References

nodgo

Российский журнал детской гематологии и онкологии (РЖДГиО)

Russian Journal of Pediatric Hematology and Oncology

2311-12672413-5496

LTD “Graphica”

10.17650/2311-1267-2015-2-2-60-71

nodgo-103

Research Article

ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ/ОБЗОРЫ ЛИТЕРАТУРЫ

ORIGINAL INVESTIGATIONS/LITERATURE REVIEWS

ПЕРВИЧНОЕ РЕЗИСТЕНТНОЕ ТЕЧЕНИЕ И РЕЦИДИВЫ ЛИМФОМЫ ХОДЖКИНА. ПРЕДОТВРАТИМЫЕ ПОТЕРИ ПРИ «САМОМ ИЗЛЕЧИМОМ» ГЕМОБЛАСТОЗЕ

PRIMARY RESISTANT COURSE AND RECURRENCE OF THE HODGKIN,S LYMPHOMA. PREVENTABLE LOSSES AT “MOST RECOVERABLE” HEMOBLASTOSIS

Жуков

Н. В.

Zhukov

N. V.

zhukov.nikolay@rambler.ru

ФГБУ ФНКЦ ДГОИ им. Дмитрия Рогачева Минздрава России; Россия, 117198, Москва, ул. Саморы Машела, 1 ГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России; Россия, 117997, Москва, ул. Островитянова, 1РоссияFederal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia; 1 Samory Mashela St., Moscow, 117198, Russia N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; 1 Ostrovityanova St., Moscow, 117997, RussiaRussian Federation

2015

29052015

226071

2015

Жуков Н.В.

Zhukov N.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.nodgo.org/jour/article/view/103

В отличие от большинства злокачественных опухолей при лимфоме Ходжкина (ЛХ) возможность излечения сохраняется и у больных, опухоли которых не ответили на терапию 1-й линии (первичная резистентность или рецидив заболевания). В настоящее время стандартным методом лечения этих пациентов является высокодозная химиотерапия с трансплантацией аутологичных клеток предшественников гемопоэза (ТКПГ). Однако в РФ этот метод лечения используется значимо реже, чем в развитых странах мира, что обусловлено дефицитом доступных трансплантационных мощностей. Невозможность проведения ТКПГ всем пациентам, нуждающимся в ней, негативно сказывается на общей результативности лечения ЛХ, что требует поиска факторов, позволяющих оптимизировать отбор больных для выполнения ТКПГ. Однако анализ результатов зарубежных и отечественных исследований свидетельствует о том, что единственным фактором, позволяющим адекватно проводить отбор больных на проведение ТКПГ, является ответ опухоли на индукционную терапию (пациенты, находящиеся вне состояния ремиссии, получать ТКПГ не должны). Остальные факторы (вариант течения болезни, проведение терапии 2-й линии в анамнезе) не обладают достаточной степенью надежности для принятия решения об отказе в выполнении ТКПГ. Таким образом, все пациенты, у которых в результате проведения индукционной терапии достигнута ремиссия, должны рассматриваться как кандидаты на выполнение ТКПГ, а единственным способом предотвращения гибели больных с рецидивами и первично-резистентным течением ЛХ в РФ является увеличение трансплантационной активности (количества трансплантационных центров).

Not like most malignant tumors, with Hodgkin,s lymphoma (HL) the possibility of curing remains at patients, which tumors did not respond to the 1st line therapy (primary resistance or disease recurrence). Nowadays the standard method of treatment of these patients is the high-dose chemotherapy with transplantation of autologous cells of hemopoiesis precursors (ТCHP). Anyway, in the RF this treatment method is used much less often than in developed world countries, what is stipulated by the deficit of available transplantation facilities. The impossibility of TCHP administration to all patients, who need it, has a negative impact on the total effectiveness of the HL treatment, requiring to look for factors, allowing to optimize the selection of patients for TCHP. Anyway, the analysis of results of foreign and national research shows, that the only factor, allowing to adequately select patients for TCHP, is the tumor response for the induction therapy (patients off remission should not receive TCHP). Other factors (treatment option, 2nd line therapy in the anamnesis) are not reliable enough to make decision to refuse to perform TCHP. So, all patients, obtaining remission due to the induction therapy, should be considered as candidates for TCHP, and the only method to prevent the peril of patients with recurrences and primary resistant HL course in the RF is the increase of the transplantation activity (number of transplantation centers).

лимфома Ходжкинарецидивпервично-резистентное течениевысокодозная химиотерапиятрансплантация клеток предшественников гемопоэза

Hodgkins lymphomarecurrenceprimary resistant coursehigh-dose chemotherapytransplantation of hemopoiesis precursor cells

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The authors declare that there are no conflicts of interest present.