лечение

Стойкое восстановление донорского гемопоэза у больной с посттрансплантационным рецидивом острого миеломонобластного лейкоза с inv(3)(q21q26), –7 и экспрессией онкогена EVI1 после трансфузий донорских лимфоцитов и использования гипометилирующих агентов

ТРАНСПЛАНТАЦИЯ КОСТНОГО МОЗГА , , , , , , ,

Н.Н. Мамаев, А.В. Горбунова, Т.Л. Гиндина, О.А. Слесарчук, В.Н. Овечкина, С.Н. Бондаренко, О.В. Голощапов, В.М. Кравцова, Б.В. Афанасьев

Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, Институт детской онкологии, гематологии и трансфузиологии им. Р.М. Горбачевой, Санкт-Петербург, Российская Федерация

РЕФЕРАТ

Представлено наблюдение успешного лечения посттрансплантационного рецидива острого миеломонобластного лейкоза (М4-вариант по ФАБ) с прогностически неблагоприятными аномалиями: инверсией inv(3)(q21q26), моносомией 7 и гиперэкспрессией гена EVI1. Достигнуто стойкое восстановление донорского гемопоэза после 1-го курса высокодозной терапии цитарабином, повторных инфузий донорских лимфоцитов и нескольких курсов гипометилирующих препаратов (децитабин, азацитидин). Обсуждаются возможные молекулярные механизмы этой эффективной терапии с целью ее воспроизведения в будущем у пациентов с аналогичными клиническими ситуациями.

Ключевые слова: ОМЛ, inv(3)(q21q26), гиперэкспрессия гена EVI1, аллогенная трансплантация гемопоэтических стволовых клеток, рецидивы, лечение, инфузии донорских лимфоцитов, гипометилирующие агенты.

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ЛИТЕРАТУРА

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Эволюция взглядов на диагностику и лечение лимфомы Беркитта

КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ ЛИМФОИДНЫХ ОПУХОЛЕЙ , , ,

Т.Т. Валиев1, Е.А. Барях2

1 НИИ детской онкологии и гематологии ФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» РАМН, Москва, Российская Федерация

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

РЕФЕРАТ

В историческом аспекте освещены вопросы диагностики и лечения наиболее агрессивной лимфоидной опухоли — лимфомы Беркитта (ЛБ). Представлены клинико-лабораторные особенности эндемического и спорадического вариантов ЛБ. Описаны возможные механизмы участия вируса Эпштейна—Барр и Plasmodium falciparum в патогенезе опухоли. Приведены основные морфологические, иммунологические и цитогенетические диагностические критерии. Рассмотрены вопросы дифференциальной диагностики с гетерогенной группой диффузных В-крупноклеточных лимфом и высокоагрессивными зрелоклеточными лимфомами из В-клеток с дополнительными аберрациями протоонкогенов («double hit» и «triple hit» лимфомы). Отдельное внимание в статье уделено вопросам терапии ЛБ и месту в ней ритуксимаба.

Ключевые слова: лимфома Беркитта, клиника, диагностика, лечение.

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