Klinicheskaya Onkogematologiya/Clinical Oncohematology最新文献

{"title":"Multiple Myeloma Complicated by Bone Plasmacytomas: Pathogenesis, Clinical Features, Treatment Approaches (A Literature Review)","authors":"Елизавета Андреевна Мамаева, М. В. Соловьева, Л. П. Менделеева","doi":"10.21320/2500-2139-2023-16-3-303-310","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-303-310","url":null,"abstract":"Bone plasmacytoma is a malignant neoplasm consisting of plasma cells. It develops in the medullary cavities of the skeletal bones. The tumor can destroy bone cortex and proliferate into the surrounding tissues. In contrast to bone plasmacytomas, extramedullary plasmacytomas occur as a result of hematogenous dissemination in various tissues and organs. Based on literature data, the incidence of bone plasmacytomas at multiple myeloma (MM) onset is 7.0 % to 32.5 %, and at relapsed/progression ММ stages it is 9.0 % to 27.4 %. During bone plasmacytoma development, tumor cells acquire a number of new features: expression of adhesion molecules is decreased, new cytogenetic aberrations occur, autocrine secretion and neoangiogenesis are increased. The clinical course of MM complicated by bone plasmacytomas is characterized by minimal bone marrow damage, hemoglobin concentration within reference range, and decreased values of β2-microglobulin, paraprotein, calcium, and lactate dehydrogenase. Acute renal failure and immunoparesis are rare, early MM stages predominate. In literature, the MM form with multiple bone plasmacytomas is referred to as ‘macrofocal MM’. Survival rates of MM patients with bone plasmacytomas are at the intermediate level in terms of prognosis. The MM patients without plasmacytomas have the most favorable prognosis, whereas the MM patients with extramedullary plasmacytomas have the poorest prognosis. There is no unified approach to the treatment of MM complicated by bone plasmacytomas. There are no randomized prospective clinical studies on the efficacy of treating it. A successful use of proteasome inhibitors and immunomodulatory drugs was reported based on a small number of MM cases with plasmacytomas. Some studies proved the efficacy of auto-HSCT in this MM form. Bone plasmacytomas are treated with radiotherapy mainly after systemic chemotherapy.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutation Profile of Normal and Tumor Cells in a Patient with Multiple Myeloma: A Case Report","authors":"А. С. Жук, И. И. Кострома, Елена Игоревна Степченкова, Д. В. Качкин, О. Б. Белопольская, И. В. Зотова, А. Д. Гарифуллин, С. В. Волошин, С. В. Грицаев, А. Ю. Аксенова","doi":"10.21320/2500-2139-2023-16-3-337-349","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-337-349","url":null,"abstract":"This paper is a case report of a patient with newly diagnosed multiple myeloma (MM) who underwent exome sequencing of peripheral blood lymphocytes and CD138+ tumor plasma cells prior to therapy. This patient showed some inherited genetic variants which are associated with underlying risk for MM. This patient’s genotype was reported to have some variants in the DNA repair genes, including inherited mutations in the RFDW3 and TP53 genes. They are involved in the maintenance of genome stability and accumulation rate of somatic mutations, including structural rearrangements and chromosome aberrations. A large number of structural variations
 and mutational signature ID6 in the tumor genetic material point to the disruption of DNA damage repair. The tumor cell exome analysis yielded a profile of somatic mutations, also the mutations in the genes previously associated with MM, as well as a functional significance of the detected abnormalities. Somatic mutations also included damaging mutations and highly significant mutations in the other tumor-associated genes, such as ASCC3, TET3, and CHD1, as well as in the antimicrobial peptide-coding genes CAMP and HTN3. With the exception of an extra copy of 1q arm in the tumor plasma cell genome, the patient showed no genetic risk factors associated with poor prognosis of the disease. Based on literature, inherited (ABCB1 mutations) and somatic (trisomy 3) variations detected in the patient’s genetic material can be characterized as positive prognostic factors in MM.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Value of Somatic Mutations of Epigenetic Regulation Genes in Acute Myeloid Leukemias in Real-World Clinical Practice: Results of an Observational Non-Interventional Prospective Interregional Study","authors":"Алексина Алексеевна Шатилова, И. Г. Будаева, А. В. Петухов, С. А. Силонов, А. Е. Ершова, Т. С. Никулина, Ю. Д. Матвиенко, Ю. В. Миролюбова, К. В. Богданов, Л. В. Анчукова, Ю. С. Нередько, С. Ю. Тяско, О. Е. Очирова, А. Г. Карпова, Э. Р. Васильева, О. Д. Сердюк, Д. А. Яскульский, Д. В. Букин, Ю. А. Алексеева, Е. Г. Ломаиа, Л. Л. Гиршова","doi":"10.21320/2500-2139-2023-16-2-174-185","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-2-174-185","url":null,"abstract":"Aim. To assess the rate of DNMT3A, IDH1, IDH2, and ASXL1 gene mutations and their effect on the prognosis both as isolated findings and in combination with well-known chromosomal aberrations and gene mutations in newly diagnosed acute myeloid leukemia (AML) patients from some regions of the Russian Federation.
 Materials & Methods. The study enrolled 83 patients with newly diagnosed AML from 22 regions of the Russian Federation, who underwent molecular genetic examination for detecting IDH1 (R132), IDH2 (R140), ASXL1, and DNMT3A gene mutations with droplet digital PCR and Sanger sequencing methods.
 Results. The mutation rate in DNMT3A was 16.7 %, in IDH1 (R132) it was 6 %, in IDH2 (R140) it was 9.6 %, and in ASXL1 it was 6 %. The R140 mutation in IDH2 correlated with the older age of patients. The mutations in IDH1 (R132), IDH2 (R140), and DNMT3A showed a significant association with mutated NPM1. The mutations in IDH1 (R132), IDH2 (R140) were reported to occur significantly more often in patients with normal karyotype. The IDH1 (R132) and IDH2 (R140) mutations appeared to have a favorable effect on AML prognosis, which is most likely to be associated with a high rate of their compatibility with NPM1 mutation. The mutated type of DNMT3A had a negative effect on overall survival of patients with NPM1 mutation. The mutation in ASXL1 also appeared to be an unfavorable prognostic factor for overall survival of patients with wild type NPM1.
 Conclusion. A high rate of mutation occurrence in epigenetic regulation genes as well as the prognostic potential of these mutations in AML necessitate the need for determining the mutation status of DNMT3A, IDH1, IDH2, and ASXL1 in the context of primary diagnosis in real-world clinical practice.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Субпопуляционный состав T-хелперов у больных острыми лейкозами после трансплантации аллогенных гемопоэтических стволовых клеток","authors":"Юлия Олеговна Давыдова, Н. М. Капранов, К. А. Никифорова, О. С. Караваева, Д. В. Камельских, М. Ю. Дроков, Л. А. Кузьмина, Т. В. Гапонова, И. В. Гальцева, Е. Н. Паровичникова","doi":"10.21320/2500-2139-2023-16-2-137-145","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-2-137-145","url":null,"abstract":"Aim. To identify the characteristics of T-helper subpopulations in healthy donors and to compare them with those reported in acute leukemia patients 6 months after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
 Materials & Methods. The study enrolled 41 blood donors and 49 patients after-HSCT. The median age of donors was 36 years (range 20–60 years), 29 of them were men and 12 were women. The median age of patients was 37 years (range 19–62 years), 18 of them were men and 31 were women. Acute myeloid leukemia was diagnosed in 27 (55 %) patients and acute lymphoblastic leukemia/lymphoma in 22 (45 %) patients. Myeloablative conditioning was administered to 4 (8 %) patients and reduced intensity conditioning to 45 (92 %) patients. T-helper subpopulations were studied in the blood of healthy donors vs. acute leukemia patients after allo-HSCT. The flow cytometry analysis was conducted to simultaneously assess the expression of markers CD3, CD4, CD8, CD25, CD45RA, CD197, CD28, CCR4, CCR6, CCR10, CXCR3, and CXCR5 in T-cells.
 Results. The study demonstrated that the count of T-helpers at different stages of differentiation (regulatory, naive T-cells, memory cells, and effector cells) comprehensively distinguishes healthy donors from patients. Moreover, the functional structure of each of these populations differ in donors vs. patients even on Month +6 after allo-HSCT. Donors appeared to have more polarized cells among the central memory T-helpers. The proportion of T-helpers type 1 among the effector cells was higher is patients.
 Conclusion. The results of the study indicate that the Т-cell parameter set can be analyzed to assess immunity and to describe its disorders in different pathologies or after drug chemotherapy.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Approaches to Cardiovascular Toxicity Assessment in Patients with Hematological Malignancies: A Literature Review","authors":"О. Е. Данилова, Гелия Рифкатовна Гиматдинова, И. Л. Давыдкин, О. В. Терешина, В. Д. Сабанова, Г. И. Давыдкин","doi":"10.21320/2500-2139-2023-16-3-331-336","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-331-336","url":null,"abstract":"Since 2016, the management of cardiovascular complications has been guided by a few documents that are based on the recommendations of the European Society of Cardiology and are regularly updated. The present literature review deals with algorithms of diagnosis and correction of cardiovascular adverse events occurring on or after drug chemotherapy in patients with hematological malignancies. The aim of this paper is to analyze the literature data on optimizing the management of chemotherapy recipients, improving their quality of life as well as reducing mortality due to drug therapy-related cardiovascular complications.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morpho-Immunohistochemical Characteristics of Different Mycosis Fungoides Stages: A Literature Review","authors":"Андрей Алексеевич Шерстнев, А. М. Ковригина","doi":"10.21320/2500-2139-2023-16-2-109-118","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-2-109-118","url":null,"abstract":"Mycosis fungoides (MF) is the most ubiquitous type of cutaneous T-cell lymphoma. MF pathogenesis has not been well studied up to now. Differential diagnosis of the disease, especially at early stages, is complicated and poses a considerable challenge. The present review covers current views on MF pathogenesis and methods of its diagnosis.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Результаты применения асциминиба, первого аллостерического ингибитора BCR::ABL1-тирозинкиназы, у больных хроническим миелолейкозом со множественной резистентностью к предшествующей терапии","authors":"А. Г. Туркина, Елена Андреевна Кузьмина","doi":"10.21320/2500-2139-2023-16-3-311-320","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-311-320","url":null,"abstract":"Currently, there is a crucial need for new treatment approaches to overcome the resistance and intolerance of several tyrosine kinase inhibitor (TKI) therapy lines in chronic myeloid leukemia (CML) patients. Asciminib, the first in its class BCR::ABL1-tyrosine kinase inhibitor specifically targeting ABL myristoyl pocket (STAMP), demonstrated efficacy and safety in CML patients with prior TKI therapy failure, including the cases with pan-resistant T315I mutation in the chimeric BCR::ABL1 gene. The present review focuses on the asciminib mechanism of action, the results of both preclinical and clinical phase I and III studies. Due to the favorable cardiovascular toxicity profile of asciminib, the scope of its application can be extended to patients with cardiovascular co-morbidities. Asciminib is registered in the Russian Federation in January 2023, so treatment algorithms for CML patients with ineffectiveness or intolerance of prior therapy should be updated in line with this new option.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"284 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients Aged over 60 Years","authors":"Иван Иванович Кострома, В. А. Юдина, Р. Р. Сабитова, Е. С. Степченкова, Ж. В. Чубукина, С. С. Бессмельцев, С. В. Сидоркевич, С. В. Грицаев","doi":"10.21320/2500-2139-2023-16-3-287-293","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-287-293","url":null,"abstract":"Aim. To compare toxicity and efficacy of high-dose melphalan chemotherapy with subsequent autologous hematopoietic stem cell transplantation (auto-HSCT) in multiple myeloma (MM) patients aged under and over 60 years.
 Materials & Methods. The retrospective analysis was conducted on the data of 107 MM patients, 78 of them were aged under 60 years (median 54 years), and 29 of them were aged 61 years and older (median 63 years). All patients received auto-HSCT in the period of 2017–2022. Single and tandem auto-HSCT were performed in 92 and 15 patients, respectively. Patients with tandem auto-HSCT (n = 15), lost to follow-up patients (n = 8), and patients who died during early post-transplant period (n = 4) were excluded from survival analysis. Survival rates were calculated based on the date of auto-HSCT.
 Results. A comparative evaluation of the results in two age groups showed a significant difference in the number of patients treated with ixazomib during the induction period (р = 0.019) and cyclophosphamide 3 g/m2 as part of auto-HSC mobilization (р = 0.014), as well as 200 or 140 mg/m2 melphalan as part of conditioning regimen (р = 0.039 and р = 0.009, respectively). With a follow-up median of 13 months (range 1–57 months), the median progression-free survival in the groups ≤ 60 years vs. > 60 years was 32 and 47 months, respectively (hazard ratio [HR] 0.688; 95% confidence interval [95% CI] 0.270–1.754; p = 0.704). The median overall survival in patients aged under 60 years appeared to be 57 months, it was not reached in patients aged 61 years and older (HR 0.689; 95% CI 0.169–2.803; р = 0.577).
 Conclusion. The results of the study suggest that all newly diagnosed MM patients aged under 70 years should be regarded as being eligible for auto-HSCT.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Классические и активирующие химерные антигенные рецепторы PD-1 как элемент мультитаргетного подхода в лечении гематологических и солидных новообразований","authors":"Ксения Александровна Левчук, А. А. Голдаева, Е. А. Столярова, П. А. Матейкович, А. Х. Валиуллина, Э. Р. Булатов, А. В. Петухов, А. А. Дакс, Н. А. Барлев, Е. В. Байдюк, Я. Г. Торопова","doi":"10.21320/2500-2139-2023-16-3-268-279","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-3-268-279","url":null,"abstract":"Aim. To generate anti-PD-L1 CAR-T effectors carrying extracellular domain PD-1 as antigen-recognizing site and to study their cytolytic activity as well as to functionally assess the anti-PD-L1 CAR-T effectors in vitro with a view to apply them in multi-targeted tumor therapy.
 Materials & Methods. Chimeric antigen receptor PD-1 was constructed using molecular cloning of PD-1 antigen-recognizing region (12–170 amino acids) into mammalian expression plasmid vector adding activation and co-stimulatory domains. Primary Т-lymphocytes of healthy donor peripheral blood mononuclear fraction were derived by expanding monoclonal antibody combination on surface markers CD3/CD28. Anti-PD-L1 CAR-T effectors were obtained by lentiviral transduction of primary T-lymphocyte genome of a healthy donor. Chimeric antigen receptor PD-1 expression and transduction efficiency were assessed by flow cytofluorometry. Specific cytotoxicity of the anti-PD-L1 CAR-T effectors was analyzed in vitro by means of real-time cytotoxicity assay (RTCA) with HeLa_PD-L1 target cell line co-cultivation. The level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, and IL-17A was assessed by flow cytofluorometry using Human Th1/Th2/Th17 CBA Kit (BD, USA).
 Results. The efficiency of lentiviral transduction and the proportion of the anti-PD-L1 CAR-T effectors were 42 %. The specificity of cytotoxic response of the anti-PD-L1 CAR-T effectors with a low effector/tumor ratio (1:20) was verified during HeLa_PD-L1 co-cultivation by a 1.5-fold decrease in the cell index (CI = 0.738) versus control (CI = 1.0645). The increase in synthesis of cytokines IL-2 (1000 pg/mL), IL-6 (438.5 pg/mL), TNF-α (44 pg/mL), and IFN-γ (1034 pg/mL) during HeLa_PD-L1 target cell line co-cultivation confirms the functionality of the analyzed effector cells.
 Conclusion. Anti-PD-L1 chimeric antigen receptor was constructed and tested in vitro. Anti-PD-L1 CAR-T lymphocytes specifically recognize and promote the cytolysis of tumor target cells by increased secretion of pro-inflammatory cytokines IFN-γ, TNF-α, IL-6, and IL-2. Chimeric antigen receptor PD-1 can be modified into chimeric switch receptor (CSR) by deleting CD3ζ-domain and can be used together with other CARs without predicted non-specific toxicity.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"659 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Отдаленные результаты лечения пациентов с классической лимфомой Ходжкина в реальной клинической практике: опыт гематологического отделения Новосибирска","authors":"Мария Сергеевна Войтко, Т. И. Поспелова, И. Н. Нечунаева, Я. Ю. Шебуняева","doi":"10.21320/2500-2139-2023-16-2-192-199","DOIUrl":"https://doi.org/10.21320/2500-2139-2023-16-2-192-199","url":null,"abstract":"Aim. To assess the long-term results of classical Hodgkin’s lymphoma (cHL) treatment in Novosibirsk in real-world clinical practice.
 Materials & Methods. The study enrolled 408 cHL patients treated and followed-up at the hematological unit of the Novosibirsk Municipal Clinical Hospital No. 2 from January 2008 to December 2021. The median age of patients was 33 years (range 26–44 years). Among them 223 (54.7 %) female and 185 (45.3 %) male patients. There were more patients with cHL stages III (n = 103; 25.2 %) and IV (n = 120; 29.4 %) than with stage II, which was identified in 185 (45.4 %) patients. ABVD regimen was administered to 132 (32.3 %) patients, 47 (11.5 %) patients received ABVD escalated to BEACOPP. BEACOPP therapy was performed in 229 (56.2 %) patients. Subsequent radiotherapy was assigned to 202 (49.5 %) patients. Second-line therapy was required by 89 (21.8 %) patients with relapsed and resistant cHL.
 Results. The 10-year overall survival (OS) was 81 %, and the 5-year OS was 91 %. Similar progression-free survival (PFS) rates were 86 % and 77 %, respectively. The 10-year PFS in patients with stage II was 87 %, while in patients with stages II (mediastinal bulky mass), III and IV, it was only 69 % (p = 0.002). The 10-year OS in patients with localized stages was 91 %, and in patients with generalized stages it was 79 % (p = 0.0006). The 10-year OS in patients less than 45 years of age was 88 %, and in patients more than 45 years of age it was 69 %. The 10-year PFS in patients less than 45 years of age was 84 %, and in the older age group it was 60 % (p = 0.001).
 Conclusion. The study results demonstrate high rates of long-term survival of cHL patients and are well comparable with the data of other study groups. Nevertheless, scientific research should be continued to develop optimal risk-adapted programs of cHL chemotherapy and to define further prospects for improving the treatment outcomes of this malignant tumor.","PeriodicalId":36905,"journal":{"name":"Klinicheskaya Onkogematologiya/Clinical Oncohematology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135339818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}