Современные возможности диагностики и лечения диффузной В-крупноклеточной лимфомы у детей и взрослых (обзор литературы)
Современные возможности диагностики и лечения диффузной В-крупноклеточной лимфомы у детей и взрослых (обзор литературы)
Левашов А.С., Валиев Т.Т., Ковригина А.М. и др. Современные возможности диагностики и лечения диффузной В-крупноклеточной лимфомы у детей и взрослых (обзор литературы). Современная онкология. 2015; 17 (3): 30–41.
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Levashov A.S., Valiev T.T., Kovrigina A.M. et al. Diagnosis and treatment of diffuse large B cell lymphoma in children and adults (review of literature). Journal of Modern Oncology. 2015; 17 (3): 30–41.
Современные возможности диагностики и лечения диффузной В-крупноклеточной лимфомы у детей и взрослых (обзор литературы)
Левашов А.С., Валиев Т.Т., Ковригина А.М. и др. Современные возможности диагностики и лечения диффузной В-крупноклеточной лимфомы у детей и взрослых (обзор литературы). Современная онкология. 2015; 17 (3): 30–41.
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Levashov A.S., Valiev T.T., Kovrigina A.M. et al. Diagnosis and treatment of diffuse large B cell lymphoma in children and adults (review of literature). Journal of Modern Oncology. 2015; 17 (3): 30–41.
Диффузная В-крупноклеточная лимфома (ДВККЛ) включает разные варианты заболевания, гетерогенные по клиническим, морфологическим, иммунологическим, цитогенетическим и молекулярно-биологическим параметрам. В данной статье представлены результаты лечения детей и взрослых с ДВККЛ по различным программам (AIEOP NHL92, B-NHL-BFM90, POG APO – IDM/HiDAC, B-NHL-BFM95, FAB/LMB96, BNHL03, FAB/LMB96 + ритуксимаб, Б-НХЛ2004м + ритуксимаб, R-CHOP,
DA-EPOCH-R, RB-CHOP, RBV-CHOP). Выделены молекулярно-биологические факторы неблагоприятного прогноза заболевания у взрослых пациентов с ДВККЛ, которые позволят улучшить стратификацию групп риска, уменьшить интенсивность проводимой терапии у некоторых пациентов, но в настоящее время требуют дополнительного изучения у детей. Особое внимание уделено изучению чувствительности опухоли к таргетной терапии, в частности к анти-CD20 моноклональным антителам.
Ключевые слова: диффузная В-крупноклеточная лимфома, диагностика, лечение, дети и взрослые.
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Diffuse large B-cell lymphoma (DLBCL) includes heterogeneous disease variants according to clinical, morphological, immunological, cytogenetic and molecular-biological features. Several different pediatric and adult protocols are presented in this article (AIEOP NHL92, B-NHL-BFM90, POG APO – IDM/HiDAC, B-NHL-BFM95, FAB/LMB96, BNHL03, FAB/LMB96 + rituximab, B-NHL2004m + rituximab, R-CHOP, DA-EPOCH-R, RB-CHOP, RBV-CHOP). There were revealed some factors of unfavorable outcome of disease in adult patients with DLBCL, that allow to improve risk group stratification and reduce chemotherapy intensiveness in some patients but require additional study in pediatric patients at the present time. Particular attention is paid to study of sensitiveness to target therapy (anti-CD20 monoclonal antibodies).
Key words: diffuse large B-cell lymphoma, diagnostic, treatment, children and adults.
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92. Kraeber-Bodere F et al. Consolidation anti-CD22 fractionated radioimmunotherapy (RIT) with 90Y- epratuzumab tetraxetan following R-CHOP in elderly diffuse large B cell lymphoma (DLBCL) patients. J Nucl Med 2013; 54 (Suppl. 2): 179.
93. Witzig TE et al. Anti-CD22 90Y-epratuzumab tetraxetan combined with anti-CD20 veltuzumab: a phase I study in patients with relapsed/refractory, aggressive non-Hodgkin lymphoma. Haematologica 2014; 99 (11): 1738–45.
94. Viardot A et al. Treatment of relapsed/refractory diffuse large B cell lymphoma with the bispecific T-cell engager (BiTE) antibody construct blinatumomab: primary analysis results from an open-label, phase II study. ASH annual meeting abstracts book, 2014; p. 4460.
95. Portell CA et al. Clinical and pharmacologic aspects of blinatumomab in the treatment of B-cell acute lymphoblastic leukemia. Clin Pharmacol Adv Appl 2013; 5: 5–11.
96. Schlegel P et al. Pediatric posttransplant relapsed/refractory B-precursor acute lymphoblastic leukemia shows durable remission by therapy with the T-cell engaging bispecific antibody blinatumomab. Haematologica 2014; 99 (7): 1212–18.
97. Stackelberg A et al. Phase 1/2 study in pediatric patients with relapsed/refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) receiving blinatumomab treatment. ASH annual meeting abstracts book, 2014; p. 2292.
98. Schuster FR et al. Immunotherapy with trifunctional anti-CD20 x anti-CD3 antibody FBTA05 (Lymphomun) in pediatric high-risk patients with recurrent CD20-positive B-cell malignancies. Br J Haematol 2015; 169 (1): 90–102.
99. Kochenderfer JN et al. Chemotherapy-refractory diffuse large B-cell lymphoma and indolent B-cell malignancies can be effectively treated with autologous T-cells expressing an anti-CD19 chimeric antigen receptor. J Clin Oncol 2014; p. 1–11.
100. Wang Y et al. Effective response and delayed toxicities of refractory advanced diffuse large B-cell lymphoma treated by CD20-directed chimeric antigen receptor-modified T cells. Clin Immunol 2014; 155: 160–75.
101. Maude S et al. Chimeric antigen receptor (CAR) modified N cells induce durable remissions in children with relapsed/refractory ALL. ASPHO annual meeting book, 2015; p. 4003.
102. Suzuki M et al. Chimeric antigen receptors and bispecific antibodies to retarget T cells in pediatric oncology. Ped Blood Cancer 2015; 62: 1326–36.
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99. Kochenderfer JN et al. Chemotherapy-refractory diffuse large B-cell lymphoma and indolent B-cell malignancies can be effectively treated with autologous T-cells expressing an anti-CD19 chimeric antigen receptor. J Clin Oncol 2014; p. 1–11.
100. Wang Y et al. Effective response and delayed toxicities of refractory advanced diffuse large B-cell lymphoma treated by CD20-directed chimeric antigen receptor-modified T cells. Clin Immunol 2014; 155: 160–75.
101. Maude S et al. Chimeric antigen receptor (CAR) modified N cells induce durable remissions in children with relapsed/refractory ALL. ASPHO annual meeting book, 2015; p. 4003.
102. Suzuki M et al. Chimeric antigen receptors and bispecific antibodies to retarget T cells in pediatric oncology. Ped Blood Cancer 2015; 62: 1326–36.
1 ФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России. 115478, Россия, Москва, Каширское ш., д. 23;
2 ФГБУ Гематологический научный центр Минздрава России. 125167, Россия, Москва, Новый Зыковский пр., д. 4
*andreyslevashov@mail.ru
1 N.N.Blokhin Russian Cancer Research Center. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23;
2 National Research Center for Hematology of the Ministry of Health of the Russian Federation. 125167, Russian Federation, Moscow, Novyi Zykovskii pr., d. 4
*andreyslevashov@mail.ru