RESUMO
BACKGROUND: T-cell lymphoma (TCL) is a heterogeneous group of lymphoproliferative diseases that account for 10-15% of all non-Hodgkin lymphomas. The aim of the study was to analyze the incidence of TCL in Ukraine, distribution according to subtypes and to assess the results of treatment of patients with TCL depending on lymphoma subtype and clinical-and-laboratory risk factors. PATIENTS AND METHODS: Data from 70 patients with TCL were analyzed from February 2018 to May 2021. T-cell lymphoid neoplasms were diagnosed according to the 2016 WHO classification. The patients were divided into 4 groups: 1st (A) - leukemic forms (n = 13) (received SMILE or HyperCVAD +/- auto/alloSCT); 2nd (B) - nodal T-cell lymphomas (n = 43) (CHOP-like regimens); 3rd (C) - cutaneous T-cell lymphomas (n = 9) (PUVA therapy, interferon, and methotrexate); 4th (D) - extranodal T-cell lymphomas (n = 5) (CHOP-like regimens). The response was determined according to the Lugano 2014 criteria. RESULTS: According to the study results, 5-6% of all non-Hodgkin lymphoma registered in Ukraine in 2018-2020 were T-cell lymphomas. The most common subtype was peripheral TCL (61%). In the studied groups of TCL patients, the overall response rate was 50% (n = 35). 2-years event-free survival rate was 62.27%. 2-years overall survival rate was 65.76%. 18-month progression-free and overall survival in group B was higher versus groups A, C and D. The factors of unfavorable prognosis were bone marrow involvement and the expression of Ki67 > 65% (p = 0.03 and p = 0.006, respectively). CONCLUSIONS: Histologic subtype of T-cell non-Hodgkin lymphoma influence the treatment outcome. The best overall response rate, overall survival rate, progression-free survival were in group of patients with nodal T-cell non-Hodgkin lymphomas, the worst - in patients from leukemic group. Poor prognostic factors are bone marrow involvement, and Ki-67 expression > 65%.
Assuntos
Linfoma não Hodgkin , Linfoma de Células T , Humanos , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/terapia , Linfoma de Células T/epidemiologia , Linfoma de Células T/patologia , Linfoma de Células T/terapia , Prognóstico , Estudos Prospectivos , Linfócitos T/patologiaRESUMO
BACKGROUND: Peripheral T-cell lymphomas (PTCLs) is a diverse group of lymphomas (10-15% of all non-Hodgkins lymphomas) with aggressive behavior. Despite the standard of 1st line anthracycline-containing regimens, clinical outcomes are poor compared to B-cell lymphomas. In addition, there are still debates about specific prognostic factors (PF) in PTCLs. AIMS: Primary endpoints - event-free survival (EFS) and overall survival (OS). To evaluate the prognostic significance of five PTCLs scores (International Prognostic Index - IPI, International Peripheral T-cell lymphoma Project Score - IPTCL, Prognostic Index for T-cell lymphoma - PIT, modified Prognostic Index for T-cell lymphoma - mPIT and T-cell score). PATIENTS AND METHODS: From 67 enrolled patients, only 50 were included: PTCL not otherwise specified (22, 44%), anaplastic large cell lymphoma ALK+ (anaplastic lymphoma kinase-positive) (10, 20%) and ALK (anaplastic lymphoma kinase-negative) (18, 36%). Patients received CHOP-like regimens (CHOP, CHOEP, EPOCH). RESULTS: The overall rate response was observed in 66% of cases (complete response 78%). There were 48% of relapses after the 1st line therapy during follow-up (median 11 months; range 1-85 months). Median age 57 (range 22-80) with male predominance 62%. In total, 40% of patients were > 60 years old, 48% had stage III-IV. Majority of patients were assessed by five prognostic scores. IPI (45 patients): the 3-year EFS and OS were higher for IPI 1 vs. IPI > 2 (80 vs. 18% and 87 vs. 27%, respectively; p = 0.0002). Receiver operating characteristic analysis confirmed poor clinical outcome to patients with PF > 1 (Se = 88 %; Sp = 68 %; AUC = 0.7; p = 0.0081). IPTCLP (41 patients): the presence of PF = 1-2 showed EFS and OS reduction. A 3-year EFS rate for 1-2 PF was 25 vs. 70% for PF = 0 (p = 0.003). Thus, 3-year OS in patients with PF = 0 vs. PF = 1-2 was 100 vs. 20% (p = 0.0001). PIT (42 patients): better 3-year EFS and OS in patients with PF = 0 vs. PF = 1-3 (88 vs. 28% and 100 vs. 34%, respectively, p = 0.001). Patients with PF = 1-3 have a higher rate of relapses vs. PF = 0 (p = 0.0005 by Cox-test). mPIT (21 patients): no significant difference between PF and clinical outcomes. T-cell score (18 patients): higher survival rates with PF 2. More than 2 PF have an impact on EFS (p = 0.005). The 3-years OS in patients with PF 2 was 77 vs. 25% in cases with PF 3 (p = 0.001). CONCLUSION: IPI, PIT, IPTCLP are still very useful in defining risk stratification. As to mPIT and T-cell score, more patients to evaluate their prognostication possibility are needed.
Assuntos
Linfoma de Células T Periférico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Linfoma de Células T Periférico/tratamento farmacológico , Linfoma de Células T Periférico/mortalidade , Linfoma de Células T Periférico/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , Ucrânia , Adulto JovemRESUMO
Determination the complex of new prognostic risk factors will optimize and improve treatment and survival of patients with primary Hodgkin's Lymphoma.
Assuntos
Biomarcadores Tumorais/metabolismo , Infecções por Vírus Epstein-Barr/diagnóstico , Doença de Hodgkin/diagnóstico , Antígeno Ki-67/metabolismo , Proteínas da Matriz Viral/metabolismo , Intervalo Livre de Doença , Infecções por Vírus Epstein-Barr/mortalidade , Infecções por Vírus Epstein-Barr/patologia , Infecções por Vírus Epstein-Barr/virologia , Doença de Hodgkin/mortalidade , Doença de Hodgkin/patologia , Doença de Hodgkin/virologia , Humanos , Estadiamento de Neoplasias , Prognóstico , Fatores de RiscoRESUMO
Presented literature data on the occurrence, diagnosis and treatment of primary lymphoma of bone. Case reports described in medical practice.
Assuntos
Neoplasias Ósseas/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/radioterapia , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/radioterapia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Resultado do TratamentoRESUMO
Management of non-Hodgkin's lymphomas (NHL) has been significantly changed during last 40 years from radiotherapy to modern polychemotherapy with application of monoclonal antibodies. A ten year experience of the treatment of patients with B-cell NHL with rituximab application was accumulated in National Cancer Institute. The group of patients with NHL, who were treated in oncohematology department in the period from 2001 to 2010, was chosen for study of the efficacy of the treatment with rituximab. The immediate and distant results of the treatment were evaluated in this group of patients. The usage of the polychemotherapy with rituximab was highly efficient in the treatment of primary and relapsed patients with NHL. This group shows high rate of the immediate and distant results of treatment.
Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Antígenos CD20/imunologia , Antineoplásicos/uso terapêutico , Linfócitos B/imunologia , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/imunologia , Prevenção Secundária , Adulto , Idoso , Anticorpos Monoclonais Murinos/administração & dosagem , Antígenos CD20/metabolismo , Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfócitos B/citologia , Biópsia , Intervalo Livre de Doença , Esquema de Medicação , Feminino , Humanos , Estudos Longitudinais , Linfoma não Hodgkin/mortalidade , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Rituximab , Linfócitos T/citologia , Linfócitos T/imunologia , Resultado do Tratamento , UcrâniaRESUMO
Achievements of world practice about development and prophilaxis of tromboembolic events (VTE) in cancer patients. Particular attention is paid to prevention of VTE in patients with multiply myeloma who receive chemotherapy with Thalidomide.
Assuntos
Fibrinolíticos/administração & dosagem , Mieloma Múltiplo/tratamento farmacológico , Talidomida/efeitos adversos , Trombose/tratamento farmacológico , Fatores Etários , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Ensaios Clínicos como Assunto , Combinação de Medicamentos , Enoxaparina/administração & dosagem , Enoxaparina/uso terapêutico , Fibrinolíticos/uso terapêutico , Humanos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/fisiopatologia , Fatores de Risco , Índice de Gravidade de Doença , Talidomida/administração & dosagem , Talidomida/uso terapêutico , Trombose/complicações , Trombose/fisiopatologia , Varfarina/administração & dosagem , Varfarina/uso terapêuticoRESUMO
The treatment of patients with refractory forms of Hodgkin's lymphomas in combination with chemo-radiotherapy is priority. Nevertheless, chemotherapy has to include multicomponent schemes and radiation therapy should be an addition and consolidative method to chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Feminino , Doença de Hodgkin/epidemiologia , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Masculino , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Radioterapia Adjuvante , Indução de Remissão , Fatores de Risco , Adulto JovemRESUMO
The results of treatment of patients with multiple myeloma with thalidomide and complications of this treatment are presented. Monotherapy with thalidomide and its combinations with corticosteroids and cytostatics is an effective as first line treatment and as a treatment of patients with refractory disease. The most common side effect is toxic neuropathy. Other complications are less common and are easily controlled with medications.