Objective:to study the prognostic significance of the expression of cancer-testis (CT) genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in patients with multiple myeloma (MM) and their influence on overall survival and relapse rate. To determine their effect on suсh clinical parameters as levels of lactate dehydrogenase, leucocytes, hemoglobin, calcium, albumen, creatinine, beta-2-microglobulin.Materials and methods.Real-time polymerase chain reaction was performed on complementary DNA obtained from bone marrow of 77 patients with MM. The statistical analysis was performed using the Statistica 10.0 software package. To estimate prognostic values of the CT gene expression data were analyzed by the Kaplan – Meier method.Results.The study was conducted to determine the level of expression of CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in a group of patients with MM. The group included primary and receiving cancer treatment in MM patients. According to the log-rank criterion expression of any of the CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 exerts a significant influence on overall survival and progression-free survival/relapse. It was also determined that providing expression of some CT genes, the levels of creatinine, calcium, beta-2-microglobulin were much higher to compare with patients without expression.
Primary mediastinal (thymic) large B-cell lymphoma (PMB-CL) is one of the primary extranodal tumors and originates from thymic medulla B cells. The disease is more common in young women and declares itself by mainly locally advanced growth within the anterior upper mediastinum with frequent involvement of chest organs. PMBCL has specific morphological, immunological, and genetic characteristics that permit to differentiate it from other similar diseases: diffuse large В-cell lymphoma, nodular sclerosis Hodgkin’s lymphoma, and mediastinal gray zone lymphoma. Immunochemotherapy with subsequent irradiation of the residual mediastinal tumor is the standard treatment of PMBCL. No benefits of one drug therapy over another have been demonstrated to date in controlled studies. Application of new imaging techniques (PET/CT) may result in withdrawal of the radiotherapy in some PMBCL patients without impairment of delayed survival rates.
Актуальность. Первичная медиастинальная (тимическая) В-крупноклеточная лимфома (ПМВКЛ) относится к первичным экстранодальным опухолям и происходит из В-клеток мозгового слоя вилочковой железы. Болезнь имеет специфические иммуноморфологическую и генетическую характеристики, которые позволяют выделить ее среди других, сходных по своим параметрам злокачественных лимфопролиферативных заболеваний. Стандартом лечения ПМВКЛ является иммунохимиотерапия с последующим облучением остаточной опухоли в средостении. К настоящему времени преимуществ одного метода лекарственного противоопухолевого воздействия перед другим в рамках контролируемых исследований не показано. Цель. Изучить современные подходы к химиолучевому лечению больных ПМВКЛ с попыткой их индивидуализации с учетом различных прогностических факторов. Материалы и методы. Анализу подвергнуты данные 131 больного с впервые выявленной ПМВКЛ, которые получали лечение в НМИЦ онкологии им. Н.Н. Блохина с 2000 по 2017 г. Более половины больных были женщины (58 %), медиана возраста составила 30 лет (диапазон 16-70 лет). На разных исторических этапах лечение ПМВКЛ проводилось с использованием различных режимов иммунохимиотерапии: MACOP-B±R-у 55 (42 %) пациентов, R-CHOP-у 40 (30,5 %), R-DA-EPOCH-у 36 (27,5 %). Лучевую терапию получили 99 из 131 больного. Результаты. Лечение во всей группе больных ПМВКЛ (n = 131) в целом оказалось высокоэффективным. Частота ремиссий составила 87 %, 3-летняя выживаемость без прогрессирования (ВБП) и общая выживаемость (ОВ)-78 и 88 % соответственно. При медиане наблюдения 37 мес. у 17 (13 %) из 131 больного в сроки до 13 мес. от начала противоопухолевого лечения развились рецидивы или констатировано прогрессирование заболевания. Ни одного LYMPHOID TUMORS
Background . Multiple myeloma (MM) is a malignant lymphoproliferative B-cell disease characterization by clonal proliferation of plasma cells in the bone marrow and beyond its borders. Currently, a wide range of cytogenetic anomalies and molecular-biological parameters are studied as prognostic factors.Objective: a comparative study of the frequency, features and clinical significance of chromosomal abnormalities in MM by conventional cytogenetic and fluorescent in situ hybridization (FISH) methods.Materials and methods . 77 patients with MM, which admitted in N.N. Blokhin National Medical Research Center of Oncology, were included in the study from 2016 to 2017.Results . Chromosomal alterations were detected only in one case (1/77) by conventional cytogenetic method G-banding. However cytogenetic aberrations were revealed in 26 % of cases (20/77) using FISH. Deletions of different regions of chromosomes, indicating the possible presence of a hypodiploid clone or loss of some regions, were found in one patient in the second FISH analysis after 6 months. In the cohort of patients with chromosomal abnormalities (n = 20) a partial trisomy 11q, a deletion of the region q32 of the chromosome 14, a translocation t(4;14)(p16;q32) and IGHV gene rearrangement were determined in 30 % (6/20) as sole anomalies. Two or more cytogenetic aberrations were identified in the remaining 14 patients. Our study confirms that chromosomal abnormalities are more likely detected at later stages of MM (IA и IIA – 0 %, IIIA и IIIВ – 27 and 47 % respectively).Conclusion . FISH allows to detect chromosomal changes in tumor plasma cells regardless of the mitosis phase. In MM, it becomes particularly important in connection with low proliferative activity of plasma cells. Additionally, in the fourth of MM patients in the study submicroscopic chromosomal aberrations were discovered using FISH. The improvement of the probe panel and the widespread use of locus specific FISH don’t replace G-banding that allows to see damages of all chromosomes at once.
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