Administration of CT in addition to RT as initial therapy for HL decreases overall SMR by reducing relapse and need for salvage therapy. Administration of RT additional to CT marginally increases overall SMR in advanced stages. Breast cancer risk (but not SMR in general) was substantially higher after EF-RT. Caution is needed in applying these findings to current therapies.
Non-clonal and clonal abnormal cells (hypodiploid, polyploid, and with chromosome aberrations) were detected by the G-method in the bone marrow and blood of the majority of patients with non-Hodgkin lymphomas before therapy. The manifestation of these abnormalities changed individually after treatment. The most incident were clones -22, del(1)(q42-43), del(2)(q-33-35), del(3)(q27), 4q-, and del(6q).
Bleomycin used as part of many chemo-therapeutic programs for treating Hodgkin lymphoma is associated with pulmonary toxicity. Development of complications after mediastinal radiotherapy is also well-known. However, the synergistic effect of the combination of radiotherapy and bleomycin is considered in the literature much less frequently and mainly when using the total focal doses (SOD) of 36 – 40 Gy. Since 1998 the chemo-radiotherapeutic regimens applied to the treatment of Hodgkin lymphoma in the MRRC (Obninsk) has involved subradical TTD of 20 – 30 Gy. The goal of the study is to evaluate pulmonary toxicity in Hodgkin lymphoma patients treated with chemo-radiotherapy involving ABVD and mediastinal treatment with TTD of 20 – 30 Gy.Methods. A series of 142 Hodgkin lymphoma patients received ABVD and mediastinal radiotherapy at the TTD 20 – 30 Gy. Conventional film and digital chest X-rays, linear and digital tomograms taken at different stages of treatment and follow up were analysed.Results. Changes in lungs in the form of a pathologic pulmonary pattern (interstitial pneumonitis) were seen in 39 (27.5%) of 142 patients. In 10 (25.6%) of 39 patients focal or confluent pneumonitis infiltration were found, that was 7% of the whole study group. Clinical evidence of bleomycin-induced pneumonitis was found in 6 (15.4%) of 39 patients. With follow-up terms up to 60 months fibrotic changes in lungs were absent. The occurrence of radiation pneumonitis was 17.6%, radiation fibrosis – 35.9%. Fibrotic changes were mainly grade 1 (94.1%). In HL patients with bleomycin-induced pneumonitis the occurrence of radiation pneumonitis was 43.6% (17 of 39 patients), radiation fibrosis – 58.9% (23 of 39 patients) while the corresponding figures for patients who did not have bleomycin-induced pneumonitis were 8.7% (9 of 103 patients) and 27.2% (28 of 103 patients), respectively (p < 0.001).Conclusion. A statistically significant increase in occurrence of radiation pneumonitis and radiation fibrosis was defined in HL patients who suffered bleomycin-induced pneumonitis.
Лимфомы с первичным поражением желудка (ЛППЖ) встречаются чаще лимфом с вовлечением какого-либо другого органа и охватывают широкий спектр иммуноморфологических вариантов -от индолентной из клеток маргинальной зоны до агрессивной диффузной В-крупноклеточной лимфомы. ЛППЖ не имеют характерных клинических проявлений, в связи с чем в ряде случаев может быть установлен ошибочный диагноз. Вследствие редкости ЛППЖ многие связанные с ними вопросы до сих пор остаются не решенными, что нашло отражение в настоящем обзоре.Ключевые слова: лимфомы с первичным поражением желудка, диффузная В-крупноклеточная лимфома, MALT-лимфома, Helicobacter pylori.
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