Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya30195Research ArticleEfficacy of therapy of different variants of anaplastic large t-cell lymphomasVinogradovaIu E-LutsenkoI N-KaplanskaiaI B-Vorob'evI A-SamoĭlovaR S-GorgidzeL A-RyzhikovaN A-ValievT T-GiliazitdinovaE A-DzhulakianU L-EgorovaE K-ZvonkovE E-Krasil'nikovaB B-MagomedovaA U-MargolinO V-Mar'inD S-KremenetskaiaA M-KravchenkoS K-Vorob'evA I-15072008807333709042020Copyright © 2008, Consilium Medicum2008Aim. To compare efficacy of NHL-BFM-90 and CHOP-like courses in the treatment of anaplastic large cell lymphoma (ALCL). Material and methods. Twenty-two patients with ALCL participated in the study. The diagnosis was made basing on the findings of clinical, device, morphological, immunohistochemical and molecular-genetic examinations with application of a panel of monoclonal antibodies to CD30, ALK, CD3, CD4, CD8, CD7, CD34, CD15, CD68, CD20, CD45RO, CD45RA, Ki-67. 14 cases of 22 were negative by kinase of anaplastic lymphocytes (ALK-) and 8 were positive (ALK+). Mean age of ALK-ALCL patients was 39.6 + 4.1 years, of ALK+ALCL patients - 23.4 + 2.6 years. 14 patients were treated by the protocol NHL-BFM-90, 8 were initially treated with other schemes (CHOP, MACOP-В, BEACOPP and others). All 14 patients treated according to NHL-BFM-90 had ALCL stages III-IV with B-symptoms. 12 patients who completed treatment by the above protocol achieved complete remission after the forth course, 2 patients failed the treatment. Of 8 ALCL patients treated initially according to other schemes, a complete remission was achieved in 4 patients (2 had stage II). One of 4 patients with remission had recurrence. Four patients who had failed to achieve complete remission died of the disease progression. Conclusion. ALCL occurs more frequently in young and middle-aged patients. The disease has an aggressive course with rapid generalization. For such processes it is more preferable to use a modified protocol NHL-BFM-90.anaplastic large ceil lymphomatherapyNHL-BFM-9NHL-BFM-9анаплазированная крупноклеточная лимфоматерапия[Kadin М. Е., Sako D., Berliner N. Childhood Ki-1 lymphoma presenting with skin lesions and peripheral lymphadenopathy. Blood 1986; 68: 1042.][Stein H., Mason D. Y., Gerdes J. et al. The expression of the Hodgkin's disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells. Blood 1985; 66: 848.][Stein H., Foss H., Durkop H. et al. CD30+ anaplastic large cell lymphoma: a review of its histopathologic, genetic, and clinical features. Blood 2000; 96: 3681-3695.][Виноградова Ю. E., Воробьев А. И. Т-клеточные лимфатические опухоли. В кн.: Воробьев А. И. (ред.). Руководство по гематологии. 3-е изд. М.: Ньюдиамед; 2002. Т. 2: 113-131.][Магомедова А. У., Кравченко С. К., Кременецкая А. М. и др. Диффузная В-крупноклеточная лимфосаркома: трудности и ошибки диагностики. Тер. арх. 2006; 7: 76-84.][Sarris А. Н., Luthra R., Papadimitracopoulou V. et al Amplification of genomic DNA demonstrates the presence of the t(2;5)(p23;q35) in anaplastic large cell lymphoma, but not on other non-Hodgkin's lymphomas. Hodgkin's disease, or lymphomatoid papulosis. Blood 1996; 88: 1771-1779.][Falini В., Pileri S., Zinzani P. L. et al. ALK+ lymphoma: clinico-pathological findings and outcome. Blood 1999; 93: 2697.][Gascoyne R., Aoun P., Wu D. et al. Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. Blood 1999; 93: 3913.][Vecchi V., Burnelli R., Pileri S. et al. Anaplastic large cell lymphoma (Ki-1+/CB30+) in childhood. Med. Pediatr. Oncol. 1993; 21: 402.][Reiter A., Schrappe M., Tiemann M. et al. Successful treatment strategy for Ki-1 anaplastic large-cell lymphoma of childhood: a prospective analysis of 62 patients enrolled in three consecutive Berlin-Frankfurt-Munster Group Studies. J. Clin. Oncol. 1994; 12: 899.][Murphy S. B. Pediatric lymphomas: recent advances and commentary on Ki-1-positive anaplastic large-cell lymphomas of childhood. Ann Oncol. 1994; 5 (suppl. 1): 31.][Greer J. P., Kinney M. C., Collins R. D. et al. Clinical features of 31 patients with Ki-1 anaplastic large-cell lymphoma. J. Clin. Oncol. 1991; 9 (4): 539-547.][Mussolin L., Pillon M., d'Amore E. S. et al. Prevalence and clinical implications of bone marrow involvement in pediatric anaplastic large cell lymphoma. Leukemia 2005; 19 (9): 1643-1647.][Escalon M. P., Liu N. S., Yang Y. et al. Prognostic factors and treatment of patients with T-cell non-Hodgkiny's lymphoma: the M. D. Anderson Cancer Center experience. Cancer 2005; 103 (10): 2091-2098.]