This document reports on the results of analyzing mutations in a cohort of 130 Indian patients with myeloproliferative neoplasms (MPNs). Key findings include:
- The most common mutations detected were JAK2 V617F (in up to 100% of PV cases, 57.6% of MF cases, and 61.7% of ET cases) and CALR exon 9 mutations (in 23.8% of total cases, 60.8% of JAK2/MPL-negative MF, and 50% of JAK2/MPL-negative ET).
- CALR type I and type II mutations were the most frequent CALR mutations observed. MPL mutations were found in up
This document reports on the results of analyzing mutations in a cohort of 130 Indian patients with myeloproliferative neoplasms (MPNs). Key findings include:
- The most common mutations detected were JAK2 V617F (in up to 100% of PV cases, 57.6% of MF cases, and 61.7% of ET cases) and CALR exon 9 mutations (in 23.8% of total cases, 60.8% of JAK2/MPL-negative MF, and 50% of JAK2/MPL-negative ET).
- CALR type I and type II mutations were the most frequent CALR mutations observed. MPL mutations were found in up
Глубокоуважаемые коллеги!
От имени научного комитета проекта "ГистоЛогика" рады сообщить, что в Вестнике РОНЦ им. Н. Н. Блохина РАМН, т. 23, №1, 2012 опубликована статья "СОВРЕМЕННЫЕ ПРИНЦИПЫ МОРФОЛОГИЧЕСКОЙ ДИАГНОСТИКИ НЕМЕЛКОКЛЕТОЧНОГО РАКА ЛЕГКОГО НА МАЛОМ БИОПСИЙНОМ И ЦИТОЛОГИЧЕСКОМ МАТЕРИАЛЕ", в которой приведены пошаговый алгоритм диагностики рака легкого на малом материале, трактовка возможных результатов иммуноморфохимических исследований и обсуждение спорных моментов.
Репринт статьи во вложении.
Работа выполнена в рамках проекта «ГистоЛогика», направленного на улучшение диагностики рака легкого в Российской Федерации и разработанного Евразийской федерацией онкологии в партнерстве с компанией «Эли Лилли».
Доклад на Пятой научно-практической конференции с международным участием «Основные тенденции в современной офтальмологии», организованной клиникой профессора Эскиной Э.Н. «Сфера», совместно с кафедрой офтальмологии ФГБОУ ДПО ИПК ФМБА России —→ http://www.sfe.ru/information/ophthalmology-news/conference2015.html
"Распространенность и выраженность недостаточности питания среди пациентов ФН...rnw-aspen
Доклад с XVI Межрегиональной научно-практической конференции "Искусственное питание и инфузионная терапия больных в медицине критических состояний" 21-22 апреля 2016 г.
Антимикробная терапия инфекций респираторного тракта с позиций национальной б...Igor Guchev
How to implement national safety rules while treating
Принципы обеспечения национальной безопасности при составлении клинических руководств и стандатров
This study aimed to determine the epidemiological characteristics and outcomes of lymphomas in HIV-positive patients in Russia. The study analyzed data from 73 patients treated between 2006-2016 at several medical centers. It found that diffuse large B-cell lymphoma was most common, comprising 34% of cases. The 2-year overall survival was 64% and was improved with chemotherapy combined with antiretroviral therapy. Poor prognostic factors included elevated LDH levels and B symptoms. Rituximab improved outcomes for CD20-positive lymphomas. Autologous stem cell transplantation was found to be a safe treatment for relapsed/refractory cases. Genome editing of stem cells may provide a cure for HIV by generating HIV-resistant immune
This document discusses treatment approaches for diffuse large B-cell lymphoma (DLBCL) including first-line and second-line therapies. For first-line treatment, a risk-adapted approach is recommended based on age and International Prognostic Index (IPI) score. For relapsed or refractory disease, options include salvage chemotherapy followed by autologous stem cell transplant in eligible patients. Novel agents are also discussed for relapsed/refractory DLBCL including antibodies, antibody-drug conjugates, and CAR T-cell therapies with overall response rates ranging from 15-86%. Ongoing clinical trials are further evaluating these novel agents.
Глубокоуважаемые коллеги!
От имени научного комитета проекта "ГистоЛогика" рады сообщить, что в Вестнике РОНЦ им. Н. Н. Блохина РАМН, т. 23, №1, 2012 опубликована статья "СОВРЕМЕННЫЕ ПРИНЦИПЫ МОРФОЛОГИЧЕСКОЙ ДИАГНОСТИКИ НЕМЕЛКОКЛЕТОЧНОГО РАКА ЛЕГКОГО НА МАЛОМ БИОПСИЙНОМ И ЦИТОЛОГИЧЕСКОМ МАТЕРИАЛЕ", в которой приведены пошаговый алгоритм диагностики рака легкого на малом материале, трактовка возможных результатов иммуноморфохимических исследований и обсуждение спорных моментов.
Репринт статьи во вложении.
Работа выполнена в рамках проекта «ГистоЛогика», направленного на улучшение диагностики рака легкого в Российской Федерации и разработанного Евразийской федерацией онкологии в партнерстве с компанией «Эли Лилли».
Доклад на Пятой научно-практической конференции с международным участием «Основные тенденции в современной офтальмологии», организованной клиникой профессора Эскиной Э.Н. «Сфера», совместно с кафедрой офтальмологии ФГБОУ ДПО ИПК ФМБА России —→ http://www.sfe.ru/information/ophthalmology-news/conference2015.html
"Распространенность и выраженность недостаточности питания среди пациентов ФН...rnw-aspen
Доклад с XVI Межрегиональной научно-практической конференции "Искусственное питание и инфузионная терапия больных в медицине критических состояний" 21-22 апреля 2016 г.
Антимикробная терапия инфекций респираторного тракта с позиций национальной б...Igor Guchev
How to implement national safety rules while treating
Принципы обеспечения национальной безопасности при составлении клинических руководств и стандатров
This study aimed to determine the epidemiological characteristics and outcomes of lymphomas in HIV-positive patients in Russia. The study analyzed data from 73 patients treated between 2006-2016 at several medical centers. It found that diffuse large B-cell lymphoma was most common, comprising 34% of cases. The 2-year overall survival was 64% and was improved with chemotherapy combined with antiretroviral therapy. Poor prognostic factors included elevated LDH levels and B symptoms. Rituximab improved outcomes for CD20-positive lymphomas. Autologous stem cell transplantation was found to be a safe treatment for relapsed/refractory cases. Genome editing of stem cells may provide a cure for HIV by generating HIV-resistant immune
This document discusses treatment approaches for diffuse large B-cell lymphoma (DLBCL) including first-line and second-line therapies. For first-line treatment, a risk-adapted approach is recommended based on age and International Prognostic Index (IPI) score. For relapsed or refractory disease, options include salvage chemotherapy followed by autologous stem cell transplant in eligible patients. Novel agents are also discussed for relapsed/refractory DLBCL including antibodies, antibody-drug conjugates, and CAR T-cell therapies with overall response rates ranging from 15-86%. Ongoing clinical trials are further evaluating these novel agents.
This document summarizes key information about chronic lymphocytic leukemia (CLL) including its invisible, inconclusive, and incurable nature at diagnosis. It notes that CLL is often asymptomatic at diagnosis but can have an aggressive clinical course over time, reflecting underlying biological heterogeneity. While treatment has progressed, CLL remains incurable. The document discusses CLL diagnosis and treatment timing and changes in the host and tumor over time. It provides background on CLL occurring in mature B cells and the importance of signaling pathways. The document summarizes prognostic factors in CLL including genetics, mutations, and biomarkers from the tumor and microenvironment. It notes the importance of biological risk stratification and targeting signaling pathways in CLL treatment.
The document discusses how PET-guided treatment based on early PET scans after 2 cycles of chemotherapy can help escalate or de-escalate treatment for early and advanced stage Hodgkin lymphoma patients. Studies have shown that escalating treatment to BEACOPP for early stage patients who are PET-positive after 2 cycles significantly improves outcomes, while de-escalating treatment by omitting radiation for early stage PET-negative patients is also effective. Randomized trials are still needed but results so far suggest PET-guided escalation of treatment to BEACOPP for advanced stage PET-positive patients and de-escalation to AB
This document summarizes prognostic factors and treatment approaches for follicular lymphoma. Some key points:
- Prognostic factors include age, histologic grade, FLIPI score, gene expression profiling, and metabolic tumor volume on PET scans.
- First-line treatment for symptomatic advanced disease is usually rituximab plus chemotherapy such as bendamustine, followed by rituximab maintenance for 2 years.
- The PRIMA trial showed improved progression-free survival with 2 years of rituximab maintenance compared to observation alone in patients achieving response to first-line treatment.
- The GALLIUM trial found improved progression-free survival for first-line treatment of follicular
Dr. Prashant Tembhare discusses minimal residual disease (MRD) detection in B-cell precursor acute lymphoblastic leukemia (BCPALL). MRD detection using flow cytometry provides important prognostic information to guide risk-stratified therapy. High sensitivity MRD assays using 8-10 color flow cytometry with acquisition of millions of events can detect MRD levels as low as 0.001%. Accurately quantifying low-level MRD requires acquiring a large number of events to avoid false negative results. MRD levels detected by sensitive multi-parameter flow assays provide powerful prognostic information to identify patients who may benefit from intensified therapy or could potentially avoid excessive treatment.
This document summarizes studies evaluating immune checkpoint inhibitors for the treatment of Hodgkin lymphoma. It discusses pivotal trials that led to FDA approval of nivolumab and pembrolizumab for relapsed/refractory HL after stem cell transplant and brentuximab vedotin. It also reviews mechanisms of action of PD-1 blockade in HL and efforts to combine checkpoint inhibitors with other agents or incorporate them into frontline treatment for high-risk patients.
- Allogeneic stem cell transplantation (allo-SCT) remains the recommended treatment for patients with blast crisis CML and those in accelerated phase who do not achieve an optimal response to tyrosine kinase inhibitors (TKIs).
- For patients who experience failure or intolerance to two or more TKIs in chronic phase, allo-SCT is also recommended if they are eligible.
- Outcomes of allo-SCT have improved over time due to advances in reduced intensity conditioning regimens, graft-versus-host disease prophylaxis, and post-transplant maintenance therapies including TKIs and donor lymphocyte infusions.
1) Allogeneic stem cell transplantation can be an effective treatment for non-Hodgkin's lymphoma, especially if performed while the patient is in remission.
2) Cytoreduction or reducing the lymphoma burden before transplantation is challenging.
3) Immunotherapies like checkpoint inhibitors have shown some activity against B-cell lymphomas before and after allogeneic stem cell transplantation.
Алгоритмы взаимодействия морфологических, гистологических и молекулярно-генетических лабораторий на этапах первичной диагностики онкогематологичеких заболеваний
This document discusses directions and issues in the treatment of acute myeloid leukemia (AML). It addresses challenging existing treatment dogmas regarding chemotherapy drug doses and post-remission therapies. Specifically, it summarizes several studies investigating optimal dose levels of cytarabine and anthracyclines during induction and consolidation for AML. It also reviews evidence comparing the effectiveness of autologous stem cell transplantation versus chemotherapy alone as post-remission consolidation approaches. The document advocates moving beyond conventional chemotherapy regimens to more personalized precision medicine approaches for AML patients.
Myelodysplastic Syndrome (MDS) is a heterogeneous group of clonal hematopoietic stem cell disorders characterized by cytopenias, dysplastic changes in one or more myeloid cell lines, and a risk of progression to acute myeloid leukemia. MDS is not a single disease, but rather a spectrum of related disorders. Diagnosis involves evaluation of blood counts, peripheral smear, bone marrow aspirate/biopsy along with cytogenetics and molecular testing to identify abnormalities. Prognosis varies from indolent to high-risk of transformation based on the WHO classification which considers disease subtype, blast percentage, and cytogenetic risk factors.
- Discontinuation of TKI treatment can be safe for some patients with CML who have achieved a deep and durable molecular response, provided certain criteria are met.
- Studies have found molecular relapse-free survival rates ranging from 33-68% after 6 months to 7 years post-discontinuation depending on the study.
- Key factors that can increase the likelihood of a successful discontinuation include longer duration of TKI therapy (>5.8 years), longer duration of deep molecular response, and no prior resistance to treatment. However, the majority of patients still require lifelong TKI treatment.
Brentuximab vedotin is an antibody-drug conjugate used to treat Hodgkin lymphoma. It consists of an antibody linked to a cytotoxic agent. The antibody targets CD30 found on Hodgkin lymphoma cells, and the cytotoxic agent is released inside those cells to kill them. Brentuximab vedotin is used as first-line treatment, for relapsed disease, and after stem cell transplantation. It has been combined successfully with chemotherapy regimens like AVD to increase response rates and failure-free survival compared to ABVD alone. Ongoing studies are exploring its use in various settings for Hodgkin lymphoma.
This document summarizes the use of allo-HSCT and immunotherapy in the treatment of relapsed or refractory classical Hodgkin lymphoma. It provides statistics on Hodgkin lymphoma incidence and outcomes with first-line therapy in Russia. It then discusses the role and indications for allo-HSCT versus auto-HSCT based on guidelines. The document also reviews outcomes from different conditioning regimens and GVHD prophylaxis for allo-HSCT. It summarizes the efficacy of novel immunotherapies like brentuximab vedotin and PD-1 inhibitors for relapsed disease, including as bridge therapy to allo-HSCT. Finally, it discusses treatment options for post-transplant relapse including donor lymph
1. Эпигенетическая терапия у детей с
впервые выявленными острыми
миелоидными лейкозами.
В.С. Немировченко, Б.В. Курдюков, Р.С. Равшанова,
А.В. Попа, Г.Л. Менткевич
НИИ Детской онкологии и гематологии, ФГБУ «РОНЦ им. Н.Н.
Блохина» МЗ РФ, г. Москва, Россия
2017г
2. Характеристика пациентов (n=21)
Возраст от 6 мес. до 16 лет (5,1±1,1 лет)
Пол Мальчики – 11 (52,4%)
Девочки – 10 (47,6%)
FAB- морфологический
вариант
М0 – 3 (14,3%)
М1 – 3(14,3%)
М2 – 5 (23,8%)
М3 – 2 (9,5%)
М4 – 1 (4,8%)
М5 – 3 (14,3%)
М7 – 4 (19,0%)
Цитогенетика Нормальный кариотип – 10 (47,7%)
Более 3 аномалий – 3 (14,3%)
Другие –2 (9,5%)
t(8;21) – 2 (9,5%)
Гиперплоидный – 2 (9,5%)
t(9;11)/ t(10;11) – 2 (9,5%)
3. Группы риска
Стандартный риск Средний риск Высокий риск
ОМЛ с t(8;21),
inv(16) или t(16;16).
FAB-М1, М2 или М4 вариантами, с
нормальным кариотипом или
утратой половой хромосомы, с
вовлечением 11q23, исключая
t(10;11), +8, аномалией длинного
плеча хромосомы 3 или
эритроидных маркеров
FAB М0, М5, М6, М7. FAB М1, М2,
М4 с t(6;9), t(10;11), t(9;22), del(7q-),
del(5q-), -7, -5, t(3;5); t(3;3),
кольцевидной хромосомой, более
3 хромосомными аномалиями
исключая стандартные. Более чем
25% бластов в миелограмме на 15
день от начала индукции ремиссии
стандартного и среднего риска
5. Дизайн протокола НИИ ДОГ ОМЛ 2012
(08/2012 – 08/2016гг)
IR
HR
SR
НR
AIE
AIE
AI haM HAE
Вальпроевая кислота
ATRA ATRA ATRAATRA
Вальпроевая кислота
ATRA ATRAATRA ATRA
HAM AI haM HAE
ATRA
Дни
1 5
6 3514 49 96 119
Децитабин
15-19 день
IR
6. На 15 день от начала лечения ответ на терапию
Ответ М-1
Ответ М-2
Ответ М-3
9,5% 9,5%
• Полный ответ (М-1) – менее 5%
бластов в костном мозге, при
отсутствии бластов в анализе
периферической крови
• Частичный ответ (М-2) – по данным
костного мозга количество бластов 6 -
25%, полное отсутствие бластов в
анализе периферической крови
• Отсутствие ответа (М-3) –
количество бластов в костном мозге
более 25% или развитие
экстрамедуллярного очага болезни
Ответ после индукционной химиотерапии
Ремиссия - при количестве бластов в костном мозге
менее 5%; восстановлении абсолютного числа
нейтрофилов более 1,0×109/л, тромбоцитов более
100×109/л, независимости от переливаний
эритроцитарной взвеси, отсутствие экстрамедулярный
очагов;
Отсутствие ремиссии при количестве бластов в костном
мозге более 6-25%
Ремиссия
100%
81,1%