[The risk-adaptive strategies of Hodgkin's lymphoma therapy].

Using of radiochemotherapy improves short-term and long-term results of treatment in patients with primary Hodgkin's lymphoma (HL) comparing with treatment by chemotherapy alone. The rates of 5-year, 10-year OS and DFS are 88%, 83% and 90%, 86% in case of radiochemotherapy, versus 73%, 66% and 72%, 68% using chemotherapy alone. The 5-year and 10-year OS, DFS estimates in treatment with ABVD are 84% and 83%, 75% and 74%; BEACOPP-baseline - 83% and 82%, 82% and 81% (p<0.05). At the same time ABVD chemotherapy develops less toxicity (p<0.001). The treatment with 6 cycles of ABVD is considered as the most appropriate in primary Hodgkin's lymphoma patients with extranodal lesions. Comparison of complications rate during chemotherapy with MOPP, ABVD, BEACOPP-baseline, BEACOPP-escalated reveals major hematologic toxicity and infectious complications rate in BEACOPP-escalated program (p<0,05). The age ≥45 years, hemoglobin <105g/l, B symptoms, fibrinogen >5g/l, involvement of 3 and more areas of lymph nodes, liver involvement, inguinal lymph nodes are defined by the multiple-factor analysis as adverse prognostic factors of patients with primary Hodgkin's lymphoma (HL) with extranodal lesions (p<0.05). Allocation of group of high risk is proved by correlation between survival and the Prognostic Score (PS). The 5-year and 10-year DFS, OS for patients with PS-0-2 estimates are 88% and 86%, 89% and 83%, for patients with PS-3-4 - 78% and 69%, 80% and 77%, for patients with PS-5-6 - 43% and 42%, 60% and 38% respectively (p<0.001).

[Combination of pegfilgrastim and plerixafor as an effective regimen of hematopoietic stem cells mobilization in cancer patients: own experience].

The method of high-dose chemotherapy is limited quantity and quality of hematopoietic material used in transplantation. In this article on own material (56 apheresis procedures) there was performed a comparative analysis of the efficacy of several mobilization regimens. In 35 patients (63%) apheresis was initiated with using DHAP ([D]examethasone; [H]igh-dose [A] ra-C; [P]latinol) + G-CSF (group No 1); in 9 patients (16%) apheresis was initiated with regimen of HDCyc ([H]igh [D] ose [Cyc]lophosphamide) + G-CSF (group No 2); in 12 patients (21%) apheresis was performed using a combination of plerixafor and pegfilgrastim (group No 3). It was shown that all three of the proposed regimens were found to be as effective. In all groups, patients failed to receive an enough amount of CD34 + cells. At the same time using new mobilizing agent plerixafor in combination with prolonged action G-CSF pegfilgrastim showed some advantages: low toxicity of this combination, which does not needs to additional blood components, antibacterial and antifungal agents, and the possibility of its use in the outpatient setting.