Estudo observacional do prognóstico e terapêutica dos portadores de linfoma difuso de grandes células B de IPIa de risco intermediário alto e alto / Observational Study of prognosis and therapeutics of Diffuse Large B Cell Lymphoma patients with high intermediate to high aIPI risk

RESUMO

Elaboramos projeto de pesquisa para verificar o papel dos marcadores CD10, Bcl-6, MUM-1, Bcl-2 e p63 e do transplante de medula óssea autólogo (ATMO), em primeira remissão completa, em portadores de linfoma difuso de grande célula B de risco intermediário alto e alto. A proteína Bcl-2 foi positiva em 27 (37%) pacientes e foi o único fator preditivo independente para sobrevida global (SG) à análise multivariada. As SG e sobrevida livre de doença (SLD) para os 16 pacientes que receberam ATMO foram de 75% e 85,2 por cento, respectivamente, com diferença estatisticamente significativa para SLD (p = 0,015). Concluímos que o ATMO foi seguro e capaz de melhorar a sobrevida, e que a expressão de Bcl-2 pode ser utilizada na programação terapêutica inicial destes pacientes...

ABSTRACT

A research project was designed in order to analyse the impact of the expression of CD10, Bcl-6, MUM-1, Bcl-2 and p63 markers and the role of autologous stem cell transplantation (ASCT) in first complete remission for diffuse large B cell lymphoma with high intermediate to high risk. Bcl-2 expression was found in 37% (27) of the patients and was the single independent predicting factor of overall survival (OS) prognosis according to multivariate analysis. OS and disease free survival (DFS) were of 75% and 85.2% respectively for the group of 16 patients treated with ASCT, with statistically significant difference for DFS (p=0.015). In this study ASCT was found to be a safe procedure for improving survival rates and the expression of Bcl-2 protein was found to be useful as one of the variables to be analysed in the therapeutic approach to these patients...