Редкое заболевание — нодулярная лимфома Ходжкина с лимфоидным преобладанием: обзор литературы и собственные наблюдения

КЛИНИКА, ДИАГНОСТИКА И ЛЕЧЕНИЕ ЛИМФОИДНЫХ ОПУХОЛЕЙ , , , ,

Е.А. Демина1, Г.С. Тумян1, А.А. Чекан1, М.Ю. Кичигина1, А.С. Антипова1, Н.А. Пробатова1, А.И. Павловская1, Н.В. Кокосадзе1, А.М. Ковригина2, О.П. Трофимова1, Е.А. Османов1

1 ФГБУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478

2 ФГБУ «Гематологический научный центр» МЗ РФ, Новый Зыковский пр-д, д. 4а, Москва, Российская Федерация, 125167

Для переписки: Е.А. Демина, д-р мед. наук, профессор, Каширское ш., д. 24, Москва, Российская Федерация, 115478; тел.: +7(499)324-90-89; e-mail: drdemina@yandex.ru

Для цитирования: Демина Е.А., Тумян Г.С., Чекан А.А., Кичигина М.Ю., Антипова А.С., Пробатова Н.А., Павловская А.И., Кокосадзе Н.В., Ковригина А.М., Трофимова О.П., Османов Е.А. Редкое заболевание — нодулярная лимфома Ходжкина с лимфоидным преобладанием: обзор литературы и собственные наблюдения. Клин. онкогематол. 2014; 7(4): 522–532.

РЕФЕРАТ

Нодулярная лимфома Ходжкина с лимфоидным преобладанием (НЛХЛП) встречается редко и составляет лишь 5 % всех случаев лимфомы Ходжкина (заболеваемость 1,5:1 000 000). От классической лимфомы Ходжкина (кЛХ) заболевание отличается как иммуноморфологическими (выраженная экспрессия CD20 на LP-клетках), так и клиническими характеристиками (значительное преобладание ранних стадий, индолентное течение с поздними рецидивами и тенденцией к трансформации в диффузную В-крупноклеточную лимфому). В связи с ограниченным числом больных во всех проспективных исследованиях НЛХЛП алгоритмы лечения исторически базируются, как правило, на ретроспективных данных, часто заимствованных из программ лечения кЛХ или индолентных В-клеточных лимфом. Больные редко умирают от НЛХЛП, общую смертность определяют преимущественно вторые опухоли и токсичность, связанная с лечением. В последнее десятилетие в целой серии публикаций показано значение ритуксимаба в лечении НЛХЛП как у первичных больных, так и при рецидиве, в т. ч. и в группе с высоким риском трансформации. Кроме того, обсуждается место тактики «наблюдай и жди», лучевой и химиотерапии. Собственный опыт использования ритуксимаба у больных НЛХЛП показал его эффективность при различных стадиях и на разных этапах течения заболевания.

Ключевые слова: нодулярная лимфома Ходжкина с лимфоидным преобладанием, диагностика, клиника, лечение, ритуксимаб.

Принято в печать: 8 сентября 2014 г.

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