uzspbgmuУчёные записки Первого Санкт-Петербургского государственного медицинского университета имени академика И. П. ПавловаThe Scientific Notes of the Pavlov University1607-41812541-8807Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1607-4181-2020-27-3-80-96uzspbgmu-769Research ArticleОРИГИНАЛЬНЫЕ РАБОТЫORIGINAL PAPERSФакторы прогноза и эффективность терапии первой линии хронического лимфолейкоза: результаты 10-летнего наблюденияPrognostic factors and effectiveness of the first-line therapy for chronic lymphocytic leukemia: results of 10-year follow-uphttps://orcid.org/0000-0002-1856-1055КалашниковаО. Б.KalashnikovaО. B.

Калашникова Ольга Борисовна, врач-гематолог гематологического отделения поликлиники с КДЦ

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Kalashnikova Оlga B., Hematologist of the Hematological Department of the Polyclinic with CDC

 6-8, L’va Tolstogo str., Saint Petersburg, 197022

o4290@yandex.ruhttps://orcid.org/0000-0003-1272-3583ИвановаМ. О.IvanovaM. O.

Иванова Мария Олеговна, кандидат медицинских наук, зав. гематологическим отделением поликлиники с КДЦ

Санкт-Петербург

Ivanova Maria O., Cand. of Sci. (Med.), Head of the Hematological Departmentof the Polyclinic with CDC

Saint Petersburg

https://orcid.org/0000-0001-6161-1444ВолковН. П.VolkovN. P.

Волков Никита Павлович, врач-гематолог отделения онкологии № 2 (химиотерапии и ТКМ) НИИ ДОГиТ им Р. М. Горбачёвой

Санкт-Петербург

Volkov Nikita P., Hematologist of the Oncology Department № 2 (Сhemotherapy and BMT), Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0001-7447-2244КондаковаЕ. В.KondakovaE. V.

Кондакова Елена Викторовна, кандидат медицинских наук, врач-гематолог отделения онкологии № 2 (химиотерапии и ТКМ) НИИ ДОГ и Т им. Р. М. Горбачёвой

Санкт-Петербург

Kondakova Elena V., Cand. of Sci. (Med.), Hematologist of the Oncology Department № 2 (Сhemotherapy and BMT), Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0002-8000-3652ИзмайловаЕ. А.IzmailovaE. A.

Измайлова Екатерина Андреевна, врач-генетик лаборатории трансплантологии и молекулярной гематологии НИИ ДОГиТ им. Р. М. Горбачёвой

Санкт-Петербург

Izmailova Ekaterina A., Geneticist of the Laboratory of Transplantology and Molecular Hematology, Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0002-1302-3311БархатовИ. М.BarhatovI. M.

Бархатов Ильдар Мунерович, кандидат медицинских наук, ведущий научный сотрудник отдела клинической онкологии, зав. лабораторией трансплантологии и молекулярной гематологии НИИ ДОГиТ им. Р. М. Горбачёвой

Санкт-Петербург

Barhatov Ildar M., Cand. of Sci. (Med.), Leading Research Fellow of the Department of Clinical Oncology, Head of the Laboratory of Transplantology and Molecular Hematology, Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0002-1959-9063ГиндинаТ. Л.GindinaT. L.

Гиндина Татьяна Леонидовна, доктор медицинских наук, зав. лабораторией цитогенетики и диагностики генетических заболеваний НИИ ДОГиТ им. Р. М. Горбачёвой

Санкт-Петербург

Gindina Tatiana L., Dr. of Sci. (Med.), Head of the Laboratory of Cytogenetics and Diagnostics of Genetic Diseases, Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0003-2875-5459БабенкоЕ. В.BabenkoE. V.

Бабенко Елена Витальевна, зав. отделением криоконсервации с лабораторией контроля качества гемопоэтических клеток НИИ ДОГиТ им. Р.М. Горбачёвой

Санкт-Петербург

Babenko Elena V., Head of the Department of Cryopreservation with the Laboratory of Quality Control of Hematopoietic Cells, Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

КулагинА. Д.KulaginA. D.

Кулагин Александр Дмитриевич, доктор медицинских наук, зав. кафедрой гематологии, трансфузиологии, трансплантологии ФПО, и. о. директора НИИ ДОГиТ им. Р. М. Горбачёвой

Kulagin Alexander D., Dr. of Sci. (Med.), Head of the Department of Hematology,Transfusiology, Transplantology the Faculty of Postgraduate Education, Acting Director of Raisa Gorbacheva Memorial Research Institute of Children Oncology

Saint Petersburg

https://orcid.org/0000-0002-4332-0114МоисеевИ. С.MikhailovaN. B.

Моисеев Иван Сергеевич, доктор медицинских наук, доцент кафедры гематологии, трансфузиологии, трансплантологии ФПО, зам. директора НИИ ДОГиТ им. Р. М. Горбачёвой по научным вопросам

Санкт-Петербург

Mikhailova Natalya B., Cand. of Sci. (Med.), Associate Professor of the Department of Hematology, Transfusiology, Transplantology of the Faculty of Postgraduate Education, Head of the Department of Clinical Oncology, Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation

Saint Petersburg

https://orcid.org/0000-0002-9589-4136МихайловаН. Б.MoiseevI. S.

Михайлова Наталья Борисовна, кандидат медицинских наук, доцент кафедры гематологии, трансфузиологии, трансплантологии ФПО, руководитель отдела клинической онкологии НИИ ДОГиТ им. Р. М. Горбачёвой

Санкт-Петербург

Moiseev Ivan S., Dr. of Sci. (Med.), Associate Professor of the Department of Hematology, Transfusiology, Transplantology of the Faculty of Postgraduate Education, Deputy Director of Raisa Gorbacheva Memorial Research Institute of \ Children Oncology

Saint Petersburg

Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation2020171120202738096Copyright © Калашникова О.Б., Иванова М.О., Волков Н.П., Кондакова Е.В., Измайлова Е.А., Бархатов И.М., Гиндина Т.Л., Бабенко Е.В., Кулагин А.Д., Моисеев И.С., Михайлова Н.Б., 20212021Калашникова О.Б., Иванова М.О., Волков Н.П., Кондакова Е.В., Измайлова Е.А., Бархатов И.М., Гиндина Т.Л., Бабенко Е.В., Кулагин А.Д., Моисеев И.С., Михайлова Н.Б.Kalashnikova О.B., Ivanova M.O., Volkov N.P., Kondakova E.V., Izmailova E.A., Barhatov I.M., Gindina T.L., Babenko E.V., Kulagin A.D., Mikhailova N.B., Moiseev I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sci-notes.ru/jour/article/view/769Введение

Введение. Биологическая гетерогенность хронического лимфолейкоза (ХЛЛ) отражается в скорости прогрессирования, потребности в терапии и ответе на проводимое лечение. Анализ факторов прогноза способствует улучшению качества лечения и рациональному распределению ресурсов здравоохранения.

Методы и материалы

Методы и материалы. Из наблюдаемых 890 пациентов с документированной стадией ХЛЛ лечение получали 405 (45,5 %). В 1-й линии 173 пациента получили интенсивные режимы (FCR или BR), 6 – таргетные препараты, 226 – все остальные режимы. В качестве прогностических маркеров анализировали исходную стадию заболевания, мутационный статус IGHV, del17p c комплексным кариотипом или без него.

Результаты

Результаты. Иммунохимиотерапевтические режимы показали высокую эффективность при условии выполнения запланированного объема лечения. Комбинация таких прогностических параметров, как исходная стадия ХЛЛ, мутационный статус IGHV и наличие del17p и (или) комплексного кариотипа, позволяет отчетливо выделить группу пациентов с неблагоприятным прогнозом, для которой целесообразно использовать либо интенсивные программы, либо таргетную терапию в 1-й линии.

Introduction

Introduction.The biological heterogeneity of chronic lymphocytic leukemia (CLL) is reflected in the rate of progression, the need for therapy, and the response to treatment. Analysis of prognostic factors contributes to improving the quality of treatment and rational distribution of healthcare resources.

Materials and methods

Materials and methods. Among 890 patients with documented stage of CLL, 405 (45.5 %) received treatment. As the first-line of treatment, 173 patients received intensive regimens (FCR or BR), 6 – new agents, and 226 – all other regimens. The initial stage of the disease, mutation status of IGHV, del17p with or without complex karyotype were analyzed as prognostic markers.

Results

Results. Immunochemotherapeutic regimens were shown to be highly effective in case planned amount of treatment was completed. The combination of such prognostic parameters as the initial stage of the disease, the mutation status of IGHV, and the presence of del17p and/or complex karyotype allows us to clearly identify a group of patients with an unfavorable prognosis, for which it is advisable to use either intensive programs or new agents in the first-line therapy.

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The authors declare that there are no conflicts of interest present.