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[睾丸弥漫性大B细胞淋巴瘤患者大剂量化疗的经验]

[Experience with high-dose chemotherapy in patients with testicular diffuse large B-cell lymphoma].

作者信息

Nesterova E S, Mangasarova Ia K, Bariakh E A, Gubkin A V, Tolstykh T N, Lukina A I, Kovrigina A M, Domracheva E V, Chernova N G, Mar'in D S, Zvonkov E E, Gemdzhian É G, Kravchenko S K

出版信息

Ter Arkh. 2014;86(7):59-67.

Abstract

AIM

To evaluate the efficiency of high-dose therapy according to the DLBL-CNS-2007 protocol in patients with testicular diffuse large B-cell lymphoma (DLBL).

SUBJECTS AND METHODS

Out of 408 male patients with non-Hodgkin lymphoma, 8 patients aged 50 to 69 years (median age 55.5 years) with primary testicular (n=3) or with generalized-stage testicular DLBL (n=5) were included in the study. These patients were followed up at the Hematology Research Center, Ministry of Health of the Russian Federation, in 2007 to 2013. Systemic chemotherapy was performed in accordance with the DLBL-CNS-2007 protocol.

RESULTS

The DLBL-CNS-2007 protocol was implemented in first-line therapy in 7 patients. At the first diagnostic stage, one patient was found to have anaplastic seminoma; in this connection right orchifuniculectomy was carried out, followed by radiotherapy applied to the scrotal region in a total focal dose of 34 Gy. This patient with disease recurrence was included in the DLBL-CNS-2007 treatment protocol. The number of polychemotherapy (PCT) cycles (n=4 or 6) was determined by the time to achieve complete remission. After completion of DLBL-CNS-2007 PCT, 6 patients achieved complete remission; the primary resistant disease was noted in 2 cases. At this moment 6 patients are alive in first complete remission during the median follow-up of 50 months (10-54 months).

CONCLUSION

The findings suggest that high-dose therapy according to the DLBL-CNS-2007 protocol in patients with testicular DLBL can achieve complete remission and increase overall and event-free survival rates. This fact should be borne out by a large number of observations.

摘要

目的

根据DLBL-CNS-2007方案评估高剂量疗法对睾丸弥漫性大B细胞淋巴瘤(DLBL)患者的疗效。

对象与方法

在408例男性非霍奇金淋巴瘤患者中,纳入8例年龄在50至69岁(中位年龄55.5岁)的原发性睾丸(n = 3)或全身性睾丸DLBL(n = 5)患者进行研究。这些患者于2007年至2013年在俄罗斯联邦卫生部血液学研究中心接受随访。全身化疗按照DLBL-CNS-2007方案进行。

结果

7例患者在一线治疗中实施了DLBL-CNS-2007方案。在首次诊断阶段,1例患者被诊断为间变性精原细胞瘤;为此进行了右侧睾丸精索切除术,随后对阴囊区域进行放疗,总局部剂量为34 Gy。该疾病复发患者被纳入DLBL-CNS-2007治疗方案。多药化疗(PCT)周期数(n = 4或6)由达到完全缓解的时间决定。完成DLBL-CNS-2007 PCT后,6例患者实现完全缓解;2例出现原发性耐药疾病。目前,6例患者在中位随访50个月(10 - 54个月)期间处于首次完全缓解状态存活。

结论

研究结果表明,根据DLBL-CNS-2007方案对睾丸DLBL患者进行高剂量疗法可实现完全缓解,并提高总生存率和无事件生存率。这一事实应通过大量观察得到证实。

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