флударабин

Хронический лимфолейкоз высокого риска: история, определение, диагностика и лечениеХронический лимфолейкоз высокого риска: история, определение, диагностика и лечение

КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ ЛИМФОИДНЫХ ОПУХОЛЕЙ , , ,

Е.А. Никитин, А.Б. Судариков

Федеральное государственное бюджетное учреждение «Гематологический научный центр Министерства здравоохранения Российской Федерации», Москва, Российская Федерация

РЕФЕРАТ

Хронический лимфолейкоз высокого риска – новое и все более уточняемое понятие, которое появилось в эру флударабина. Клиническое значение ХЛЛ высокого риска объясняется очень плохим прогнозом по сравнению с остальной группой пациентов. В статье представлен краткий исторический обзор, а также современное определение этого понятия, рассматриваются молекулярные механизмы, лежащие в основе ХЛЛ высокого риска, а также подходы к терапии.

Ключевые слова: хронический лимфолейкоз, TP53, делеция 17p, флударабин.

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ЛИТЕРАТУРА

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Лечение рефрактерных форм острого лимфобластного лейкоза у детей и подростков: реиндукция ремиссии с последующей аллогенной трансплантацией гемопоэтических стволовых клеток

КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ ЛИМФОИДНЫХ ОПУХОЛЕЙ , , , , , ,

Е.В. Семёнова, Н.В. Станчева, С.Н. Бондаренко, В.Н. Вавилов, Д.А. Багге, О.В. Паина, С.В. Разумова, А.С. Боровкова, Т.А. Быкова, А.А. Рац, Л.С. Зубаровская, Б.В. Афанасьев

Институт Детской Гематологии и Трансплантологии им. Р.М. Горбачевой, Санкт-Петербургский Государственный Медицинский Университет им. академика И. П. Павлова, Санкт-Петербург, Российская Федерация

РЕФЕРАТ

Цель исследования: оценка эффективности программ химиотерапии, содержащих нуклеозидные аналоги (флударабин и неларабин) с последующим применением аллогенной трансплантации гемопоэтических стволовых клеток (алло-ТГСК) при рефрактерных формах острого лимфобластного лейкоза (ОЛЛ) у детей и подростков.

Материал и методы: Пациентам (n=33) в возрасте от 1 до 21 года (медиана – 11,5) с рецидивами и рефрактерными формами острого лимфобластного лейкоза с целью индукции ремиссии выполнена химиотерапия по схемам, содержащим флударабин (FLAG±Ida) (n=23) или неларабин (n=10). В последующем 24 пациентам в последующем проведена алло-ТГСК.

Результаты: Из 23 пациентов, получивших FLAG и FLAG-Ida полная ремиссия (ПР)  достигнута у 11 (48%). Среди 10 пациентов, которым провели лечение по схемам с неларабином, ПР получена у 7 (70%). Длительность ПР составила, в среднем, 4,9 мес (1-18 мес). Общая 3-х летняя выживаемость (ОВ) пациентов после алло-ТГСК, выполненной в ремиссии, составила 58%, в рецидиве – 8%, без алло-ТГСК – 0%.

Заключение: схемы химиотерапии, содержащие флударабин или неларабин, могут применяться  как этап подготовки с целью достижения ремиссии перед аллогенной трансплантацией гемопоэтических стволовых клеток у детей и подростков с прогностически неблагоприятными формами острого лимфобластного лейкоза.

Ключевые слова: флударабин, неларабин, алло-ТГСК, острый лимфобластный лейкоз, резистентные формы, дети, подростки.

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ЛИТЕРАТУРА

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