Experience with high-dose chemotherapy in patients with testicular diffuse large B-cell lymphoma


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AIM. To evaluate the efficiency of high-dose therapy according to the DLBL-CNS-2007 protocol in patients with testicular diffuse large B-cell lymphoma (DLBL). MATERIALS AND METHODS. Out of 408 male patients with non-Hodgkin lymphoma, 8 patients aged 50 to 69 years (median age 55.5 years) with primary testicular (n=3) or with generalized-stage testicular DLBL (n=5) were included in the study. These patients were followed up at the Hematology Research Center, Ministry of Health of the Russian Federation, in 2007 to 2013. Systemic chemotherapy was performed in accordance with the DLBL-CNS-2007 protocol. RESULTS. The DLBL-CNS-2007 protocol was implemented in first-line therapy in 7 patients. At the first diagnostic stage, one patient was found to have anaplastic seminoma; in this connection right orchifuniculectomy was carried out, followed by radiotherapy applied to the scrotal region in a total focal dose of 34 Gy. This patient with disease recurrence was included in the DLBL-CNS-2007 treatment protocol. The number of polychemotherapy (PCT) cycles (n=4 or 6) was determined by the time to achieve complete remission. After completion of DLBL-CNS-2007 PCT, 6 patients achieved complete remission; the primary resistant disease was noted in 2 cases. At this moment 6 patients are alive in first complete remission during the median follow-up of 50 months (10-54 months). CONCLUSION. The findings suggest that high-dose therapy according to the DLBL-CNS-2007 protocol in patients with testicular DLBL can achieve complete remission and increase overall and event-free survival rates. This fact should be borne out by a large number of observations.

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Опыт применения высокодозной химиотерапии у больных диффузной В-крупноклеточной лимфомой с поражением яичка. - Резюме. Цель исследования. Оценить эффективность высокодозной терапии по протоколу ДВККЛ-ЦНС-2007 у больных диффузной В-крупноклеточной лимфомой (ДВККЛ) с поражением яичка. Материалы и методы. Из 408 пациентов мужского пола с неходжкинской лимфомой в исследование включено 8 больных ДВККЛ с первичным вовлечением яичка (у 3) или с генерализованной стадией ДВККЛ, у которых клиническая картина дебютировала с поражения яичка (у 5) в возрасте от 50 до 69 лет (медиана возраста 55,5 года). Данные пациенты наблюдались с 2007 по 2013 г. в ФГБУ "Гематологический научный центр" (ГНЦ) Минздрава России. Системная химиотерапия проводилась согласно протоколу ДВККЛ ЦНС-2007. Результаты. В первой линии терапии протокол ДВККЛ ЦНС-2007 выполнен у 7 пациентов. Одному пациенту на первом этапе диагностики установлен диагноз анапластической семиномы, в связи с чем произведена орхифуникулэктомия справа и в дальнейшем проведена лучевая терапия на область мошонки в суммарной очаговой дозе 34 Гр. В рецидиве заболевания данный пациент включен в протокол лечения ДВККЛ ЦНС-2007. Количество курсов ПХТ (4 или 6) определялось периодом достижения полной ремиссии. После завершения полихимиотерапии по схеме ДВККЛ-ЦНС-2007 полная ремиссия достигнута у 6 пациентов, в 2 случаях отмечалось первично-резистентное течение заболевания. В настоящий момент 6 пациентов живы в первой полной ремиссии при медиане наблюдения 50 (10-54) мес. Заключение. Полученные результаты позволяют предположить, что терапия в высоких дозах согласно протоколу ДВККЛ-ЦНС-2007 у больных ДВККЛ с поражением яичка позволяет достичь полной ремиссии заболевания, увеличить общую и "бессобытийную" выживаемость пациентов. Для подтверждения данного факта необходимо большее количество наблюдений.
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