная лимфома, Т- и В-лимфобластные лимфомы, лечение, дети.

Получено: 12 июня 2016 г.

Принято в печать: 17 июня 2016 г.

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ЛИТЕРАТУРА

  1. Swerdlow SH, Campo E, Harris NL, et al, eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition. Lyon: IARC Press; 2008. pp. 439.
  2. Burkhardt B, Zimmermann M, Oschlies I, et al. The impact of age and gender on biology, clinical features and treatment outcome of non-Hodgkin lymphoma in childhood and adolescence. Br J Haematol. 2005;131(1):39–49. doi: 10.1111/j.1365-2005.05735.x.
  3. Hochberg J, Waxman IM, Kelly KM, et al. Adolescent non-Hodgkin lymphoma and Hodgkin lymphoma: state of the science. Br J Haematol. 2009;144(1):24–40. doi: 10.1111/j.1365-2008.07393.x.
  4. Baccarani M, Corbelli G, Amadori S, et al. Adolescent and adult lymphoblastic leukemia: prognostic features outcome of therapy. А study of 293 patients. Blood. 1982;60(3):677–84.
  5. Gill PS, Meyer PR, Pavlova Z, et al. B-cell acute lymphoblastic leukemia in adults: clinical, morphologic and immunologic findings. J Clin Oncol. 1986;4(5):737–43.
  6. Bernstein JI, Coleman CN, Strickler JG, et al. Combined modality therapy for adult with small noncleaved cell lymphoma (Burkitt and Burkitt-like type). J Clin Oncol. 1986;4(6):847–58.
  7. Reiter A, Schrappe M, Tiemann M, et al. Improved treatment results in childhood B-cell neoplasms with tailored intensification of therapy: a report of the Berlin-Frankfurt-Munster Group Trial NHL-BFM-90. Blood. 1999;94(10):3294–306.
  8. Patte C, J. Michon, Frappaz D, et al. Therapy of Burkitt and other B-cell acute lymphoblastic leukaemia and lymphoma: experience with the LMB protocols of the SFOP (French Paediatric Oncology Society) in children and adults. Bail Clin Haematol. 1994;7(2):339–48. doi: 10.1016/s0950-3536(05)80206-
  9. Patte C, Philip T, Rodary C, et al. High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol. 1991;9(1):123–32.
  10. Sun XF, Su YS, Liu DG, et al. Comparing CHOP, CHOP+HD-MTX, and BFM-90 regimens in the survival rate of children and adolescents with B cell non-Hodgkin’s lymphoma. Ai Zheng. 2004;23(8):933–8.
  11. Muller J, Csoka M, Jakab Z, et al. Hungarian experience with non-Hodgkin’s lymphoma in childhood. Magy Onkol. 2006;50(3):253–9.
  12. Cairo MS, Sposto R, Gerrard M, et al. Advanced stage, increased lactate dehydrogenase, and primary site, but not adolescent age (³ 15 years), are associated with an increased risk of treatment failure in children and adolescents with mature B-cell non-Hodgkin’s lymphoma: results of the FAB LMB 96 study. J Clin Oncol. 2012;30(4):387–93. doi: 10.1200/jco.2010.33.3369.
  13. Schwenn M, Blattner S, Lynch E, et al. HiC-COM: a 2-month intensive chemotherapy regimen for children with stage III and IV Burkitt’s lymphoma and B-cell acute lymphoblastic leukemia. J Clin Oncol. 1991;9(1):133–8.
  14. Bowman WP, Shuster JJ, Cook B, et al. Improved survival for children with B-cell acute lymphoblastic leukemia and stage IV small noncleaved-cell lymphoma: a pediatric oncology group study. J Clin Oncol. 1996;14(4):1252–61.
  15. Magrath I, Adde M, Shad A, et al. Adults and children with small non-cleaved-cell lymphoma have similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996;14(3):925–34.
  16. Atra A, Gerrard M, Hobson R, et al. Improved cure rate in children with B-cell acute lymphoblastic leukemia and IV stage B-cell non-Hodgkin lymphoma – results of the UKCCSG 9003 protocol. Br J Cancer. 1998;77(12):2281–5. doi: 10.1038/bjc.1998.379.
  17. Burkhardt B, Oschlies I, Klapper W, et al. Non-Hodgkin’s lymphoma in adolescents: experiences in 378 adolescent NHL patients treated according to pediatric NHL-BFM protocols. Leukemia. 2011;25(1):153–60. doi: 10.1038/leu.2010.245.
  18. Patte C, Auperin A, Michon J, et al. The Societe Francaise d’Oncologie Pediatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood. 2001;97(11):3370–9. doi: 10.1182/blood.v97.11.3370.
  19. Patte C, Auperin A, Gerrard M, et al. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007;109(7):2773–80. doi: 10.1182/blood-2006-07-
  20. Laver JH, Kraveka JM, Hutchison RE, et al. Advanced-stage large-cell lymphoma in children and adolescents: results of a randomized trial incorporating intermediate-dose methotrexate and high-dose cytarabine in the maintenance phase of the APO regimen: a Pediatric Oncology Group phase III trial. J Clin Oncol. 2005;23(3):541–7. doi: 10.1200/jco.2005.11.075.
  21. Woessmann W, Seidemann K, Mann G.et al. The impact of the methotrexate administration schedule and dose in the treatment of children and adolescents with B-cell neoplasms: a report of the BFM Group Study NHL-BFM95. Blood. 2005;105(3):948–58. doi: 10.1182/blood-2004-03-
  22. Gerrard M, Cairo MS, Weston C, et al. Excellent survival following two courses of COPAD chemotherapy. Br J Haematol. 2008;141(6):840–87. doi: 10.1111/j.1365-2008.07144.x.
  23. Seidemann K, Tiemann M, Lauterbach I, et al. Primary mediastinal large B-cell lymphoma with sclerosis in pediatric and adolescent patients: treatment and results from three therapeutic studies of the Berlin-Frankfurt-Munster Group. J Clin Oncol. 2003;21(9):1782–19. doi: 10.1200/jco.2003.08.151.
  24. Akbayram S, Dogan M, Akgun C, et al. Use of rituximab in three children with relapsed/refractory Burkitt lymphoma. Target Oncol. 2010;5(4):291–4. doi: 10.1007/s11523-010-0161-
  25. Okur VF, Oguz A, Karadeniz C, et al. Refractoriness to rituximab monotherapy in a child with relapsed/refractory Burkitt non-Hodgkin lymphoma. Pediatr Hematol Oncol. 2006;23(1):25–31. doi: 10.1080/08880010500313298.
  26. Holmberg LA, Maloney D, Bensinger W. Immunotherapy with rituximab/interleukin-2 after autologous stem cell transplantation as treatment for CD20+ non-Hodgkin’s lymphoma. Clin Lymph Myel. 2006;7(2):135–9. doi: 10.3816/clm.2006.n.051.
  27. Cooney-Qualter E, Krailo M, Angiolillo A.et al. A Phase I Study of 90Yttrium-Ibritumomab-Tiuxetan in Children and Adolescents with Relapsed/Refractory CD20-Positive Non-Hodgkin’s Lymphoma: A Children’s Oncology Group study. Clin Cancer Res. 2007;13(Suppl 18):5652–60. doi: 10.1158/1078-ccr-07-1060.
  28. Richard H, Termuhlen A, Smith L, et al. Autologous peripheral blood stem cell transplantation in children with refractory or relapsed lymphoma: results of Children’s Oncology Group Study A5962. Biol Blood Marrow Transplant. 2011;17(2):249–58. doi: 10.1016/j.bbmt.2010.07.002.
  29. Pinkel D, Johnson W, Aur RJ. Non-Hodgkin’s lymphoma in children. Br J Cancer. 1975;2:298–23.
  30. Wollner N, Exelby PR, Lieberman PH. Non-Hodgkin’s lymphoma in children: a progress report on the original patients treated with the LSA2-L2 protocol. Cancer. 1979;44(6):1990–9. doi: 10.1002/1097-0142(197912)44:6<1990::aid-cncr2820440605>3.0.co;2-
  31. Asselin BL, Devidas M, Wang C, et al. Effectiveness of high-dose methotrexate in T-cell lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma: a randomized study by the Children’s Oncology Group (POG 9404). Blood. 2011;118(4):874–83. doi: 10.1182/blood-2010-06-
  32. Wiernik P, Goldman J, Dutcher J. Neoplastic disease of the blood. Cambridge; 1216 p.
  33. Tubergen D, Krailo M, Meadows A, et al. Comparison of treatment regimens for pediatric lymphoblastic non-Hodgkin’s lymphoma: a Children’s Cancer Group study. J Clin Oncol Leuk. 1999;13(3):335–42.
  34. Amylon MD, Shuster J, Pullen J, et al. Intensive high-dose asparaginase consolidation improves survival for pediatric patients with T cell acute lymphoblastic leukemia and advanced stage lymphoblastic lymphoma; Pediatr Oncol Group study. Leukemia. 1999;13(3):335–42. doi: 1038/sj.leu.2401310.
  35. Patte C, Philip T, Rodary C, et al. Improved survival rate in children with stage III-IV B-cell non-Hodgkin lymphoma and leukemia using multiagent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. J Clin Oncol. 1986;4(8):1219–26.
  36. Reiter A, Schrappe M, Ludwig WD, et al. Favorable outcome of B-cell acute lymphoblastic leukemia in childhood: a report of three consecutive studies of the BFM group. Blood. 1992;80(10):2471–8.
  37. Reiter A, Schrappe M, Parwaresch R, et al. Non-Hodgkin’s lymphomas of childhood and adolescence: results of a treatment stratified for biologic subtypes and stage – a report of the Berlin-Frankfurt-Munster Group. J Clin Oncol. 1995;13(2):359–72.
  38. Nachman J, Sather HN, Cherlow JM, et al. Response of children with high-risk acute lymphoblastic leukemia treated with and without cranial irradiation: a report from the Children’s Cancer Group. J Clin Oncol. 1998;16(3):920–30.
  39. Tang JY, Xue HL, Chen J, et al. Multi-center trial based on SCMC-ALL-2005 for children’s acute lymphoblastic leukemia. Zhonghua Er Ke Za Zhi. 2013;51(7):495–501.
  40. Tallen G, Ratei R, Mann G, et al. Long-term outcome in children with relapsed acute lymphoblastic leukemia after time-point and site-of-relapse stratification and intensified short-course multidrug chemotherapy: results of trial ALL-REZ BFM 90. J Clin Oncol. 2010;28(14):2339–47. doi: 10.1200/jco.2009.25.1983.
  41. Dunsmore KP, Devidas M, Linda SB, et al. Pilot study of nelarabine in combination with intensive chemotherapy in high-risk T-cell acute lymphoblastic leukemia: a report from the Children’s Oncology Group. J Clin Oncol. 2012;30(22):2753–9. doi: 10.1200/jco.2011.40.8724.
  42. Lambe CU, Averett DR, Paff MT, et al. 2-Amino-6-methoxypurine arabinoside: an agent for T-cell malignancies. Cancer Res. 1995;55(15):3352–6.
  43. Cooper TM, Razzouk BI, Gerbing R, et al. Phase I/II trial of clofarabine and cytarabine in children with relapsed/refractory acute lymphoblastic leukemia (AAML0523): a report from the Children’s Oncology Group. Pediatr Blood Cancer. 2013;60(7):1141–7. doi: 10.1002/pbc.24398.
  44. Schroeder H, Garwicz S, Kristinsson J, et al. Outcome after first relapse in children with acute lymphoblastic leukemia: a population-based study of 315 patients from the Nordic Society of Pediatric Hematology and Oncology (NOPHO). Med Pediatr Oncol. 1995;25(5):372–8. doi: 10.1002/mpo.2950250503.
  45. Rosenwald A, Wright G, Leroy K, et al. Molecular diagnosis of primary mediastinal B cell lymphoma identifies a clinically favourable subgroup of diffuse large B cell lymphoma related to Hodgkin lymphoma. J Exp Med. 2003;198(6):851–62. doi: 10.1084/jem.20031074.
  46. Borgmann A, von Stackelberg A, Hartmann R, et al. Unrelated donor stem cell transplantation compared with chemotherapy for children with acute lymphoblastic leukemia in a second remission: a matched-pair analysis. 2003;101(10):3835–9. doi: 10.1182/blood.v101.10.3835.
  47. Wheeler K, Richards S, Bailey C, et al. Comparison of bone marrow transplant and chemotherapy for relapsed childhood acute lymphoblastic leukaemia: the MRC UKALL X experience. Medical Research Council Working Party on Childhood Leukaemia. Br J Haematol. 1998;101(1):94–103. doi: 10.1046/j.1365-2141.1998.00676.x.
  48. Stein H, Mason DY, Gerdes J, et al. The expression of Hodgkin’s disease associated antigen Ki-1 in reactive and neoplasic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from avtivated lymphoid cells. Blood. 1985;66(4):848–58.
  49. Ferreri AJ, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-negative. Crit Rev Oncol Hematol. 2013;85(2):206–15. doi: 10.1016/j.critrevonc.2012.06.004.
  50. Sibon D, Fournier M, Briere J, et al. Prognostic Factors and Long Term Outcome of 138 Adults with Systemic Anaplastic Large-Cell Lymphoma: a Retrospective Study by the Groupe d’Etude Des Lymphomes De l’Adulte (GELA). Blood. 2010;116: Abstract 322.
  51. Park SJ, Kim S, Lee DH, et al. Primary Systemic Anaplastic Large Cell Lymphoma in Korean Adults: 11 Years’ Experience at Asan Medical Center. Yonsei Med J. 2008;49(4):601–9. doi: 10.3349/ymj.2008.49.4.601.
  52. Wang YF, Yang YL, Gao ZF, et al. Clinical and laboratory characteristics of systemic anaplastic large cell lymphoma in Chinese patients. J Hematol Oncol. 2012;5(1):38. doi: 10.1186/1756-8722-5-38.
  53. Amin HM, Lai R. Pathobiology of ALK+ anaplastic large-cell lymphoma. Blood. 2007;110(7):2259–67. doi: 10.1182/blood-2007-04-060715.
  54. Moreno L, Garzon L, Bautista FJ, et al. Diagnosis of paediatric anaplastic large-cell lymphoma: a historical perspective from a single institution. Clin Transl Oncol. 2009;11(5):318–21. doi: 10.1007/s12094-009-0360-
  55. Le Deley MC, Reiter A, Williams D, et al. Prognostic factors in childhood anaplastic large cell lymphoma: results of a large European intergroup study. Blood. 2008;111(3):1560–6. doi: 10.1182/blood-2007-07-
  56. Pillon M, Gregucci F, Lombardi A, et al. Results of AIEOP LNH-97 protocol for the treatment of anaplastic large cell lymphoma of childhood. Pediatr Blood Cancer. 2012;59(5):828–33. doi: 10.1002/pbc.24125.
  57. Gascoyne RD, Aoun P, Wu D, et al. Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. Blood. 1999;93(11):3913–21.
  58. Savage KJ, Harris NL, Vose JM, et al. ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral Tcell Lymphoma Project. Blood. 2008;111(12):5496–504. doi: 10.1182/blood-2008-01-
  59. Abramov D, Oschlies I, Zimmermann M, et al. Expression of CD8 is associated with non-common type morphology and outcome in pediatric anaplastic lymphoma kinase-positive anaplastic large cell lymphoma. Haematologica. 2013;98(10):1547–53. doi: 10.3324/haematol.2013.085837.
  60. Damm-Welk C, Mussolin L, Zimmermann M, et al. Early assessment of minimal residual disease identifies patients at very high relapse risk in NPM-ALK-positive anaplastic large-cell lymphoma. Blood. 2014;123(3):334–7. doi: 10.1182/blood-2013-09-
  61. Bonvini P, Gastaldi T, Falini B, et al. Nucleophosmin-anaplastic lymphoma kinase (NPM-ALK), a novel Hsp90-client tyrosine kinase: down-regulation of NPM-ALK expression and tyrosine phosphorylation in ALK+ CD30+ lymphoma cells by Hsp90 antagonist 17-allylamino, 17-demethoxygeldanamycin. Cancer Res. 2002;62(5):1559–66.
  62. Ergin M, Denning MF, Izban KF, et al. Inhibition of tyrosine kinase activity induces caspase-dependent apoptosis in anaplastic large cell lymphoma with NPM-ALK (p80) fusion protein. Exp Hematol. 2001;29(9):1082–90. doi: 10.1016/s0301-472x(01)00688-
  63. Han Y, Amin HM, Franko B, et al. Loss of SHP1 enhances JAK3/STAT3 signaling and decreases proteasome degradation of JAK3 and NPM-ALK in ALK+ anaplastic large-cell lymphoma. Blood. 2006;108(8):2796–803. doi: 10.1182/blood-2006-04-
  64. Ogura M, Tobinai K, Hatake K, et al. Phase I/II study of brentuximab vedotin in Japanese patients with relapsed or refractory CD30-positive Hodgkin’s lymphoma or systemic anaplastic large-cell lymphoma. Cancer Sci. 2014;105(7):840–6. doi: 10.1111/cas.12435.
  65. Mosse YP, Lim MS, Voss SD, et al. Safety and activity of crizotinib for paediatric patients with refractory solid tumours or anaplastic large-cell lymphoma: a Children’s Oncology Group phase 1 consortium study. Lancet Oncol. 2013;14(6):472–80. doi: 10.1016/s1470-2045(13)70095-
  66. Brugieres L, Le Deley MC, Rosolen A, et al. Impact of the methotrexate administration dose on the need for intrathecal treatment in children and adolescents with anaplastic large-cell lymphoma: a results of a randomized trial of the EICNHL Group. J Clin Oncol. 2009;27(6):897–903. doi: 10.1200/jco.2008.18.1487.
  67. Seidemann K, Tiemann M, Schrappe M, et al. Short-pulse B-non-Hodgkin lymphoma-type chemotherapy is efficacious treatment for pediatric anaplastic large cell lymphoma: a report of the Berlin-Frankfurt-Munster Group Trial NHL-BFM 90. Blood. 2001;97(12):3699–706. doi: 10.1182/blood.v97.12.3699.
  68. Woessmann W, Zimmermann M, Lenhard M, et al. Relapsed or refractory anaplastic large-cell lymphoma in children and adolescents after Berlin-Frankfurt-Muenster (BFM)-type first-line therapy: a BFM-group study. J Clin Oncol. 2011;29(22):3065–71. doi: 10.1200/jco.2011.34.8417.
  69. Goldberg JD, Casulo C, Horwitz The role of hematopoietic stem cell transplantation in peripheral T-cell lymphomas. In: Non-Hodgkin Lymphoma Cancer Drug Discovery and Development. Springer; 2013. pp. 279–93. doi: 10.1007/978-1-4614-5851-7_16.
  70. Giulino-Roth L, Ricafort R, Kernan NA, et al. Ten-year follow-up of pediatric patients with non-Hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation. Pediatr Blood Cancer. 2013;60(12):2018–24. doi: 10.1002/pbc.24722.
  71. Woessmann W, Peters C, Lenhard M. Allogeneic haematopoietic stem cell transplantation in relapsed or refractory anaplastic large cell lymphoma of children and adolescents – a Berlin-Frankfurt-Munster group report. Br J Haematol. 2006;133(2):176–82. doi: 10.1111/j.1365-2141.2006.06004.x.
  72. Mori T, Takimoto T, Katano N, et al. Recurrent childhood anaplastic large cell lymphoma: a retrospective analysis of registered cases in Japan. Br J Haematol. 2006;132(5):594–7. doi: 10.1111/j.1365-2005.05910.x.
  73. Луговская С.А., Почтарь М.Е., Тупицын Н.Н. Иммунофенотипирование в диагностике гемобластозов. М.: Триада, 2005. 165 с.
    [Lugovskaya SA, Pochtar’ ME, Tupitsyn NN. Immunofenotipirovanie v diagnostike gemoblastozov. (Immunophenotyping in diagnosis of hemoblastoses.) Moscow: Triada Publ.; 2005. 165 p. (In Russ)]
  74. Курильников А.Я. Мабтера — первые моноклональные антитела в терапии неходжкинских лимфом. Современная онкология. 2002;4(1):25–8.
    [Kuril’nikov AYa. Mabtera: first monoclonal antibodies in therapy of non-Hodgkin’s lymphomas. Sovremennaya onkologiya. 2002;4(1):25–8. (In Russ)]
  75. Reff M, Carner C, Chambers K, et al. Depletion of B-cells in vivo by a chimeric mouse human monoclonal antibody to CD20. Blood. 1994;83(2):435–45.
  76. Okur FV, Oguz A, Karadeniz C, et al. Refractoriness to rituximab monotherapy in a child with relapsed/refractory Burkitt non-Hodgkin lymphoma. Pediatr Hematol Oncol. 2006;23(1):25–31. doi: 10.1080/08880010500313298.
  77. Marcus R, Hagenbeek A. The therapeutic use of rituximab in non-Hodgkin’s lymphoma. Eur J Haematol. 2007;78(s67):5–14. doi: 10.1111/j.1600-0609.2006.00789.x.
  78. Plosker GL, Figgitt DP. Rituximab. Drugs. 2003;63(8):803–43. doi: 10.2165/00003495-200363080-
  79. Михайлова Н.Б. Роль ритуксимаба в лечении неходжкинских лимфом (реферативный обзор рандомизированных клинических исследований). Современная онкология. 2009;11(3):28–31.
    [Mikhailova NB. Role of rituximab in treatment of non-Hodgkin’s lymphomas (abstract review of randomized clinical trials). Sovremennaya onkologiya. 2009;11(3):28–31. (In Russ)]
  80. Li X, Liu Z, Cao J, et al. Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in China: a 10-year retrospective follow-up analysis of 437 cases from Shanghai Lymphoma Research Group. Ann Hematol. 2012;91(6):837–45. doi: 10.1007/s00277-011-1375-
  81. Thomas DA, Faderl S, O’Brien S, et al. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. 2006;106(7):1569–80. doi: 10.1002/cncr.21776.
  82. Fayad L, Thomas D, Romaguera J. Update of the M. D. Anderson Cancer Center experience with hyper-CVAD and rituximab for the treatment of mantle cell and Burkitt-type lymphomas. Clin Lymph Myel. 2007;8(2):57–62. doi: 10.3816/clm.2007.s.034.
  83. Meinhardt A, Burkhardt B, Zimmermann M, et al. Phase II Window Study on Rituximab in Newly Diagnosed Pediatric Mature B-Cell Non-Hodgkin’s Lymphoma and Burkitt Leukemia. J Clin Oncol. 2010;28(19):3115–21. doi: 10.1200/jco.2009.26.6791.
  84. Bilic E, Femenic R, Conja J, et al. CD20-positive childhood B-non-Hodgkin lymphoma: morphology, immunophenotype and a novel treatment approach: a single center experience. Coll Antropol. 2010;34(1):171–5.
  85. Смирнова Н.В., Мякова Н.В., Белогурова М.Б. и др. Лечение зрелоклеточных В-клеточных неходжкинских лимфом с использованием комбинированной иммунохимиотерапии: возможности оптимизации терапевтической стратегии. Онкогематология. 2015;10(4):15–24. doi: 10.17650/1818-8346-2015-10-4-15-24.
    [Smirnova NV, Myakova NV, Belogurova MB, et al. Treatment of B-cells non-Hodgkin lymphomas with combined immunochemotherapy: ability to treatment optimization. Oncohematology. 2015;10(4):15–24. doi: 10.17650/1818-8346-2015-10-4-15-24. (In Russ)]
  86. Miyamoto KI, Kobayashi Y, Maeshima AM, et al. Clinicopathological prognostic factors of 24 patients with B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Int J Hematol. 2016;103(6):693–702. doi: 1007/s12185-016-1989-z.
  87. Gerrard M, Cairo MS, Weston C, et al. Excellent survival following two courses of COPAD chemotherapy. Br J Haematol. 2008;141(6):840–7. doi: 10.1111/j.1365-2008.07144.x.
  88. Patte C, Auperin A, Gerrard M, et al. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007;109(7):2773–80. doi: 10.1182/blood-2006-07-
  89. Stary J, Zimmermann M, Campbell M, et al. Intensive chemotherapy for childhood acute lymphoblastic leukemia: results of the randomized intercontinental trial ALL IC-BFM 2002. J Clin Oncol. 2014;32(3):174–84. doi: 10.1200/jco.2013.48.6522.

 

Значение биохимического исследования мозгового натрийуретического пептида у больных c диффузной В-крупноклеточной лимфомой

ЛАБОРАТОРНАЯ ДИАГНОСТИКА , , , , ,

М.О. Егорова, Е.Н. Комолова, C.Е. Самсонова

ФГБУ «Гематологический научный центр» МЗ РФ, Москва, Российская Федерация

РЕФЕРАТ

<Работа посвящена исследованию концентрации мозгового натрийуретического пептида (brain natriuretic peptide — BNP) в крови больных диффузной В-крупноклеточной лимфомой (ДВКЛ) до начала полихимиотерапии и после ее проведения. В исследование включено 10 пациентов. Среди них было 6 мужчин и 4 женщины в возрасте 39–63 лет (средний возраст 51 ± 12 лет). Группу контроля составили 20 практически здоровых доноров. В работе показано, что при ДВКЛ на основании исследования BNP в плазме можно выявить группы больных с высоким риском сердечной недостаточности. Результаты скрининговых исследований с определением уровня BNP могут влиять на выбор химиотерапии при ДВКЛ.

Ключевые слова: диффузная В-крупноклеточная лимфома, химиотерапия, мозговой натрийуретический пептид, BNP, острый инфаркт миокарда, застойная левожелудочковая недостаточность.

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ЛИТЕРАТУРА

  1. Морозова А.К., Звонков Е.Е., Кременецкая А.М. и др. Первый опыт применения модифицированной программы NHL-BFM-90 при лечении пер- вичной диффузной B-крупноклеточной лимфосаркомы костей и мягких тканей с факторами неблагоприятного прогноза. Тер. арх. 2009; 7: 61–5. [Morozova A.K., Zvonkov Ye.Ye., Kremenetskaya A.M., et al. Initial experience with using modified NHL-BFM-90 program in management of primary diffuse large B-cell lymphosarcoma of bones and soft tissues with unfavorable prognostic factors. Ter. arkh. 2009; 7: 61–5. (In Russ.)].
  2. Myers C. The Role of Iron in Doxorubicin-Induced Cardiomyopathy. Sem. Oncol. 1998; 25(4 Suppl. 10): 10–4.
  3. Орел Н.Ф. Кардиотоксичность антрациклинов: возможности преодо- ления. Совр. онкол. 2004; 3: 121–4. [Orel N.F. Cardiotoxicity of anthracyclines: potential overcoming. Sovr. onkol. 2004; 3: 121–4. (In Russ.)].
  4. Bhardwaj A., Rehman S.U., Mohammed A. et al. Design and methods of the Pro-B Type Natriuretic peptide outpatient tailored chronic heart failure therapy (PROTECT) Study. Am. Heart J. 2010; 159: 532–8.el.
  5. Maisel A.S., Krishnaswamy P., Nowak R.M. et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N. Engl. J. Med. 2002; 347: 161–7.
  6. Sadanandan S., Cannon C.P., Chekuri K. et al. Association of elevated B-type natriuretic peptide levels with angiographic findings among patients with unstable angina and non-ST-segment elevation myocardial infarction. J. Am. Coll. Cardiol. 2004; 44: 564–8.
  7. Елисеев О.М. Натрийуретические пептиды: эволюция знаний. Тер. арх. 2003; 9: 40–5. [Yeliseyev O.M. Natriuretic peptides: knowledge evolution. Ter. arkh. 2003; 9: 40–5. (In Russ.)].
  8. Gackowskia A., Isnarda R., Golmardc J.-L. et al. Comparison of echocardiography and plasma B-type natriuretic peptide for monitoring the response to treatment in acute heart failure. Eur. Heart J. 2004; 25: 1788–96.
  9. Days J., Lehman R., Glasziou P. The Role of BNP Testing in Heart Failure. Am. Fam. Phys. 2006; 74(11): 1893–900.
  10. Harrison A., Morrison L.K., Krishnaswamy P. et al. B-Type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea. Ann. Emerg. Med. 2002; 39: 131–8.
  11. Leya F.S., Arab D., Joyal D. et al. The efficacy of brain natriuretic peptide levels in differentiating constrictive pericarditis from restrictive cardiomyopathy. J. Am. Coll. Cardiol. 2005; 45: 1900–2.

Лучевая терапия в комбинированном лечении диффузной B-крупноклеточной лимфомы

КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ ЛИМФОИДНЫХ ОПУХОЛЕЙ , , ,

Ю.Н. Виноградова, Н.В. Ильин, Д.В. Ларинов, М.М. Ходжибекова, Н.А. Костеников, Л.И. Корытова

ФГБУ «Российский научный центр радиологии и хирургических технологий» МЗ РФ, Санкт-Петербург, Российская Федерация

РЕФЕРАТ

В исследование включено 86 первичных больных диффузной В-крупноклеточной лимфомой I–IV стадии в возрасте от 18 до 83 лет, получавших лечение по схеме (R)-СНОР и лучевую терапию в ЦНИРРИ (РНЦРХТ) в период с 2000 по 2012 г. Медиана наблюдения составила 42 мес. (диапазон 5–120 мес.). ПЭТ с 18F-ФДГ выполнена 45 больным. У всех пациентов изучали динамику гематологических показателей исходно, до и после лучевой терапии. После комбинированного лечения ремиссия достигнута у 80 (93 %) из 86 больных, полная и неуверенная или неподтвержденная/сомнительная полная — у 86 %, частичная — у 7 %. Прогрессирование заболевания в процессе первичной терапии наблюдали у 6 (7,0 %) пациентов. После этапа лекарственного лечения полная ремиссия констатирована лишь у 56 (65,1 %) пациентов. Дополнительная лучевая терапия способствовала увеличению частоты полного/неуверенного полного ответа на 21,9 %. Генерализованные рецидивы опухоли развились у 2 (2,5 %) из 80 больных. В группах пациентов, получавших облучение в разных режимах фракционирования, частота полного ответа не различалась. Показатели общей 5-летней, безрецидивной и выживаемости без прогрессирования составили 89,7 ± 3,9, 96,6 ± 2,4 и 85,4 ± 4,8 % соответственно. У 20,6 % больных, обследованных после этапа (иммуно-)химиотерапии, результаты ПЭТ-исследования были положительными. В то же время после лучевого этапа все обследованные в эти сроки больные оказались ПЭТ-отрицательными. При лучевой терапии гематологическая токсичность была в основном I–II степени, у 16–58 % больных прерывание лечения не требовалось. Нейтропения и тромбоцитопения встречались чаще при облучении больных 2 раза в день.

Ключевые слова: диффузная В-крупноклеточная лимфома, лучевая терапия, позитронная эмиссионная томография, гематологическая токсичность

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Литература

  1. Friedberg J.W. Pros — R-CHOP is the current standard therapy for patients with advanced stage DLBCL. Hematol. Oncol. Special Issue: 12th International Conference on Malignant Lymphoma, Palazzo dei Congressi, Lugano, Switzerland, June 19–22, 2013; 31: Abstract 004.
  2. Miller T.P., Dahlberg S., Cassady J.R. et al. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate and high grade non Hodgkin’s lymphoma. N. Engl. J. Med. 1998; 339: 21–6.
  3. Ng A.K., Mauch P.M. Role of radiation therapy in localized aggressive lymphoma. J. Clin. Oncol. 2007; 25: 757–9. 4. Gospodarowicz M.K. Radiotherapy in non-Hodgkin lymphomas. Ann. Oncol. 2008; 19(4): 47–50.
  4. Illidge T.X. When should radiotherapy be used in lymphoma? Ann. Oncol. 2011; 22(4): 57–60.
  5. Tilly H., Vitolo U., Walewski J. et al. Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2012; 23(7): 78–82.
  6. Асланиди И.П., Мухортова О.В., Шурупова И.В. и др. Позитронно- эмиссионная томография: уточнение стадии болезни при злокачественных лимфомах. Клин. онкогематол. 2010; 3(2): 119–29.[Aslanidi I.P., Mukhortova O.V., Shurupova I.V. i dr. Pozitronnoemissionnaya tomografiya: utochneniye stadii bolezni pri zlokachestvennykh limfomakh (Positron emission tomography: ascertaining disease stage in malignant lymphomas. In: Clin. oncohematol.). Klin. onkogematol. 2010; 3(2): 119–29.]
  7. Yahalom J., Mauch P. The involved field is back: issues in delineating the radiation field in Hodgkin’s disease. Ann. Oncol. 2002; 13(1): 79–83.
  8. Cheson B., Horning S., Coiffer B. et al. Report of an International Workshop to standardize Response Criteria for Non-Hodgkin’s Lymphomas. J. Clin. Oncol. 1999; 17(4): 1244–53.
  9. Cheson B., Pfistner B., Juweid M. et al. Revised response criteria for malignant lymphoma. J. Clin. Oncol. 2007; 25: 579–86.
  10. Cox J., Stetz J., Pajak T. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and European Organization for Research and Treatment of Cancer (EORTC). Intern. J. Radiat. Oncol. Biol. Phys. 1995; 31: 1341–6.
  11. Morschhauser F. R-CHOP is not the standard for high-risk DLBCL. Hematological Oncology. Special Issue: 12th International Conference on Malignant Lymphoma, Palazzo dei Congressi, Lugano, Switzerland, June 19–22, 2013; 31: Abstrфсе 005.
  12. Zelenetz А.О., Abramson J.S., Advani R.H. et al. NCCN Clinical Practice Guidelines in Oncology non Hodgkin’s lymphomas. J. Natl. Compr. Canc. Netw. 2010; 8: 288–334.
  13. Phan J., Mazloom A., Jeffrey Medeiros L. et al. Benefit of consolidative radiation therapy in patients with diffuse large В cell lymphoma treated with RCHOP chemotherapy. J. Clin. Oncol. 2010; 28: 4170–6.
  14. Bonnet С., Fillet G., Mournier N. et al. CHOP alone compared with CHOP plus radiotherapy for localised aggressive lymphoma in elderly patients a study by the Groupe d Etude des Lymphomes de l’ Adulte. J. Clin. Oncol. 2007; 25: 787–92.
  15. Dabaja B., Vanderplas A., Abel G. et al. Pole of radiation in patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era: a comprehensive analysis from the National Comprehensive Cancer Network (NCCN) lymphoma outcomes project. Hematol. Oncol. 2013; 31(1): 136.
  16. Zwick C., Held G., Ziepert M. et al. The role of radiotherapy to bulky disease in elderly patients with aggressive B-cell lymphoma. Results from two prospective trials of the DSHNHL. Hematol. Oncol. 2013; 31(1): 137.
  17. Sehn L.H., Klasa R., Shenkier T. et al. Long-term experience with PETguided consolidative radiation therapy (XRT) in patients with advanced stage diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP. Hematol. Oncol. 2013; 31(1): 137.
  18. Gang A. O., Strom C., Pedersen M. et al. R-CHOEP-14 improves overall survival in young high-risk patients with diffuse large B-cell lymphoma compared with R-CHOP-14. A population-based investigation from the Danish Lymphoma Group. Ann. Oncol. 2012; 23(1): 147–53.
  19. Bosly A., Bron D., Van Hoof A. et al. Achievement of optimal average relative dose intensity and correlation with survival in diffuse large B-cell lymphoma patients treated with CHOP. Ann. Hematol. 2008; 87: 277–83.
  20. Pfreundschuh M., Schubert J., Ziepert M. et al. Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomized controlled trial (RICOVER-60). Lancet Oncol. 2008; 9(2): 105–16.
  21. Persky D.O., Unger J.M., Speir C.M. et al. Phase II study of rituximab plus 3 cycles of CHOP and involved field radiotherapy for patients with limited stage aggressive B cell lymphoma: Southwest Oncology Group Study 0014. J. Clin. Oncol. 2008; 26: 2258–63.
  22. Linch D. Today’s treatment of diffuse large B-cell lymphomas in adults. Hematol. Educ. (The education program for the annual congress of the EHA) 2011; 5: 210–6. 24. Jaeger U., TrnenyM., Melzer H. et al. Rituximab maintenance treatment versus observation in patients with aggressive B-cell lymphoma: results of the AGMT NHL13 trial. Hematol. Oncol. 2013; 31(1): 136.
  23. Swinnen L.J., Li H., Quon A. et al. Response-adapted therapy and predictive value of mid-treatment PET scanning for diffuse large B-cell lymphoma. ECOG study E3404. Hematol. Oncol. 2013; 31(1): 101.
  24. Mamot C., Klingbiel D., Renner C. Final results of a prospective evaluation of the predictive value of interim PET in patients with DLBCL under R-CHOP-14 (SAKK 38/07). Hematol. Oncol. 2013; 31(1): 100.
  25. Moskowitz C.H., Schoder H., Hamlin P.A. et al. Evaluation of dual tracer (FLT and FDG) PET imaging as part of risk-adapted therapy for patients (PTS) with advanced stage diffuse large B-cell lymphoma (DLBCL). Hematol. Oncol. 2013; 31(1): 101.