Eight-year experience in treating aggressive mediastinal large B-cell lymphomas

Mangasarova Ia.K.; Magomedova A.U.; Kravchenko S.K.; Shmakov R.G.; Bariakh E.A.; Vorob’ev V.I.; Mar'in D.S.; Skidan N.I.; Gemdzhyan E.G.; Misiurin A.V.; Kremenetskaia A.M.; Vorob'ev A.I.

doi:https://doi.org/

Mangasarova Ia.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Magomedova A.U.

Federal Research and Clinical Center of Sports Medicine, Federal Biomedical Agency of the Russia, Moscow, Russia

Kravchenko S.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Shmakov R.G.

Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» Ministry of Healthcare of the Russian Federation, Moscow, Russia

ORCID: 0000-0002-2206-1002

Bariakh E.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Vorob’ev V.I.

S.P. Botkin State Clinical Hospital, Moscow, Russia

Mar'in D.S.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Skidan N.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Gemdzhyan E.G.

National Research Center for Hematology, Moscow, Russia

Misiurin A.V.

Federal'nyĭ nauchno-klinicheskiĭ tsentr detskoĭ gematologii, onkologii i immunologii im. Dmitriia Rogacheva Minzdrava Rossii, Moskva

Kremenetskaia A.M.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Vorob'ev A.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Eight-year experience in treating aggressive mediastinal large B-cell lymphomas

Authors:

Mangasarova Ia.K., Magomedova A.U., Kravchenko S.K., Shmakov R.G., Bariakh E.A., Vorob’ev V.I., Mar'in D.S., Skidan N.I., Gemdzhyan E.G., Misiurin A.V., Kremenetskaia A.M., Vorob'ev A.I.

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Journal: Therapeutic Archive. 2013;85(7): 50‑56

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To cite this article:

Mangasarova IaK, Magomedova AU, Kravchenko SK, et al. . Eight-year experience in treating aggressive mediastinal large B-cell lymphomas. Therapeutic Archive. 2013;85(7):50‑56. (In Russ.)

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Abstract:

Aim. To make a differential diagnosis of diffuse large B-cell lymphoma (DLBCL) with primary involvement of the mediastinal lymph nodes (LN) and primary mediastinal large B-cell lymphoma (PMLBCL); to evaluate the efficiency of a modified NHL-BFM-90 (M-NHL-BFM-90) program in the treatment of the above nosological entities. Subjects and methods. The investigation enrolled 60 patients with large B-cell lymphoma (LBCL) with primary involvement of mediastinal LN who had been treated at the Hematology Research Center, Ministry of Health of Russia, in 2004 to 2012. The diagnosis of PMLBCL and DLBCL with primary involvement of mediastinal LN was based on histological findings, the phenotype of tumor cells, and molecular evidence. Treatment was performed according to the M-NHL-BFM-90 program. Three pregnant women received predelivery polychemotherapy (PCT) according to the VACOP-B protocol and continued to have a DexaBEAM chemotherapy regimen 3-4 weeks postpartum. In case of a residual mass, all the patients underwent consolidation radiotherapy to the mediastinal area in a total focal dose of 36 Gy. Results. The diagnosis of PMLBCL was established in 39 patients: 10 men and 29 women whose ages were 18 to 60 years (median age 30 years); DLBCL with primary involvement of mediastinal LN was verified in 21 patients: 8 men and 13 women whose age was 21 to 70 years (median age 30 years). After m-NHL-BFM-90 treatment protocol, 5-year overall survival rates in the patients with DLBCL with primary involvement of mediastinal LN and in those with PMLBCL were 95±5 and 86±6% and 5-year event-free survival rates were 95±5 and 78±7%, respectively. All the pregnant women diagnosed with PMLBCL who had received the VACOP-B ⇒ delivery ⇒ Dexa-BEAM PCT regimen during pregnancy achieved remission. The follow-up periods were 30, 36, and 42 weeks. Conclusion. The patients with new-onset LBCL and primary involvement of mediastinal LN are a heterogeneous group that includes patients having two different diagnoses: PMLBCL and DLBCL. The efficiency of high-dose PCT is different in the patients with DLBCL with primary involvement of mediastinal LN and in those with PMLBCL (in spite of their similar clinical features, similar epidemiological characteristics, and the presence of the same unfavorable prognostic factors at onset).

Keywords:

diffuse large B-cell lymphoma

primary mediastinal large B-cell lymphoma

m-NHL-BFM-90

radiotherapy

real-time polymerase chain reaction

statistical analysis

multivariate analysis

Cox mode

diffuse large B-cell lymphoma

primary mediastinal large B-cell lymphoma

m-NHL-BFM-90

radiotherapy

real-time polymerase chain reaction

statistical analysis

multivariate analysis

Cox mode

Authors:

Mangasarova Ia.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Magomedova A.U.

Federal Research and Clinical Center of Sports Medicine, Federal Biomedical Agency of the Russia, Moscow, Russia

Kravchenko S.K.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Shmakov R.G.

Federal State Budget Institution «Research Center for Obstetrics, Gynecology and Perinatology» Ministry of Healthcare of the Russian Federation, Moscow, Russia

ORCID: 0000-0002-2206-1002

Bariakh E.A.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Vorob’ev V.I.

S.P. Botkin State Clinical Hospital, Moscow, Russia

Mar'in D.S.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Skidan N.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Gemdzhyan E.G.

National Research Center for Hematology, Moscow, Russia

Misiurin A.V.

Federal'nyĭ nauchno-klinicheskiĭ tsentr detskoĭ gematologii, onkologii i immunologii im. Dmitriia Rogacheva Minzdrava Rossii, Moskva

Kremenetskaia A.M.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

Vorob'ev A.I.

Gematologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii

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