Pub Date : 2024-04-02DOI: 10.17650/1818-8346-2024-19-2-118-131
N. T. Vatutin, E. Sklyannaya, V. V. Gribov
Glucocorticosteroids are highly effective anti-inflammatory and immunosuppressive agents. The drugs were introduced into therapeutic practice from the mid-20th century and are still widely used in the treatment of various diseases. They are an integral part of the treatment of patients with hematological malignancies. One of the clinically significant complications of glucocorticosteroid therapy is steroid-induced carbohydrate metabolism disorders. Diabetes mellitus is one of the main risk factors for the development of cardiovascular diseases, which are the main non-oncological cause of death in the population and a significant treatment complication in patients with malignant neoplasms. Early detection of the disease and improved treatment efficiency increase the survival rate of patients with various types of neoplasms. It is also important to pay attention to quality of life improving in cancer patients after treatment.The aim of this review is to analyze the pathogenesis features, as well as predictors of early detection and prevention of possible complications of persistent hyperglycemia in patients with hematological malignancies.
{"title":"Important aspects of carbohydrate metabolism disorders development in hematology/oncology patients during therapy with glucocorticosteroids: a review of the literature","authors":"N. T. Vatutin, E. Sklyannaya, V. V. Gribov","doi":"10.17650/1818-8346-2024-19-2-118-131","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-2-118-131","url":null,"abstract":"Glucocorticosteroids are highly effective anti-inflammatory and immunosuppressive agents. The drugs were introduced into therapeutic practice from the mid-20th century and are still widely used in the treatment of various diseases. They are an integral part of the treatment of patients with hematological malignancies. One of the clinically significant complications of glucocorticosteroid therapy is steroid-induced carbohydrate metabolism disorders. Diabetes mellitus is one of the main risk factors for the development of cardiovascular diseases, which are the main non-oncological cause of death in the population and a significant treatment complication in patients with malignant neoplasms. Early detection of the disease and improved treatment efficiency increase the survival rate of patients with various types of neoplasms. It is also important to pay attention to quality of life improving in cancer patients after treatment.The aim of this review is to analyze the pathogenesis features, as well as predictors of early detection and prevention of possible complications of persistent hyperglycemia in patients with hematological malignancies.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"105 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.17650/1818-8346-2024-19-2-75-82
M. A. Mingalimov, E. Baryakh, O. Kochneva, E. Misyurina, Y. Y. Polyakov, E. Zhelnova, K. Yatskov, A. B. Makeshova, T. Tolstykh, T. S. Chudnova, D. D. Ivanova, D. V. Lebedev, E. Zotina, D. Gagloeva, M. Beregov, E. A. Mamatturdiev, I. Samsonova, M. A. Lysenko
Diffuse large B-cell lymphoma is the most common immunomorphological variant of lymphoma in adults. Extranodal lesions are observed in a third of patients at the disease onset. The organs most often involved are the gastrointestinal tract, testicles, bones, thyroid gland, and skin. Primary involvement of the nasal cavity and paranasal sinuses occur extremely rarely and cause diagnostic and therapeutic difficulties.The article demonstrates a rare clinical case of newly diagnosed diffuse large B-cell lymphoma with sinonasal tract involvement. It took 6 months to verify the final diagnosis. At the moment, the induction stage of treatment for diffuse large B-cell lymphoma continues, the achieved complete metabolic response is maintained.
{"title":"Sinonasal diffuse large B-cell lymphoma: own clinical observation and literature review","authors":"M. A. Mingalimov, E. Baryakh, O. Kochneva, E. Misyurina, Y. Y. Polyakov, E. Zhelnova, K. Yatskov, A. B. Makeshova, T. Tolstykh, T. S. Chudnova, D. D. Ivanova, D. V. Lebedev, E. Zotina, D. Gagloeva, M. Beregov, E. A. Mamatturdiev, I. Samsonova, M. A. Lysenko","doi":"10.17650/1818-8346-2024-19-2-75-82","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-2-75-82","url":null,"abstract":"Diffuse large B-cell lymphoma is the most common immunomorphological variant of lymphoma in adults. Extranodal lesions are observed in a third of patients at the disease onset. The organs most often involved are the gastrointestinal tract, testicles, bones, thyroid gland, and skin. Primary involvement of the nasal cavity and paranasal sinuses occur extremely rarely and cause diagnostic and therapeutic difficulties.The article demonstrates a rare clinical case of newly diagnosed diffuse large B-cell lymphoma with sinonasal tract involvement. It took 6 months to verify the final diagnosis. At the moment, the induction stage of treatment for diffuse large B-cell lymphoma continues, the achieved complete metabolic response is maintained.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"25 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.17650/1818-8346-2024-19-2-141-146
T. T. Valiev, E. Kumirova, V. Rozinov, T. R. Panferova, I. Khvorostov, K. L. Kondratchik, O. Y. Fuks, P. A. Kerimov, N. Matinyan, A. N. Belyaeva, A. Efremenkov, A. A. Bystrova, A. P. Kurkin, V. V. Gorev
L-asparaginase is one of the most effective drugs in pediatric and adult acute lymphoblastic leukemia treatment. But drug side effects are an important problem. pancreatitis and pancreatic necrosis are not common (2–18 %) complication, but high chance of severe disease with fatal outcome make to bring in careful attention of pediatric oncologists-hematologists, surgeons, intensivists, radiologists. Recognizing multidisciplinary importance of this problem, at June 21st, 2023 at Morozov Children’s Clinical hospital a Round table on pancreatitis/pancreatic necrosis after L-asparaginase use was organized. This article presents expert recommendations from federal and regional clinics in diagnosis and treatment of such severe complication.
{"title":"Expert recommendations for pancreatitis/pancreatic necrosis treatment after L-asparaginase in children with acute lymphoblastic leukemia","authors":"T. T. Valiev, E. Kumirova, V. Rozinov, T. R. Panferova, I. Khvorostov, K. L. Kondratchik, O. Y. Fuks, P. A. Kerimov, N. Matinyan, A. N. Belyaeva, A. Efremenkov, A. A. Bystrova, A. P. Kurkin, V. V. Gorev","doi":"10.17650/1818-8346-2024-19-2-141-146","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-2-141-146","url":null,"abstract":"L-asparaginase is one of the most effective drugs in pediatric and adult acute lymphoblastic leukemia treatment. But drug side effects are an important problem. pancreatitis and pancreatic necrosis are not common (2–18 %) complication, but high chance of severe disease with fatal outcome make to bring in careful attention of pediatric oncologists-hematologists, surgeons, intensivists, radiologists. Recognizing multidisciplinary importance of this problem, at June 21st, 2023 at Morozov Children’s Clinical hospital a Round table on pancreatitis/pancreatic necrosis after L-asparaginase use was organized. This article presents expert recommendations from federal and regional clinics in diagnosis and treatment of such severe complication.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.17650/1818-8346-2024-19-2-147-148
A. Editorial
Во время региональной конференции «Современный взгляд на терапию пациента с множественной миеломой в реальной клинической практике» была затронута важная тема, посвященная болевому синдрому. С докладами о проблемах болевого синдрома выступили Али Мурадович Мудунов, Максим Бокманович Пак и Вадим Евгеньевич Груздев.
{"title":"Resolution on the results of the regional conference “Modern view of the multiple myeloma patient treatment in real clinical practice”. February 21, 2024, Irkutsk","authors":"A. Editorial","doi":"10.17650/1818-8346-2024-19-2-147-148","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-2-147-148","url":null,"abstract":"Во время региональной конференции «Современный взгляд на терапию пациента с множественной миеломой в реальной клинической практике» была затронута важная тема, посвященная болевому синдрому. С докладами о проблемах болевого синдрома выступили Али Мурадович Мудунов, Максим Бокманович Пак и Вадим Евгеньевич Груздев.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"479 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.17650/1818-8346-2024-19-2-34-45
E. Zakharko, V. Dvirnyk, Yuliya Chabaeva, D. Drokova, E. B. Rybkina, K. A. Lavrishinets, A. V. Bulgakov, M. N. Panasenko, Z. Fidarova, I. A. Lukianova, O. A. Aleshina, S. M. Kulikov, T. Gaponova, V. Troitskaya, E. N. Parovichnikova
Background. Vascular endothelial growth factor A (VEGFA) is one of the most important factors for regulation of hematopoietic stem cells differentiation. It is involved in leukemogenesis and central nervous system (CNS) damage in acute leukemia. According to the literature, the VEGFA production by blast cells is increased, but the values of serum concentration and the associations with CNS involvement are contradictory.Aim. evaluate the VEGFA, VEGFR1, VEGFR2 concentration in serum and cerebrospinal fluid of patient with different types of acute leukemia in disease onset and during treatment.Materials and methods. The concentration of VEGFA in serum and cerebrospinal fluid was studied in 74 primary patients with acute leukemia. The comparison group consisted of 67 healthy donors. VEGFR1, VEGFR2 were studied in serum and cerebrospinal fluid in 34 patients at the onset of the disease. The comparison group consisted of 10 healthy donors. For the analysis, an enzyme immunoassay was used on a semi-automatic Personal Lab analyzer (Adaltis) and Affymetrix eBioscience human VEGF-A Platinum ELISA reagents.Results. Serum VEGFA concentration was statistically significantly lower in acute leukemia patients than that of donors (median 149.78 and 432.19 pg/ml respectively; p <0.0001). Factor deficiency was significantly more pronounced in patients with blastemia (p <0.015). During antitumor therapy, there was a tendency to increase the amount of the factor in the blood serum. Serum concentration of soluble VEGFR2 was also lower in patients than that of donors (6949.9 and 8795.9 pg/ml respectively; p = 0.0026). For concentration of VEGFR1 such deviations were not found. The concentrations of VEGFR1 and VEGFR2 in serum were higher than in cerebrospinal fluid (p <0.0001), while VEGFR1 showed a positive correlation between serum and cerebrospinal fluid concentrations. the concentration of VEGFR1 in the cerebrospinal fluid was significantly lower in patients with B-lymphoblastic leukemia/lymphoma compared to other types of leukemia.Conclusion. the concentration of VEGFA in serum decreases in patients with blastemia, this may indicate a lack of secretion and excessive consumption of the factor by blast cells with a decrease in the proportion of leukocytes that normally secrete the factor. In the cerebrospinal fluid, the concentrations of VEGFR1 and VEGFR2 are lower than in serum, with the lowest values being found in patients with B-lymphoblastic leukemia/lymphoma, but no relationship with the development of CNS involvement was found.
{"title":"VEGFA, VEGFR1, VEGFR2 serum and cerebrospinal fluid concentration in patients with acute leukemia","authors":"E. Zakharko, V. Dvirnyk, Yuliya Chabaeva, D. Drokova, E. B. Rybkina, K. A. Lavrishinets, A. V. Bulgakov, M. N. Panasenko, Z. Fidarova, I. A. Lukianova, O. A. Aleshina, S. M. Kulikov, T. Gaponova, V. Troitskaya, E. N. Parovichnikova","doi":"10.17650/1818-8346-2024-19-2-34-45","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-2-34-45","url":null,"abstract":"Background. Vascular endothelial growth factor A (VEGFA) is one of the most important factors for regulation of hematopoietic stem cells differentiation. It is involved in leukemogenesis and central nervous system (CNS) damage in acute leukemia. According to the literature, the VEGFA production by blast cells is increased, but the values of serum concentration and the associations with CNS involvement are contradictory.Aim. evaluate the VEGFA, VEGFR1, VEGFR2 concentration in serum and cerebrospinal fluid of patient with different types of acute leukemia in disease onset and during treatment.Materials and methods. The concentration of VEGFA in serum and cerebrospinal fluid was studied in 74 primary patients with acute leukemia. The comparison group consisted of 67 healthy donors. VEGFR1, VEGFR2 were studied in serum and cerebrospinal fluid in 34 patients at the onset of the disease. The comparison group consisted of 10 healthy donors. For the analysis, an enzyme immunoassay was used on a semi-automatic Personal Lab analyzer (Adaltis) and Affymetrix eBioscience human VEGF-A Platinum ELISA reagents.Results. Serum VEGFA concentration was statistically significantly lower in acute leukemia patients than that of donors (median 149.78 and 432.19 pg/ml respectively; p <0.0001). Factor deficiency was significantly more pronounced in patients with blastemia (p <0.015). During antitumor therapy, there was a tendency to increase the amount of the factor in the blood serum. Serum concentration of soluble VEGFR2 was also lower in patients than that of donors (6949.9 and 8795.9 pg/ml respectively; p = 0.0026). For concentration of VEGFR1 such deviations were not found. The concentrations of VEGFR1 and VEGFR2 in serum were higher than in cerebrospinal fluid (p <0.0001), while VEGFR1 showed a positive correlation between serum and cerebrospinal fluid concentrations. the concentration of VEGFR1 in the cerebrospinal fluid was significantly lower in patients with B-lymphoblastic leukemia/lymphoma compared to other types of leukemia.Conclusion. the concentration of VEGFA in serum decreases in patients with blastemia, this may indicate a lack of secretion and excessive consumption of the factor by blast cells with a decrease in the proportion of leukocytes that normally secrete the factor. In the cerebrospinal fluid, the concentrations of VEGFR1 and VEGFR2 are lower than in serum, with the lowest values being found in patients with B-lymphoblastic leukemia/lymphoma, but no relationship with the development of CNS involvement was found.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"50 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-27DOI: 10.17650/1818-8346-2024-19-1-113-124
Y. S. Korkina, M. Shervashidze, T. T. Valiev, N. Batmanova, T. R. Panferova
Treatment intensification of acute lymphoblastic leukemia in children with L-asparaginase (L-ASP) improves therapy effectiveness and shows high survival rates. The unique biological properties of this enzyme make it possible to suppress tumor blasts proliferation by reducing blood asparagine concentration. L-ASP use is limited by toxicity and hypersensitivity reactions observed in 75 % of cases. Although most complications during L-ASP therapy are mild/moderate and are manageable with adequate accompanying therapy, the development of severe side effects leads to forced withdrawal of L-ASP, which significantly reduces the likelihood of a favorable outcome in children with acute lymphoblastic leukemia. One of the most severe toxicity manifestations is the development of asparaginase-associated pancreatitis. It worsens the prognosis and may cause patients’ death. This article presents both current data about asparaginase-associated pancreatitis and treatment experience of this complication at the Research Institute of Pediatric Oncology and Hematology of the N. N. Blokhin National Research Center of Oncology.
使用 L-天冬酰胺酶(L-ASP)强化治疗儿童急性淋巴细胞白血病可提高疗效,并显示出较高的存活率。这种酶具有独特的生物特性,可以通过降低血液中天冬酰胺的浓度来抑制肿瘤细胞的增殖。L-ASP 的使用受到毒性的限制,75% 的病例会出现超敏反应。虽然 L-ASP 治疗期间的大多数并发症都是轻度/中度的,并可通过适当的辅助治疗加以控制,但严重副作用的出现会导致被迫停用 L-ASP,这大大降低了急性淋巴细胞白血病患儿获得良好治疗结果的可能性。天冬酰胺酶相关性胰腺炎是最严重的毒性表现之一。它使预后恶化,并可能导致患者死亡。本文介绍了天冬酰胺酶相关性胰腺炎的最新数据,以及 N. N. Blokhin 国家肿瘤研究中心儿科肿瘤与血液学研究所对这种并发症的治疗经验。Blokhin 国家肿瘤学研究中心儿科肿瘤学和血液学研究所的治疗经验。
{"title":"Successful treatment of pancreatitis caused by L-asparaginase in clinical practice","authors":"Y. S. Korkina, M. Shervashidze, T. T. Valiev, N. Batmanova, T. R. Panferova","doi":"10.17650/1818-8346-2024-19-1-113-124","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-1-113-124","url":null,"abstract":"Treatment intensification of acute lymphoblastic leukemia in children with L-asparaginase (L-ASP) improves therapy effectiveness and shows high survival rates. The unique biological properties of this enzyme make it possible to suppress tumor blasts proliferation by reducing blood asparagine concentration. L-ASP use is limited by toxicity and hypersensitivity reactions observed in 75 % of cases. Although most complications during L-ASP therapy are mild/moderate and are manageable with adequate accompanying therapy, the development of severe side effects leads to forced withdrawal of L-ASP, which significantly reduces the likelihood of a favorable outcome in children with acute lymphoblastic leukemia. One of the most severe toxicity manifestations is the development of asparaginase-associated pancreatitis. It worsens the prognosis and may cause patients’ death. This article presents both current data about asparaginase-associated pancreatitis and treatment experience of this complication at the Research Institute of Pediatric Oncology and Hematology of the N. N. Blokhin National Research Center of Oncology.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"184 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140530285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-26DOI: 10.17650/1818-8346-2024-19-1-56-69
O. Pisarevskaya, S. A. Alekseev, O. Rukavitsyn
Aim. Identify risk factors for the development of osteodestructive syndrome. To determine the relationship between the types of secreted monoclonal immunoglobulin (paraprotein) and the severity of osteodestructive syndrome in patients with paraproteinemic hemoblastoses (PH) and Waldenström’s macroglobulinemia (WM).Materials and methods. A retrospective analysis of data from 116 patients with PH and WM was performed. 104 patients (89.6 %) were diagnosed with multiple myeloma. Less commonly observed were WM (in 8 patients – 6.9 %), plasma cell leukemia (in 2 patients – 1.8 %), solitary plasmacytoma and monoclonal gammopathy of unknown significance were diagnosed in one case (0.9 %) each. According to the severity of osteodestructive syndrome, all patients were divided into 4 groups. The first group (0) included patients who did not have osteodestructive changes in the bones. In patients of the second group, a mild degree (I) osteodestructive process was observed, and in patients from the third and fourth groups – moderate (II) and severe (III) degrees, respectively. All patients underwent protein electrophoresis followed by immunofixation to determine the type of paraprotein and its concentration in serum and urine.Results. In the majority of patients, paraproteins were detected in the blood – Gκ (35.1 %), Gλ (24.6 %), Bence Jones protein λ-type (BJλ) (14.9 %); in urine – BJλ protein (14.9 %) and Bence Jones protein κ-type (BJκ) (28.1 %). Secretion of other types of paraproteins in the blood was less frequently detected – Aκ (9.6 %), Aλ (7.0 %), Mκ (3.5 %), Mλ (3.5 %), Dλ (2.6 %), BJκ (4.4 %). Osteodestructive syndrome of I and II severity was diagnosed in 43 (37.1 %) and 40 (34.5 %) patients, respectively; lytic destruction of III degree was less frequently detected in 20 (17.2 %) patients, in 13 (11.2 %) patients osteodestruction was not detected (degree 0). It was noted that a higher degree of destruction (II, III) was observed in patients with multiple myeloma occurring with paraproteinemia Dλ and BJλ in the blood, as well as hypercalcemia. Osteodestructive syndrome of the lowest degree (0, I) was diagnosed in patients with the secretion of monoclonal proteins Ak and Mλ. There was no statistically significant relationship between the type of secretion of paraproteins Gκ, Gλ, Aλ, Mκ, BJκ in the blood, as well as proteins BJκ and BJλ in the urine and the severity of the osteodestructive process.Conclusion. The results obtained in the study make it possible to identify risk groups, and parameters such as the type of paraprotein, the concentration of calcium in the blood serum can be considered as prognostic factors when assessing the severity of osteodestructive syndrome in patients with PH and WM.
目的确定发生骨破坏综合征的危险因素。确定副蛋白血母细胞增多症(PH)和瓦尔登斯特伦巨球蛋白血症(WM)患者分泌的单克隆免疫球蛋白(副蛋白)类型与骨破坏综合征严重程度之间的关系。对 116 名 PH 和 WM 患者的数据进行了回顾性分析。104名患者(89.6%)被诊断为多发性骨髓瘤。较少见的是WM(8例患者,占6.9%)、浆细胞白血病(2例患者,占1.8%)、单浆细胞瘤和意义不明的单克隆丙种球蛋白病各1例(占0.9%)。根据骨破坏综合征的严重程度,所有患者被分为 4 组。第一组(0)包括骨骼没有发生骨质破坏性改变的患者。第二组患者的骨破坏过程为轻度(I),第三组和第四组患者的骨破坏过程分别为中度(II)和重度(III)。所有患者均接受了蛋白质电泳和免疫固定检查,以确定副蛋白质的类型及其在血清和尿液中的浓度。大多数患者的血液中检测到副蛋白--Gκ(35.1%)、Gλ(24.6%)、本斯-琼斯蛋白λ型(BJλ)(14.9%);尿液中检测到副蛋白--BJλ蛋白(14.9%)和本斯-琼斯蛋白κ型(BJκ)(28.1%)。血液中其他类型副蛋白的分泌较少:Aκ(9.6 %)、Aλ(7.0 %)、Mκ(3.5 %)、Mλ(3.5 %)、Dλ(2.6 %)、BJκ(4.4 %)。43(37.1%)和 40(34.5%)名患者被诊断为 I 级和 II 级严重骨质破坏综合征;20(17.2%)名患者被诊断为 III 级溶解性破坏,13(11.2%)名患者未被诊断为骨质破坏(0 级)。值得注意的是,多发性骨髓瘤患者血液中出现副蛋白血症 Dλ 和 BJλ 以及高钙血症时,骨质破坏程度(II、III 度)较高。分泌单克隆蛋白 Ak 和 Mλ 的患者被诊断为最低程度(0,I)的骨质破坏综合征。血液中副蛋白Gκ、Gλ、Aλ、Mκ、BJκ以及尿液中蛋白质BJκ和BJλ的分泌类型与骨质破坏过程的严重程度之间没有统计学意义上的显著关系。研究结果有助于确定危险人群,在评估 PH 和 WM 患者骨破坏综合征的严重程度时,可将副蛋白类型、血清钙浓度等参数视为预后因素。
{"title":"Monoclonal immunoglobulin as a prognostic factor for the severity of bone damage in paraproteinemic hemoblastoses and Waldenström’s macroglobulinemia","authors":"O. Pisarevskaya, S. A. Alekseev, O. Rukavitsyn","doi":"10.17650/1818-8346-2024-19-1-56-69","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-1-56-69","url":null,"abstract":"Aim. Identify risk factors for the development of osteodestructive syndrome. To determine the relationship between the types of secreted monoclonal immunoglobulin (paraprotein) and the severity of osteodestructive syndrome in patients with paraproteinemic hemoblastoses (PH) and Waldenström’s macroglobulinemia (WM).Materials and methods. A retrospective analysis of data from 116 patients with PH and WM was performed. 104 patients (89.6 %) were diagnosed with multiple myeloma. Less commonly observed were WM (in 8 patients – 6.9 %), plasma cell leukemia (in 2 patients – 1.8 %), solitary plasmacytoma and monoclonal gammopathy of unknown significance were diagnosed in one case (0.9 %) each. According to the severity of osteodestructive syndrome, all patients were divided into 4 groups. The first group (0) included patients who did not have osteodestructive changes in the bones. In patients of the second group, a mild degree (I) osteodestructive process was observed, and in patients from the third and fourth groups – moderate (II) and severe (III) degrees, respectively. All patients underwent protein electrophoresis followed by immunofixation to determine the type of paraprotein and its concentration in serum and urine.Results. In the majority of patients, paraproteins were detected in the blood – Gκ (35.1 %), Gλ (24.6 %), Bence Jones protein λ-type (BJλ) (14.9 %); in urine – BJλ protein (14.9 %) and Bence Jones protein κ-type (BJκ) (28.1 %). Secretion of other types of paraproteins in the blood was less frequently detected – Aκ (9.6 %), Aλ (7.0 %), Mκ (3.5 %), Mλ (3.5 %), Dλ (2.6 %), BJκ (4.4 %). Osteodestructive syndrome of I and II severity was diagnosed in 43 (37.1 %) and 40 (34.5 %) patients, respectively; lytic destruction of III degree was less frequently detected in 20 (17.2 %) patients, in 13 (11.2 %) patients osteodestruction was not detected (degree 0). It was noted that a higher degree of destruction (II, III) was observed in patients with multiple myeloma occurring with paraproteinemia Dλ and BJλ in the blood, as well as hypercalcemia. Osteodestructive syndrome of the lowest degree (0, I) was diagnosed in patients with the secretion of monoclonal proteins Ak and Mλ. There was no statistically significant relationship between the type of secretion of paraproteins Gκ, Gλ, Aλ, Mκ, BJκ in the blood, as well as proteins BJκ and BJλ in the urine and the severity of the osteodestructive process.Conclusion. The results obtained in the study make it possible to identify risk groups, and parameters such as the type of paraprotein, the concentration of calcium in the blood serum can be considered as prognostic factors when assessing the severity of osteodestructive syndrome in patients with PH and WM.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"17 4-5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140530127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.17650/1818-8346-2024-19-1-40-50
T. T. Valiev, A. A. Khachatryan, S. V. Goryacheva, N. Batmanova, K. Kirgizov, S. Varfolomeeva
The use of high-effective, multicomponent, risk-adopted chemoimmunotherapy schemes in children with Burkitt lymphoma reached advanced long-term progression-free survival over 90 % even for high risk patients. Unfortunately, conventional therapeutic strategy for relapsed/refractory disease is not accepted, and the effectiveness of carboplat‑in- and gemcitabine-containing regimens is unsatisfactory. Clinical experience of rituximab, ibrutinib and nivolumab in combination with polychemotherapy and own clinical case of successful relapsed Burkitt lymphoma treatment with targeted therapy and following autologous and allogeneic hematopoietic stem cell transplantation are presented. Proposed program could achieve a complete remission of Burkitt lymphoma, but short-term after allogeneic hematopoietic stem cell transplantation diagnosed T-cell precursor acute lymphoblastic leukemia became fatal for the patient.
{"title":"The experience of relapsed Burkitt lymphoma treatment with targeted drugs and autologous/allogeneic stem cell transplantation","authors":"T. T. Valiev, A. A. Khachatryan, S. V. Goryacheva, N. Batmanova, K. Kirgizov, S. Varfolomeeva","doi":"10.17650/1818-8346-2024-19-1-40-50","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-1-40-50","url":null,"abstract":"The use of high-effective, multicomponent, risk-adopted chemoimmunotherapy schemes in children with Burkitt lymphoma reached advanced long-term progression-free survival over 90 % even for high risk patients. Unfortunately, conventional therapeutic strategy for relapsed/refractory disease is not accepted, and the effectiveness of carboplat‑in- and gemcitabine-containing regimens is unsatisfactory. Clinical experience of rituximab, ibrutinib and nivolumab in combination with polychemotherapy and own clinical case of successful relapsed Burkitt lymphoma treatment with targeted therapy and following autologous and allogeneic hematopoietic stem cell transplantation are presented. Proposed program could achieve a complete remission of Burkitt lymphoma, but short-term after allogeneic hematopoietic stem cell transplantation diagnosed T-cell precursor acute lymphoblastic leukemia became fatal for the patient.","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140530167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.17650/1818-8346-2024-19-1-14-20
M. I. Akhmedov, P. A. Zeynalova
.
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{"title":"Review of the Expert Council “Multiple myeloma: the era of monoclonal antibodies in the treatment of patients with multiple myeloma”","authors":"M. I. Akhmedov, P. A. Zeynalova","doi":"10.17650/1818-8346-2024-19-1-14-20","DOIUrl":"https://doi.org/10.17650/1818-8346-2024-19-1-14-20","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":518071,"journal":{"name":"Oncohematology","volume":"49 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140530724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}