RESUMO
The authors give their own data in the first Russian publication on 170 patients with lymphomas and hepatitis concurrent with HIV infection, on the distribution of therapy regimens by nosological entities and the number of deaths. Conventional protocols and programs were used for diagnosis and treatment. All the patients received highly active antiretroviral therapy. Lymphoma was treated according to the conventional programs using rituximab in people without hepatitis B. Aggressive lymphomas, such as diffuse large B-cell lymphoma, Burkitt lymphoma, and plasmablastic lymphoma, were identified in most patients. Hodgkin's lymphoma is the matter of a separate study; it differs in its pathogenesis from other lymphomas. The rate of coinfection with hepatitis was high in the entire group of patients with lymphomas. The major prognostic indicators included low CD4 T-cell counts (less than 50), stage IVB lymphoma, and hepatitis. Complete remissions were achieved in 40% of patients. Forty-one (24%) patients died.
Assuntos
Infecções por HIV , Hepatite Viral Humana , Linfoma , Administração dos Cuidados ao Paciente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Hepatite Viral Humana/diagnóstico , Hepatite Viral Humana/epidemiologia , Hepatite Viral Humana/terapia , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Internados , Linfoma/epidemiologia , Linfoma/patologia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Moscou/epidemiologia , Avaliação das Necessidades , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/organização & administração , Melhoria de QualidadeRESUMO
Parameters of hemogram and myelogram were studied in patients with aggressive and indolent non-Hodgkin's lymphomas: the relationships between the parameters recorded before treatment and during remission or progress 6 months after chemotherapy were studied by multifactorial analysis. The progress of indolent non-Hodgkin's lymphomas was associated with changes caused by tumor infiltration of the bone marrow; lymphocytosis in the myelogram or hemogram was associated with a relative decrease in the count of granulocytic hemopoietic stem cells. A sign associated with the absence of remission in aggressive non-Hodgkin's lymphomas was decreased level of hemoglobin and erythroid cells. Changes in myelogram attesting to anemia and suppressed erythropoiesis before chemotherapy are additional prognostic factors indicating obligatory intensification of chemotherapy for patients with aggressive non-Hodgkin's lymphomas.
Assuntos
Tratamento Farmacológico , Linfoma não Hodgkin/diagnóstico , Análise de Variância , Células da Medula Óssea/citologia , Progressão da Doença , Células Eritroides/citologia , Feminino , Células Precursoras de Granulócitos/citologia , Hemoglobinas/metabolismo , Humanos , Modelos Logísticos , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
Study of MDR1 polymorphism in intron 6 and exon 12 of healthy individuals and patients with chronic lymphoproliferative diseases showed that the presence of mutant 6+139T allele is a factor determining resistance to lymphoproliferative diseases. Comparison of genotyping results in 53 patients and the data on the efficiency of drug therapy showed no significant associations of C(6+139)T and C(1236)T genotypes with drug resistance.
Assuntos
Resistencia a Medicamentos Antineoplásicos/genética , Genes MDR , Transtornos Linfoproliferativos/genética , Polimorfismo Genético , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Sequência de Bases , Estudos de Casos e Controles , DNA/genética , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Linfocítica Crônica de Células B/genética , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/genética , Transtornos Linfoproliferativos/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mutação , Federação RussaRESUMO
Study of polymorphism in MDR1 gene exons 21 and 26 revealed that T2677T and T3435T alleles are not a factor predisposing to lymphoproliferative diseases, but they determine the efficiency chemotherapy. Individuals with T2677T and T3435T haplotypes are at highest risk of drug resistance. Association between genotypes G2677T and C3435T was detected in normal subjects and in patients with lymphoproliferative diseases.
Assuntos
Antineoplásicos/uso terapêutico , Genes MDR , Leucemia Linfoide/tratamento farmacológico , Linfoma não Hodgkin/tratamento farmacológico , Polimorfismo Genético , Alelos , Genótipo , Humanos , Leucemia Linfoide/genética , Linfoma não Hodgkin/genética , Reação em Cadeia da Polimerase , Valor Preditivo dos TestesRESUMO
Functional activity of P-glycoprotein in lymphocytes of patients with lymphoproliferative diseases was studied using rhodamine 123. Functional activity of P-glycoprotein in patients receiving a course of chemotherapy was lower than in controls. P-glycoprotein activity was higher in patients receiving more aggressive therapy. Initially activity of P-glycoprotein was higher in patients who did not respond to chemotherapy in comparison with those whose clinical status improved after a course of chemotherapy.