Иммуноглобулинопатии у больных ангиоиммунобластной Т-клеточной лимфомой
Иммуноглобулинопатии у больных ангиоиммунобластной Т-клеточной лимфомой
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Аннотация
Цель. Охарактеризовать частоту выявления и типы иммуноглобулинопатий у первичных больных ангиоиммунобластной Т-клеточной лимфомой (АИТЛ).
Материалы и методы. В исследование включено 55 первичных больных АИТЛ с медианой возраста 61 (29–81) год, соотношение мужчины/женщины – 30/25.
Результаты. Исследование иммунохимических показателей продемонстрировало наличие иммуноглобулинопатий у 89,1% больных в дебюте АИТЛ. Поликлональная гипергаммаглобулинемия наблюдалась у 74,5% больных, в том числе класса G – в 49,2%, класса Е – в 48,0%, класса А – в 38,2%, класса М – в 32,7% случаев. Олигоклональная секреция выявлена у 7,3% больных, моноклональная секреция – у 20%. Гипогаммаглобулинемию наблюдали у 8 больных, в 2 случаях на фоне моноклональной секреции.
Заключение. Количественные и качественные изменения иммуноглобулинов наблюдаются у большинства больных АИТЛ. Иммунохимическое исследование белков сыворотки крови является необходимым методом первичной диагностики этого вида лимфомы. Выявленная моноклональная секреция возможно является как проявление лимфопролиферации, так и сопутствующей моноклональной гаммапатии неопределенного значения. Прогностическое значение иммунохимических показателей на настоящий момент остается неясным и требует динамического наблюдения и изучения.
Ключевые слова: ангиоиммунобластная Т-клеточная лимфома, иммуноглобулинопатии, поликлональная гипергаммаглобулинемия, гипогаммаглобулинопатия, олигоклональная секреция, моноклональная секреция.
Objective: The aim of the study was to characterize quantitative and qualitative immunoglobulinopathies in patients with AITL at the onset of the disease.
Patients and methods. 55 patients with newly diagnosed AITL were enrolled in the study, the male/female ratio was 30/25; median age was 61 (29-81) years. Diagnosis was based on standard WHO criteria. Immunochemical studies of blood serum included serum protein electrophoresis/immunofixation, nephelometric quantification of total immunoglobulins, serum free light chain assay.
Results. Quantitative and qualitative immunoglobulinopathies were determined in 49 (89,1%) of 55 pts. Quantitative immunoglobulinopathies were revealed in 47 (85.5%) of 55 cases, qualitative – in 14 (25,5%). Combination quantitative and qualitative immunoglobulinopathies was observed in 12 (21,8%) of 55 pts. The detected immunoglobulinopathies were divided into 4 groups: polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, and monoclonal gammapathy. Polyclonal hypergammaglobulinaemia was marked in 41 (74.5%) of 55 pts, elevated level of IgG was determined in 27 (49,15%) of 55 cases, IgM – in 18 (32,7%) and IgA – in 21 (38.2%). Interestingly, polyclonal IgE hypergammaglobulinaemia was detected in 12 (48,0%) of 25 cases of performed studies.
Hypogammaglobulinaemia was detected in 8 (14,5%) of 55 cases. Oligoclonal gammapathy was determined in 4 (7.3%) of 55 pts. Monoclonal gammapathy was revealed in 11 (20,0%) of 55 cases. The amount of monoclonal immunoglobulin varied from 2.6 to 14.1 g/l. Monoclonal immunoglobulin Gk was detected in 5 of 11 pts, Gλ – in 2, Mλ – in 2, Mk – in 2. Monoclonal gammapathy was accompanied by polyclonal hypergammaglobulinaemia in 9 of 11 cases, hypogammaglobulinaemia – in 2.
Conclusions. Quantitative and qualitative immunoglobulinopathies are observed in most patients at the onset of AITL. Quantitative abnormalities were determined more often than qualitative. Monoclonal gammapathy can be a manifestation of lymphoproliferation and other concomitant disorders. The prognostic value of immunochemical parameters is still unclear and requires dynamic observation and study.
Keywords: angioimmunoblastic T-cell lymphoma, immunoglobulinopathies, polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, monoclonal gammapathy.
Материалы и методы. В исследование включено 55 первичных больных АИТЛ с медианой возраста 61 (29–81) год, соотношение мужчины/женщины – 30/25.
Результаты. Исследование иммунохимических показателей продемонстрировало наличие иммуноглобулинопатий у 89,1% больных в дебюте АИТЛ. Поликлональная гипергаммаглобулинемия наблюдалась у 74,5% больных, в том числе класса G – в 49,2%, класса Е – в 48,0%, класса А – в 38,2%, класса М – в 32,7% случаев. Олигоклональная секреция выявлена у 7,3% больных, моноклональная секреция – у 20%. Гипогаммаглобулинемию наблюдали у 8 больных, в 2 случаях на фоне моноклональной секреции.
Заключение. Количественные и качественные изменения иммуноглобулинов наблюдаются у большинства больных АИТЛ. Иммунохимическое исследование белков сыворотки крови является необходимым методом первичной диагностики этого вида лимфомы. Выявленная моноклональная секреция возможно является как проявление лимфопролиферации, так и сопутствующей моноклональной гаммапатии неопределенного значения. Прогностическое значение иммунохимических показателей на настоящий момент остается неясным и требует динамического наблюдения и изучения.
Ключевые слова: ангиоиммунобластная Т-клеточная лимфома, иммуноглобулинопатии, поликлональная гипергаммаглобулинемия, гипогаммаглобулинопатия, олигоклональная секреция, моноклональная секреция.
________________________________________________
Objective: The aim of the study was to characterize quantitative and qualitative immunoglobulinopathies in patients with AITL at the onset of the disease.
Patients and methods. 55 patients with newly diagnosed AITL were enrolled in the study, the male/female ratio was 30/25; median age was 61 (29-81) years. Diagnosis was based on standard WHO criteria. Immunochemical studies of blood serum included serum protein electrophoresis/immunofixation, nephelometric quantification of total immunoglobulins, serum free light chain assay.
Results. Quantitative and qualitative immunoglobulinopathies were determined in 49 (89,1%) of 55 pts. Quantitative immunoglobulinopathies were revealed in 47 (85.5%) of 55 cases, qualitative – in 14 (25,5%). Combination quantitative and qualitative immunoglobulinopathies was observed in 12 (21,8%) of 55 pts. The detected immunoglobulinopathies were divided into 4 groups: polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, and monoclonal gammapathy. Polyclonal hypergammaglobulinaemia was marked in 41 (74.5%) of 55 pts, elevated level of IgG was determined in 27 (49,15%) of 55 cases, IgM – in 18 (32,7%) and IgA – in 21 (38.2%). Interestingly, polyclonal IgE hypergammaglobulinaemia was detected in 12 (48,0%) of 25 cases of performed studies.
Hypogammaglobulinaemia was detected in 8 (14,5%) of 55 cases. Oligoclonal gammapathy was determined in 4 (7.3%) of 55 pts. Monoclonal gammapathy was revealed in 11 (20,0%) of 55 cases. The amount of monoclonal immunoglobulin varied from 2.6 to 14.1 g/l. Monoclonal immunoglobulin Gk was detected in 5 of 11 pts, Gλ – in 2, Mλ – in 2, Mk – in 2. Monoclonal gammapathy was accompanied by polyclonal hypergammaglobulinaemia in 9 of 11 cases, hypogammaglobulinaemia – in 2.
Conclusions. Quantitative and qualitative immunoglobulinopathies are observed in most patients at the onset of AITL. Quantitative abnormalities were determined more often than qualitative. Monoclonal gammapathy can be a manifestation of lymphoproliferation and other concomitant disorders. The prognostic value of immunochemical parameters is still unclear and requires dynamic observation and study.
Keywords: angioimmunoblastic T-cell lymphoma, immunoglobulinopathies, polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, monoclonal gammapathy.
Список литературы
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3. Виноградова Ю.Е., Луценко И.Н., Кременецкая А.М., Капланская И.Б., Самойлова Р.С., Шкловский-Корди Н.Е., Гилязитдинова Е.А., Губкин А.В., Джулакян У.Л., Марголин О.В., Марьин Д.С., Чернова Н.Г., Кравченко С.К. Структура T/NK-клеточных лимфатических опухолей в Гематологическом научном центре РАМН. Проблемы гематологии и переливания крови. 2005; (4): 30-4. [Vinogradova YuE, Lutsenko IN, Kremenetskaya AM, Kaplanskaya IB, Samoylova RS, Shklovskiy-Kordi NE et al. Structure of T/NK-cell lymphomas in the National Research Center for Hematology of the Russian Academy of Medical Sciences. Russian journal of problems of hematology and blood transfusion (Problemy gematologii i perelivaniya krovi). 2005; 4:30-4. (In Russ.)].
4. Виноградова Ю.Е., Зингерман Б.В. Нозологические формы и выживаемость пациентов с Т- и НК-клеточными лимфатическими опухолями, наблюдавшихся в ГНЦ в течение 10 лет. Клиническая онкогематология. Фундаментальные исследования и клиническая практика. 2011; 4(3): 201-12. [Vinogradova YuE, Zingerman BV. Nosological forms and survival of patients with Tand NK-cell lymphoid neoplasms observed in HSC during 10 years. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2011; 4(3): 201-12. (In Russ.)].
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6. Lukes RJ, Tindle BH. Immunoblastic lymphadenopathy. A hyperimmune entity resembling Hodgkin's disease. N Engl J Med. 1975 Jan 2; 292(1):1-8.
7. Frizzera G, Moran EM, Rappaport H. Angioimmunoblastic lymphadenopathy: diagnosis and clinical course. Am J Med. 1975; 59: 803-18.
8. Dogan A, Attygalle AD, Kyriakou C. Angioimunoblastic T-cell lymphoma. Br J Haematol. 2003; 121:681-91.
9. Willenbrock K, Renné C, Gaulard P, Hansmann ML. In angioimmunoblastic T-cell lymphoma, neoplastic T cells may be a minor cell population. A molecular single-cell and immunohistochemical study. Virchows Arch. 2005 (Jan); 446(1):15-20.
10. De Leval L, Christian Gisselbrecht C, Gaulard P. Advances in the understanding and management of angioimmunoblastic T-cell lymphoma. Br J Haematol. 2009; 148: 673-89. doi:10.1111/j.1365-2141.2009.08003.x
11. Aizawa Y, Zawadzki ZA, Micolonghi TS, McDowell JW, Neiman RS. Vasculitis and Sjögren's syndrome with IgA-IgG cryoglobulinemia terminating in immunoblastic sarcoma. Am J Med. 1979 Jul; 67(1):160-6.
12. Lin P, Hao S, Handy BC, Bueso-Ramos CE, Medeiros LJ. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol. 2005 (Feb);123(2):200-5.
13. Cartron G, Roingeard P, Benboubker L, Vaillant L, Tartas S, Delain M, Lefranc T, Brémond JL, Bout M, Linassier C, Colombat P. Sezary syndrome in a patient with multiple myeloma: demonstration of a clonally distinct second malignancy. Eur J Haematol. 1999 (Nov); 63(5):354-7.
14. Bryant E, Ronan SG, Iossifides IA. Plasma cell myeloma in a patient with a cutaneous T-cell lymphoma. Cancer. 1982 Nov 15; 50(10): 2122-5.
15. Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G, Kroger N, Einsele H, Vesole DH, Dimopoulos M, San Miguel J, Avet-Loiseau H, Hajek R, Chen WM, Anderson KC, Ludwig H, Sonneveld P, Pavlovsky S, Palumbo A, Richardson PG, B Barlogie B, Greipp P, Vescio R, Turesson I, Westin J, Boccadoro M. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia. 2010; 24(6):1121-7. doi:10.1038/leu.2010.60
16. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, Therneau TM, Clark R, Kumar SK, Bradwell A, Fonseca R, Jelinek DF, Rajkumar SV. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet. 2010 (May 15); 375(9727):1721-8. doi: 10.1016/S0140-6736(10)60482-5
17. Чернова Н.Г., Виноградова Ю.Е., Сидорова Ю.В., Капланская И.Б., Гилязитдинова Е.А., Горенкова Л.Г., Марьин Д.С., Кременецкая А.М., Воробьев А.И., Кравченко С.К. Длительные режимы цитостатической терапии ангиоиммунобластной Т-клеточной лимфомы. Клиническая онкогематология. Фундаментальные исследования и клиническая практика. 2014; 7(1):57-62. [Chernova NG, Vinogradova YuE, Sidorova YuV, Kaplanskaya IB, Gilyazitdinova EA, Gorenkova LG, Mar'in DS, Kremenetskaya AM, Vorob'ev AI, Kravchenko SK. Prolonged chemotherapy for angioimmunoblastic
T-cell lymphoma. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2014; 7(1): 57-62. (In Russ.)].
18. Papadi B, Polski JM, Clarkson DR, Liu-Dumlao TO. Atypical angioimmunoblastic T-cell lymphomas masquerading as systemic polyclonal B-immunoblastic proliferation. Virchows Arch. 2012; 461:323-31. doi: 10.1007/s00428-012-1280-5
19. Nagoshi H, Kuroda J, Kobayashi T, Maegawa S, Chinen Y, Kiyota M, Nakayama R, Mizutani S, Shimura Y, Yamamoto-Sugitani M, Matsumoto Y, Horiike S, Taniwaki M. Clinical manifestation of angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis. Int J Hematol. 2013 Sep; 98(3):366-74. doi: 10.1007/s12185-013-1411-z
2. Vose J, Armitage J, Weisenburger D. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008 (1); 26(25):4124-30. doi:10.1200/ JCO.2008.16.4558
3. [Vinogradova YuE, Lutsenko IN, Kremenetskaya AM, Kaplanskaya IB, Samoylova RS, Shklovskiy-Kordi NE et al. Structure of T/NK-cell lymphomas in the National Research Center for Hematology of the Russian Academy of Medical Sciences. Russian journal of problems of hematology and blood transfusion (Problemy gematologii i perelivaniya krovi). 2005; 4:30-4. (In Russ.)].
4. [Vinogradova YuE, Zingerman BV. Nosological forms and survival of patients with Tand NK-cell lymphoid neoplasms observed in HSC during 10 years. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2011; 4(3): 201-12. (In Russ.)].
5. Frizzera G, Moran EM, Rappaport H. Angioimmunoblastic lymphadenopathy with dysproteinaemia. Lancet. 1974; 1:1070-3.
6. Lukes RJ, Tindle BH. Immunoblastic lymphadenopathy. A hyperimmune entity resembling Hodgkin's disease. N Engl J Med. 1975 Jan 2; 292(1):1-8.
7. Frizzera G, Moran EM, Rappaport H. Angioimmunoblastic lymphadenopathy: diagnosis and clinical course. Am J Med. 1975; 59: 803-18.
8. Dogan A, Attygalle AD, Kyriakou C. Angioimunoblastic T-cell lymphoma. Br J Haematol. 2003; 121:681-91.
9. Willenbrock K, Renné C, Gaulard P, Hansmann ML. In angioimmunoblastic T-cell lymphoma, neoplastic T cells may be a minor cell population. A molecular single-cell and immunohistochemical study. Virchows Arch. 2005 (Jan); 446(1):15-20.
10. De Leval L, Christian Gisselbrecht C, Gaulard P. Advances in the understanding and management of angioimmunoblastic T-cell lymphoma. Br J Haematol. 2009; 148: 673-89. doi:10.1111/j.1365-2141.2009.08003.x
11. Aizawa Y, Zawadzki ZA, Micolonghi TS, McDowell JW, Neiman RS. Vasculitis and Sjögren's syndrome with IgA-IgG cryoglobulinemia terminating in immunoblastic sarcoma. Am J Med. 1979 Jul; 67(1):160-6.
12. Lin P, Hao S, Handy BC, Bueso-Ramos CE, Medeiros LJ. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol. 2005 (Feb);123(2):200-5.
13. Cartron G, Roingeard P, Benboubker L, Vaillant L, Tartas S, Delain M, Lefranc T, Brémond JL, Bout M, Linassier C, Colombat P. Sezary syndrome in a patient with multiple myeloma: demonstration of a clonally distinct second malignancy. Eur J Haematol. 1999 (Nov); 63(5):354-7.
14. Bryant E, Ronan SG, Iossifides IA. Plasma cell myeloma in a patient with a cutaneous T-cell lymphoma. Cancer. 1982 Nov 15; 50(10): 2122-5.
15. Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G, Kroger N, Einsele H, Vesole DH, Dimopoulos M, San Miguel J, Avet-Loiseau H, Hajek R, Chen WM, Anderson KC, Ludwig H, Sonneveld P, Pavlovsky S, Palumbo A, Richardson PG, B Barlogie B, Greipp P, Vescio R, Turesson I, Westin J, Boccadoro M. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia. 2010; 24(6):1121-7. doi:10.1038/leu.2010.60
16. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, Therneau TM, Clark R, Kumar SK, Bradwell A, Fonseca R, Jelinek DF, Rajkumar SV. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet. 2010 (May 15); 375(9727):1721-8. doi: 10.1016/S0140-6736(10)60482-5
17. [Chernova NG, Vinogradova YuE, Sidorova YuV, Kaplanskaya IB, Gilyazitdinova EA, Gorenkova LG, Mar'in DS, Kremenetskaya AM, Vorob'ev AI, Kravchenko SK. Prolonged chemotherapy for angioimmunoblastic
T-cell lymphoma. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2014; 7(1): 57-62. (In Russ.)].
18. Papadi B, Polski JM, Clarkson DR, Liu-Dumlao TO. Atypical angioimmunoblastic T-cell lymphomas masquerading as systemic polyclonal B-immunoblastic proliferation. Virchows Arch. 2012; 461:323-31. doi: 10.1007/s00428-012-1280-5
19. Nagoshi H, Kuroda J, Kobayashi T, Maegawa S, Chinen Y, Kiyota M, Nakayama R, Mizutani S, Shimura Y, Yamamoto-Sugitani M, Matsumoto Y, Horiike S, Taniwaki M. Clinical manifestation of angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis. Int J Hematol. 2013 Sep; 98(3):366-74. doi: 10.1007/s12185-013-1411-z
2. Vose J, Armitage J, Weisenburger D. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008 (1); 26(25):4124-30. doi:10.1200/ JCO.2008.16.4558
3. Виноградова Ю.Е., Луценко И.Н., Кременецкая А.М., Капланская И.Б., Самойлова Р.С., Шкловский-Корди Н.Е., Гилязитдинова Е.А., Губкин А.В., Джулакян У.Л., Марголин О.В., Марьин Д.С., Чернова Н.Г., Кравченко С.К. Структура T/NK-клеточных лимфатических опухолей в Гематологическом научном центре РАМН. Проблемы гематологии и переливания крови. 2005; (4): 30-4. [Vinogradova YuE, Lutsenko IN, Kremenetskaya AM, Kaplanskaya IB, Samoylova RS, Shklovskiy-Kordi NE et al. Structure of T/NK-cell lymphomas in the National Research Center for Hematology of the Russian Academy of Medical Sciences. Russian journal of problems of hematology and blood transfusion (Problemy gematologii i perelivaniya krovi). 2005; 4:30-4. (In Russ.)].
4. Виноградова Ю.Е., Зингерман Б.В. Нозологические формы и выживаемость пациентов с Т- и НК-клеточными лимфатическими опухолями, наблюдавшихся в ГНЦ в течение 10 лет. Клиническая онкогематология. Фундаментальные исследования и клиническая практика. 2011; 4(3): 201-12. [Vinogradova YuE, Zingerman BV. Nosological forms and survival of patients with Tand NK-cell lymphoid neoplasms observed in HSC during 10 years. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2011; 4(3): 201-12. (In Russ.)].
5. Frizzera G, Moran EM, Rappaport H. Angioimmunoblastic lymphadenopathy with dysproteinaemia. Lancet. 1974; 1:1070-3.
6. Lukes RJ, Tindle BH. Immunoblastic lymphadenopathy. A hyperimmune entity resembling Hodgkin's disease. N Engl J Med. 1975 Jan 2; 292(1):1-8.
7. Frizzera G, Moran EM, Rappaport H. Angioimmunoblastic lymphadenopathy: diagnosis and clinical course. Am J Med. 1975; 59: 803-18.
8. Dogan A, Attygalle AD, Kyriakou C. Angioimunoblastic T-cell lymphoma. Br J Haematol. 2003; 121:681-91.
9. Willenbrock K, Renné C, Gaulard P, Hansmann ML. In angioimmunoblastic T-cell lymphoma, neoplastic T cells may be a minor cell population. A molecular single-cell and immunohistochemical study. Virchows Arch. 2005 (Jan); 446(1):15-20.
10. De Leval L, Christian Gisselbrecht C, Gaulard P. Advances in the understanding and management of angioimmunoblastic T-cell lymphoma. Br J Haematol. 2009; 148: 673-89. doi:10.1111/j.1365-2141.2009.08003.x
11. Aizawa Y, Zawadzki ZA, Micolonghi TS, McDowell JW, Neiman RS. Vasculitis and Sjögren's syndrome with IgA-IgG cryoglobulinemia terminating in immunoblastic sarcoma. Am J Med. 1979 Jul; 67(1):160-6.
12. Lin P, Hao S, Handy BC, Bueso-Ramos CE, Medeiros LJ. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol. 2005 (Feb);123(2):200-5.
13. Cartron G, Roingeard P, Benboubker L, Vaillant L, Tartas S, Delain M, Lefranc T, Brémond JL, Bout M, Linassier C, Colombat P. Sezary syndrome in a patient with multiple myeloma: demonstration of a clonally distinct second malignancy. Eur J Haematol. 1999 (Nov); 63(5):354-7.
14. Bryant E, Ronan SG, Iossifides IA. Plasma cell myeloma in a patient with a cutaneous T-cell lymphoma. Cancer. 1982 Nov 15; 50(10): 2122-5.
15. Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G, Kroger N, Einsele H, Vesole DH, Dimopoulos M, San Miguel J, Avet-Loiseau H, Hajek R, Chen WM, Anderson KC, Ludwig H, Sonneveld P, Pavlovsky S, Palumbo A, Richardson PG, B Barlogie B, Greipp P, Vescio R, Turesson I, Westin J, Boccadoro M. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia. 2010; 24(6):1121-7. doi:10.1038/leu.2010.60
16. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, Therneau TM, Clark R, Kumar SK, Bradwell A, Fonseca R, Jelinek DF, Rajkumar SV. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet. 2010 (May 15); 375(9727):1721-8. doi: 10.1016/S0140-6736(10)60482-5
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16. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, Therneau TM, Clark R, Kumar SK, Bradwell A, Fonseca R, Jelinek DF, Rajkumar SV. Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet. 2010 (May 15); 375(9727):1721-8. doi: 10.1016/S0140-6736(10)60482-5
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T-cell lymphoma. Russian Journal of klinicheskaya onkogematologiya. Fundamental'nye issledovaniya i klinicheskaya praktika. 2014; 7(1): 57-62. (In Russ.)].
18. Papadi B, Polski JM, Clarkson DR, Liu-Dumlao TO. Atypical angioimmunoblastic T-cell lymphomas masquerading as systemic polyclonal B-immunoblastic proliferation. Virchows Arch. 2012; 461:323-31. doi: 10.1007/s00428-012-1280-5
19. Nagoshi H, Kuroda J, Kobayashi T, Maegawa S, Chinen Y, Kiyota M, Nakayama R, Mizutani S, Shimura Y, Yamamoto-Sugitani M, Matsumoto Y, Horiike S, Taniwaki M. Clinical manifestation of angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis. Int J Hematol. 2013 Sep; 98(3):366-74. doi: 10.1007/s12185-013-1411-z
Авторы
Н.Г. ЧЕРНОВА 1, Н.П. СОБОЛЕВА 1, С.А. МАРЬИНА 1, Ю.В. СИДОРОВА 1, М.Н. СИНИЦЫНА 1, В.Н. ДВИРНЫК 1, Д.С. БАДМАЖАПОВА 1, Ю.Е. ВИНОГРАДОВА 2, Е.Е. ЗВОНКОВ 1, В.Г. САВЧЕНКО 1
1 ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, отделение интенсивной химиотерапии лимфом, Москва, Россия;
2 ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова» Минздрава России, Москва, Россия
1 National Research Center for Hematology, Russian Federation, Moscow, Russia;
2 The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation, Moscow, Russia
1 ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, отделение интенсивной химиотерапии лимфом, Москва, Россия;
2 ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова» Минздрава России, Москва, Россия
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1 National Research Center for Hematology, Russian Federation, Moscow, Russia;
2 The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation, Moscow, Russia
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