Impactul tratamentului targetat în limfoamele Non-Hodgkin cu afectarea primară a ganglionilor limfatici

Hematology Discipline, Nicolae Testemitanu SUMPhBackground. Non-Hodgkin's lymphomas (NHL) are malignant hematopoietic tumors that develop from lymphoid tissue. Primary lymph node involvement (l/n) is the most common localization of it, summing 52-70%. The integration of Rituximab (R) in combination with conventional polychemotherapy (PChT) in the NHL treatment. Objective of the study. To evaluate the therapeutic impact of the use of R in combination with conventional PChT in the treatment of nodal onset NHL. Material and Methods. A descriptive cohort study was performed, which included 80 patients diagnosed with NHL monitored at the PMSI Oncological Institute. Statistical processing of materials was performed using Microsoft Excel and IBM SPSS statistics v.26. Results. In the study participated: men-39, women-41. The mean age of the patients was 56.09±13.6 years. The onset of NHL occurred in peripheral l/n in 85.0% of cases, in mediastinal l/n-7.5%, and in abdominals in 7.5%. Stages I-II were determined in 21(26.2%) patients, stages III-IV in 59(73.7%) cases. Aggressive NHLs were diagnosed in 52(65.0%) patients, indolent NHLs in 28(35.0%) cases. In 61(76.3%) patients, first-line R+PChT treatment was applied-group 1(G1), and in 19(23.8%) cases conventional PChT was applied-group 2(G2). The overall response rate(ORR) in G1 was 86.8%, in G2-63.1%. Complete remissions (CR) were obtained in G1 in 63.9% of patients in G2-47.3% of cases. Conclusion. The use of Rituximab increased the ORR rate (86.8% vs. 63.1%), the frequency of CR (63.9% vs. 47.3%) and PFS (20 months vs. 12 months (p <0.05)).Introducere. Limfoamele non-Hodgkin (LNH) reprezintă tumori hematopoietice maligne ce se dezvoltă din țesutul limfoid. Afectarea primară a ganglionilor limfatici (gl) este cea mai frecventă localizare, însumând 52-70%. Integrarea în tratamentul LNH al Rituximabului (R) în asociere cu polichimioterapia. Scopul lucrării. Evaluarea impactului terapeutic al utilizării R în asociere cu PChT convențională în tratamentul LNH cu debut nodal. Material și Metode. A fost efectuat un studiu descriptiv de cohortă unde au fost incluși 80 de pacienți cu diagnosticul de LNH monitorizați în cadrul IMSP Institutul Oncologic. Procesarea statistică a materialelor a fost efectuată cu utilizarea Microsoft Excel și IBM SPSS statistics v.26. Rezultate. În lotul de studiu bărbați au fost – 39, femei – 41. Vârsta medie a pacienților a constituit 56,09±13,6 ani. Debutul LNH a avut loc în gl periferici în 85,0% de cazuri, în mediastin – 7,5% și gl abdominali – 7,5%. Stadiile I-II au fost determinate la 21(26,2%) de pacienți, stadiile III-IV în 59 (73,7%) cazuri. LNH agresive au fost diagnosticate la 52(65,0%) de pacienți, LNH indolente în 28(35,0%) de cazuri. La 61(76,3%) de pacienți s-a aplicat tratamentul de prima linie R+PChT– lotul 1(L1), iar în 19 (23,8%) cazuri PChT convențională–lotul 2(L2). Rata generală de răspuns (ORR) în L1 a constituit 86,8%, în L2 –63,1%. Remisiuni complete (RC) au fost obținute în L1 la 63,9% pacienți, în L2 – 47,3% cazuri. Concluzii. Utilizarea de Rituximab a crescut rata de ORR (86,8% vs. 63,1%), frecvența RC (63,9% vs. 47,3%) și SFP (20 luni vs. 12 luni (p<0,05))

Impact of targeted treatment in non-Hodgkin’s lymphoma with primary lymph node involvement

Discipline of Hematology, Nicolae Testemitanu State University of Medicine and Pharmacy, Department of Hematology, Institute of Oncology, Chisinau, the Republic of MoldovaBackground: Non-Hodgkin’s lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. Primary lymph node (LN) involvement is the most common localization (52-70%). The integration of Rituximab (R) in the NHL treatment represented a turning point. The aim of this study was to evaluate the therapeutic impact of the use of R in combination with conventional polychemotherapeutic (PChT) in the treatment of nodal onset NHL. Material and methods: A descriptive cohort study was performed on 80 patients diagnosed with NHL. Results: In the study participated: men – 39(48.8%), women – 41(51.2%). The mean age of the patients was 56.09 ± 13.6 years. The onset of NHL occurred in peripheral l/n in 85.0% of cases, in mediastinal LN – 7.5%, and abdominals in 7.5%. Stages I-II were identified in 21(26.2%) patients, stages III-IV in 59(73.8%) cases. Aggressive NHLs were diagnosed in 54(67.5%) patients, indolent NHLs in 26(32.5%) cases. In 61(76.3%) patients, first-line R+PChT treatment was applied – group 1(G1), and in 19(23.8%) cases conventional PChT was applied – group 2(G2). The overall response rate (ORR) in G1 was 86.8%, in G2 – 63.1%. Complete remissions (CR) were obtained in G1 in 63.9% of patients, in G2 – 47.3% of cases. Progression-free survival (PFS) in G1 had a median of 20 months, and in G2 the median was 12 months (p <0.05). Conclusions: The use of Rituximab increased the ORR rate (86.8% vs 63.1%), the frequency of CR (63.9% vs 47.3%) and PFS (20 months vs 12 months (p <0.05)