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Длительные режимы цитостатической терапии ангиоиммунобластной Т-клеточной лимфомы

Длительные режимы цитостатической терапии ангиоиммунобластной Т-клеточной лимфомы

Abstract

Введение. Применяемая в настоящее время СНОР-подобная терапия малоэффективна при ангиоиммунобластной Т-клеточной лимфоме (АИТЛ), что диктует необходимость поиска новых лечебных программ. Цель. Определить рациональные подходы к диагностике и лечению АИТЛ. Материалы и методы. В ФГБУ «Гематологический научный центр» МЗ РФ под наблюдением находилось 15 пациентов с АИТЛ. Медиана возраста 61 год (диапазон 29-77 лет), мужчин 11, женщин 4. У всех больных установлена IV стадия распространения опухоли. Поражение костного мозга наблюдалось у 14 (93 %) пациентов, легких у 9 (60 %), селезенки у 12 (80 %), печени у 9 (60 %), кожи у 6 (40 %). Результаты. У 11 больных применялся режим длительной цитостатической терапии на разных этапах течения АИТЛ. У 4 больных > 65 лет за основу лечения был взят раздел поддерживающей терапии из программ, разработанных для острых лимфобластных лейкозов: GMALL 2002 и ОЛЛ-2009. Иными словами, в качестве режима длительного цитостатического воздействия использовался только этап поддерживающей терапии этих протоколов. У 7 пациентов протоколы применены в полном объеме. У 6 (55 %) больных достигнута полная ремиссия заболевания. Медиана наблюдения в этой группе составила 33 мес. Заключение. Лечение больных АИТЛ короткими программами полихимиотерапии типа CHOP («импульсное» воздействие) недостаточно эффективно. Применение длительной цитостатической терапии более целесообразно, т. к. чаще позволяет достичь полные и частичные ремиссии.

Introduction: Current СНОР-like therapy for angioimmunoblastic T-cell lymphoma demonstrates unsatisfactory results with respect to the achievement of complete remission. It indicates the need in the search for new approaches to therapy of angioimmunoblastic T-cell lymphoma. Objective: To define the rational approaches to the diagnosis and treatment of angioimmunoblastic T-cell lymphoma (AITL). Materials and methods: Within the period from 2002 to 2012, we followed-up 15 patients with angioimmunoblastic T-cell lymphoma, with median age of 61 years (range 29-77) and the male/female ratio of 11/4. All patients had stage IV disease; the bone marrow, lungs, spleen, and skin were involved in 14 (93 %), 9 (60 %), 12 (80 %), and 6 (40 %) patients, respectively. Results: We used prolonged chemotherapy GMALL 2002 and ALL-2009 regimens for treatment of angioimmunoblastic T-cell lymphoma (11 patients). Complete remission was achieved in 55 % of cases with median follow up of 33 mouths. Conclusion: The usage of short-term chemotherapy programs (CHOP-like) for treatment of angioimmunoblastic T-cell lymphoma doesn't seem to give good results. Administration of prolonged chemotherapy is more appropriate and allows achieving remission of the disease.

Keywords

АНГИОИММУНОБЛАСТНАЯ Т-КЛЕТОЧНАЯ ЛИМФОМА, ДЛИТЕЛЬНАЯ ЦИТОСТАТИЧЕСКАЯ ТЕРАПИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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