Analysis of treatment results of 165 primary adult patients with diffuse B large-cells lymphoma (DBLCL) treating in Moscow municipal clinics is presented. Study aimed on analysis of efficacy of various dose intensity chemotherapy schedule according to disease molecular genetics variants. 28 adolescents and young adults (median age — 21.7 years) have received treatment according to pediatric BFM-NHL 90m and BFM-NHL 2004M protocols, 46 (median age — 29.0 years) and 91 (median age — 59.5) adults according to courses CHOP and R-CHOP, respectively. It was not randomized study. Germinal and postgerminal variants DBLCL were determined using immunohistochemical technique for 58 (35%) patients with appropriate primary samples. For young patients with germinal DBLCL therapy superiority of intensive BFM-NHL 90m and B-NHL 2004M protocols in relation to postgerminal variants was revealed: 5-years event-free survival (EFS) was 1.0 ± 0.0 (n = 6) versus 0.44 ± 0.15 (n = 9), respectively (p 0.05). Data receiving proves expediency of treatment adolescents and young adults with DBCLC from germinal center cells according to intensity BFM-like protocols.
Efficacy and safety results of rituximab and bendamustine combination (Scheme BR) in patients with relapsed and refractory chronic lymphocytic leukemia (CLL) are presented. From 01.2012 to 04.2013, the treatment was initiated in 43 patients (21 with relapses are sensitive to the last line of therapy; 22 – with refractory CLL). Median age at start of therapy was 63.5 years (range from 43 to 81 years). In 40 patients response was evaluated according to NCI-WG criteria (1996). Complete remission (CR) is documented in 5 (12.5 %) cases, partial (PR) or nodular partial remission (nPR) in 17 (42.5 %) cases. MRD-negative CR was achieved in 1 (20.0 %) of 5 patients with CR. With 23.5 months of median follow-up for surviving patients 2-year progression-free survival (PFS) was 47.2 ± 8.5 % (median – 18.5 months), overall survival (OS) – 66.9 ± 7.9 % (median not achieved). Hematological toxicity Grade 3–4 occurred in 15 (34.9 %) cases, same degree infectious complicationsin 5 (11.6 %) cases. Patients received 3 or more therapy lines before this treatment (37.5 ± 16.1 % against 74.7 ± 8.3 %; p = 0.016), with «bulky disease» more than 10 cm (0.0 % vs. 75.4 ± 7.5 %; p < 0.001) and received rituximab in combination with chemotherapy in the previous lines, compared to the «naive» cases (44.1 ± 10.5 % against 92.9 ± 6.9 %; p = 0.009) have significantly worsened 2-year OS.