Myelotoxicity and Reduction in Number of CD34 + Early Hematopoietic Progenitors in Adult Poor-Prognosis Patients with Diffuse Large B-Cell Lymphoma in Late Period After High-Dose Chemotherapy by mNHL-BFM-90

2016 ◽  
Vol 16 ◽  
pp. S121-S122
Author(s):  
Elena Dorokhina ◽  
Aminat Magomedova ◽  
Irina Galtseva ◽  
Valentina Dvirnyk ◽  
Svetlana Glinkina ◽  
...  
Keyword(s):  
B Cell ◽  
Poor Prognosis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Late Period ◽  
Hematopoietic Progenitors ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Numbers of early CD34+ progenitors of bone marrow hematopoiesis in patients with diffuse large B-cell lymphoma

2017 ◽  
Vol 89 (1) ◽  
pp. 43-48
Author(s):  
E I Dorokhina ◽  
A U Magomedova ◽  
I V Galtseva ◽  
V N Dvirnyk ◽  
S A Glinkina ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Late Period ◽  
Large B Cell Lymphoma ◽  
Relationship Of ◽  
Large B Cell

Aim. To estimate the number of early progenitors of bone marrow (BM) hematopoiesis in patients with diffuse large B-cell lymphoma (DLBCL) in the late period after high-dose chemotherapy (HDCT) according to the mNHL-BFM-90 program. Subjects and methods. The investigators analyzed the results of BM immunophenotypic and histological studies in 40 patients (median age, 57 years) with DLBCL who received HDCT according to the mNHL-BFM-90 program at the Hematology Research Center (HRC), Ministry of Health of the Russian Federation (MHRF), in the period 2002 to 2009. A comparison group consisted of 19 patients (median age, 70 years) treated according to the CHOP/R-CHOP program at HRC, MHRF, in the same period. The median follow-up period was 6 years. The results of BM examination were analyzed before and 5—10 years after the end of HDCT. Immunophenotypic study determined the number of early CD34+ hematopoietic progenitors. BM cellularity, the size of erythroid, granulocytic and megakaryocytic lineages, their ratio, the presence of dysplasia signs, and secondary stromal changes were histologically determined. The BM toxic injury signs found for the first time were evaluated as manifestations of late myelotoxicity. Results. At 5-to-10-year follow-ups after the end of HDCT according to the mNHL-BFM-90 program, the patients showed a smaller number of early CD34+ progenitors of BM hematopoiesis in 31 (78%) cases than those treated according to the CHOP/R-CHOP-21 program (n=8 (2%)) (p=0.005). Myelopoiesis with decreased CD34+ cell count was characterized by hypocellularity in 8 (26%) patients (p=0.07), the narrowing of megakaryocytic lineage in 14 (45%) (p=0.006), erythroid one in 7 (23%) (p=0.01), and granulocytic one in 8 (26%) (p=0.92), pronounced secondary stromal changes in 15 (48%) (p=0.03), and grade 1 thrombocytopenia in 13 (42%); p=0.02). Conclusion. There is evidence that the number of early CD34+ progenitors of BM hematopoiesis decreased in patients with DLBCL in the late period after HDCT. The investigation shows the relationship of the reduction in the number of early CD34+ progenitors of BM hematopoiesis in the late follow-up period to the presence of pronounced secondary changes in the BM stroma (p=0.02). There was no statistically significant relationship of the decreased number of CD34+ cells to the age younger or older than 60 years, to the period after the end of chemotherapy, to gender or presence of specific BM injury.

Late myelotoxicity of high-dose chemotherapy according to the modified NHL-BFM-90 program in adult patients with diffuse large B-cell lymphoma

2016 ◽  
Vol 88 (7) ◽  
pp. 43
Author(s):  
E. I. Dorokhina ◽  
A. U. Magomedova ◽  
V. N. Dvirnyk ◽  
I. V. Galtseva ◽  
S. A. Glinkina ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Dose Chemotherapy ◽  
Adult Patients ◽  
High Dose ◽  
Large B Cell Lymphoma ◽  
Large B Cell

The Treatment of Diffuse Large B-cell Lymphoma with Poor Prognosis in the Rituximab Era – State of the Art and Future Perspectives

2010 ◽  
Vol 00 (04) ◽  
pp. 75
Author(s):  
Umberto Vitolo ◽  
Annalisa Chiappella ◽  
Chiara Frairia ◽  
Barbara Botto ◽  
◽  
...  
Keyword(s):  
B Cell ◽  
Poor Prognosis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Phase Iii ◽  
High Dose ◽  
Phase Ii Trials ◽  
Large B Cell Lymphoma ◽  
Dose Dense ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma. The International Prognostic Index, gene profiling and early positron-emission tomography (PET) evaluation are important prognostic factors, each with a different role in predicting outcome. The addition of rituximab to standard chemotherapy – cyclophosphamide, doxorubicine, vincristine and prednisone (CHOP) – improved the outcome in elderly newly diagnosed DLBCL patients and in young patients with favourable prognostic profiles. The best treatment of young poorprognosis patients affected by DLBCL is controversial. Several phase II trials have demonstrated that the addition of rituximab to dose-dense chemotherapy CHOP14 or the addition of rituximab to high-dose chemotherapy (HDC) with peripheral stem cell transplantation were feasible and effective. The question of whether rituximab–HDC may be more effective compared with rituximab–dose-dense chemotherapy is under investigation in randomised phase III trials by major international groups. Novel therapeutic options should be investigated to increase the outcome in poor-prognosis DLBCL patients, both as single agents and in combination with standard therapy. Radioimmunotherapy, immunomodulating agents (IMiDs), dacetuzumab (SGN-40), mammalian target of rapamycin (mTOR) inihibitors, proteasome inhibitors, histone deacetylase inhibitors and anti-angiogenetic agents (anti-vascular endothelial growth factor [VEGF]) are under evaluation in clinical trials. The results will provide new insights into the treatment of DLBCL following poor prognosis.

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