NOT OTHERWISE SPECIFIED T-CELL LYMPHOMA: OUTCOMES OF A SINGLE CENTER STUDY.

BACKGROUND: The peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is the most common subtype of peripheral T-cell lymphoma (PTCL). It constitutes approximately 25% of all PTCLs and accounts for more than 15% of all lymphomas. The results of the first Ukrainian prospective study of patients with PTCL-NOS are presented in the article. The aim of the study was to analyze the morbidity of PTCL patients and the treatment performed, to evaluate overall survival and progression-free survival, and to determine the factors that predict the treatment response. PATIENTS AND METHODS: An analysis was performed on the data of 31 patients diagnosed with peripheral PTCL-NOS from February 2018 to the present. T-cell lymphoid neoplasms were diagnosed according to the 2016 WHO classification. The treatment regimens were in alignment with ESMO and NCCN guidelines. More than 90% of patients were prescribed anthracycline-based regimens (CHOP; CHOEP - cyclophosphamide, doxorubicin, etoposide, vincristine, prednisone). An initial treatment was performed with CHOP-based regimens in 38.70% (n = 12) of patients, with the addition of etoposide in 58.06% of patients (n = 18). RESULTS: The response was assessed according to the response criteria for malignant lymphoma (Cheson, 2008, 2014). The overall response to therapy was 58.06% (n = 18), with complete responses in 29.03% of patients and partial responses in 29.03% of patients. The stabilization of the disease occurred in 3.44%, while the disease progression in 41.37% of patients. The 12-month and 24-month survival rates were 75.44% and 50.81%, respectively. The 12-month and 24-month progression-free survivals were 47.68% and 33.1%, respectively. Ki-67 overexpression (> 65%) was a negative prognostic factor. CONCLUSIONS: The results of the treatment of PTCL obtained in a Ukrainian population study are similar to those in other European studies, all of which remain unsatisfactory. Further research is required to develop a new strategy for examination and therapy to improve treatment outcomes. The emphasis should be placed on the pragmatic clinical trials comparing the efficacy of first-line treatment in PTCL patients with both favorable and unfavorable clinical factors.

Ukrainian prospective study in patients with T-cell non-Hodgkin lymphomas.

BACKGROUND: T-cell lymphoma (TCL) is a heterogeneous group of lymphoproliferative diseases that account for 10-15% of all non-Hodgkin lymphomas. The aim of the study was to analyze the incidence of TCL in Ukraine, distribution according to subtypes and to assess the results of treatment of patients with TCL depending on lymphoma subtype and clinical-and-laboratory risk factors. PATIENTS AND METHODS: Data from 70 patients with TCL were analyzed from February 2018 to May 2021. T-cell lymphoid neoplasms were diagnosed according to the 2016 WHO classification. The patients were divided into 4 groups: 1st (A) - leukemic forms (n = 13) (received SMILE or HyperCVAD +/- auto/alloSCT); 2nd (B) - nodal T-cell lymphomas (n = 43) (CHOP-like regimens); 3rd (C) - cutaneous T-cell lymphomas (n = 9) (PUVA therapy, interferon, and methotrexate); 4th (D) - extranodal T-cell lymphomas (n = 5) (CHOP-like regimens). The response was determined according to the Lugano 2014 criteria. RESULTS: According to the study results, 5-6% of all non-Hodgkin lymphoma registered in Ukraine in 2018-2020 were T-cell lymphomas. The most common subtype was peripheral TCL (61%). In the studied groups of TCL patients, the overall response rate was 50% (n = 35). 2-years event-free survival rate was 62.27%. 2-years overall survival rate was 65.76%. 18-month progression-free and overall survival in group B was higher versus groups A, C and D. The factors of unfavorable prognosis were bone marrow involvement and the expression of Ki67 > 65% (p = 0.03 and p = 0.006, respectively). CONCLUSIONS: Histologic subtype of T-cell non-Hodgkin lymphoma influence the treatment outcome. The best overall response rate, overall survival rate, progression-free survival were in group of patients with nodal T-cell non-Hodgkin lymphomas, the worst - in patients from leukemic group. Poor prognostic factors are bone marrow involvement, and Ki-67 expression > 65%.

[Primary bone lymphoma].

Presented literature data on the occurrence, diagnosis and treatment of primary lymphoma of bone. Case reports described in medical practice.

[Efficiency therapy with rituximab in patients with non-Hodgkin's lymphomas].

Management of non-Hodgkin's lymphomas (NHL) has been significantly changed during last 40 years from radiotherapy to modern polychemotherapy with application of monoclonal antibodies. A ten year experience of the treatment of patients with B-cell NHL with rituximab application was accumulated in National Cancer Institute. The group of patients with NHL, who were treated in oncohematology department in the period from 2001 to 2010, was chosen for study of the efficacy of the treatment with rituximab. The immediate and distant results of the treatment were evaluated in this group of patients. The usage of the polychemotherapy with rituximab was highly efficient in the treatment of primary and relapsed patients with NHL. This group shows high rate of the immediate and distant results of treatment.

[Thromboprophylaxis in patients with multiply myeloma who receives chemotherapy with thalidomide].

Achievements of world practice about development and prophilaxis of tromboembolic events (VTE) in cancer patients. Particular attention is paid to prevention of VTE in patients with multiply myeloma who receive chemotherapy with Thalidomide.

[The treatment of patients with refractory forms of Hodgkin's lymphomas].

The treatment of patients with refractory forms of Hodgkin's lymphomas in combination with chemo-radiotherapy is priority. Nevertheless, chemotherapy has to include multicomponent schemes and radiation therapy should be an addition and consolidative method to chemotherapy.

[Experience of using thalidomide in the treatment of patients with multiple myeloma].

The results of treatment of patients with multiple myeloma with thalidomide and complications of this treatment are presented. Monotherapy with thalidomide and its combinations with corticosteroids and cytostatics is an effective as first line treatment and as a treatment of patients with refractory disease. The most common side effect is toxic neuropathy. Other complications are less common and are easily controlled with medications.

[Periferal blood subpopulation and apoptosis indices in the treatment of chronic myelogenous leukemia with Imatinib].

The results of immunophenotyping investigations of periferal blood granulocyte and lymphocyte population, number of p53+ and Bcl-2+ in 57 patients (among them 18 persons suffered after the Chernobyl NPP accident) with chronic phase of chronic myelogenic leukemia were presented in the article. The reduction of CD34+ granulocytes number, normalization of CD95 cells, negative correlation between the number of CD95 and p53, Bcl-2 granulocytes in Imatinib treated patients in comparison with a control group was determined. The results of the investigation confirmed the efficiency of using BCR/ABL tyrosin kinase inhibitor Imatinib in the treatment of chronic phase of CML.

[Long-term results of treatment of chronic B-cell lymphoid leukocytes in persons who participated in the elimination of the effects of the nuclear accident at the Chernobyl nuclear station]. / Rezul'taty likuvannia khronichnoho B-klitynnoho limfoleikozu v uchasnykiv likvidatsiï naslidkiv avariï na ChAES u viddalenomu periodi.

Clinical-and-hematological characteristics are presented of B-cell chronic lymphoid leukosis in those persons who took part in the elimination of the effects of the Chornobyl accident in the remote period. Results are highlighted of treatment of 16 patients with making use of different chemical drug preparations. Employment of fludarabin and cyclophosphan combined in treatment of the medical condition in question has been shown to promote long-term complete and partial remissions in a major proportion of patients, which effect was not achievable with standard means of remediation. A side effect of fludarabin was leukocytopenia that in the presence of changed immunity threatened the patients with development and exacerbation of infections complications. Use of manax and erbisol moderated the immunosuppressive and toxic action of fludarabin, due to which fact infectious complications and drug-induced hepatitis have came to be less common, the patients' quality of life gotten better.