Vinogradova Iu E, Lutsenko I N, Kaplanskaia I B, Vorob'ev I A, Samoĭlova R S, Gorgidze L A, Ryzhikova N A, Valiev T T, Giliazitdinova E A, Dzhulakian U L, Egorova E K, Zvonkov E E, Krasil'nikova B B, Magomedova A U, Margolin O V, Mar'in D S, Kremenetskaia A M, Kravchenko S K, Vorob'ev A I
Ter Arkh. 2008;80(7):33-7.
To compare efficacy of NHL-BFM-90 and CHOP-like courses in the treatment of anaplastic large cell lymphoma (ALCL).
Twenty-two patients with ALCL participated in the study. The diagnosis was made basing on the findings of clinical, device, morphological, immunohistochemical and molecular-genetic examinations with application of a panel of monoclonal antibodies to CD30, ALK, CD3, CD4, CDS, CD7, CD34, CD15, CD68, CD20, CD45RO, CD45RA, Ki-67. 14 cases of 22 were negative by kinase of anaplastic lymphocytes (ALK-) and 8 were positive (ALK+). Mean age of ALK-ALCL patients was 39.6 +/- 4.1 years, of ALK+ALCL patients - 23.4 +/- 2.6 years. 14 patients were treated by the protocol NHL-BFM-90, 8 were initially treated with other schemes (CHOP, MACOP-B, BEACOPP and others). All 14 patients treated according to NHL-BFM-90 had ALCL stages III-IV with B-symptoms. 12 patients who completed treatment by the above protocol achieved complete remission after the forth course, 2 patients failed the treatment. Of 8 ALCL patients treated initially according to other schemes, a complete remission was achieved in 4 patients (2 had stage II). One of 4 patients with remission had recurrence. Four patients who had failed to achieve complete remission died of the disease progression.
ALCL occurs more frequently in young and middle-aged patients. The disease has an aggressive course with rapid generalization. For such processes it is more preferable to use a modified protocol NHL-BFM-90.
比较NHL - BFM - 90方案与类CHOP方案治疗间变性大细胞淋巴瘤(ALCL)的疗效。
22例ALCL患者参与本研究。诊断基于临床、器械、形态学、免疫组化及分子遗传学检查结果,应用一组针对CD30、ALK、CD3、CD4、CD5、CD7、CD34、CD15、CD68、CD20、CD45RO、CD45RA、Ki - 67的单克隆抗体。22例中有14例间变性淋巴细胞激酶检测为阴性(ALK -),8例为阳性(ALK +)。ALK - ALCL患者的平均年龄为39.6±4.1岁,ALK + ALCL患者为23.4±2.6岁。14例患者采用NHL - BFM - 90方案治疗,8例最初采用其他方案(CHOP、MACOP - B、BEACOPP等)治疗。所有按照NHL - BFM - 90方案治疗的14例患者均为伴有B症状的Ⅲ - Ⅳ期ALCL。12例完成上述方案治疗的患者在第4疗程后达到完全缓解,2例治疗失败。在最初按照其他方案治疗的8例ALCL患者中,4例(2例为Ⅱ期)达到完全缓解。4例缓解患者中有1例复发。4例未达到完全缓解的患者死于疾病进展。
ALCL在中青年患者中更常见。该疾病病程侵袭性强,进展迅速。对于此类病情,更宜采用改良的NHL - BFM - 90方案。