Molecular phenotype of diffuse large B-cell lymphoma as a basis for a personalized treatment approach of elderly patients

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Abstract

Background. The use of molecular genetic profiling in clinical practice and the registration of immunotargeted agents have undoubtedly led to the development of a personalized approach in oncohematology, with diffuse large B-cell lymphoma (DLBCL) being no exception. Elderly patients represent a complex group of patients with DLBCL, which leads to difficulties in treatment due to their comorbidity.
Aim. To evaluate the efficacy, tolerability and safety of an individualized approach based on the mutational landscape in elderly patients with newly diagnosed DLBCL.
Materials and methods. The clinical study included 10 elderly patients with newly diagnosed DLBCL. The median age was 68 (65–78) years. Eight patients were classified as being at high risk of early progression according to the international prognostic index. The frequency of genotypes in the considered cohort of elderly patients: MCD – 1 (10 %), N1 – 3 (30 %), BN2 – 1 (10 %), EZB – 2 (20 %), NOS – 3 (30 %).
Results. Overall and complete metabolic response rates were 100 %. Clinically significant hematological toxicity depending on the number of cycles (n = 60): grade III–IV neutropenia in 5 cycles, grade III–IV thrombocytopenia in 2, grade III–IV anemia in 3. Non-hematological toxicity did not exceed grades I–II.
Conclusion. High efficacy and low toxicity profile of a personalized approach in elderly patients with newly diagnosed DLBCL were demonstrated. The obtained preliminary results indicate the possibility of continuing the developed clinical study of elderly patients with DLBCL.

About the authors

M. A. Mingalimov

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Author for correspondence.
Email: mingalimovm@yandex.ru
ORCID iD: 0000-0002-8491-2140

Build. 3, 3 Pekhotnaya St., Moscow 123182

 

Russian Federation

E. A. Baryakh

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University);1Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

ORCID iD: 0000-0001-6880-9269

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993

Russian Federation

A. V. Misyurin

Vavilov Institute of General Genetics, Russian Academy of Sciences

ORCID iD: 0000-0003-1349-2879

3 Gubkina St., Moscow 119991

Russian Federation

L. A. Kesaeva

GeneTechnology

ORCID iD: 0000-0001-8277-8649

104 Profsoyuznaya St., Moscow 117437

Russian Federation

A. S. Mkrtchyan

GeneTechnology

ORCID iD: 0000-0002-0638-213X

104 Profsoyuznaya St., Moscow 11

Russian Federation

E. N. Misyurina

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0003-2419-4850

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

M. A. Donskoy

Moscow International Oncology Center (European Medical Center)

ORCID iD: 0009-0007-1757-4683

Build. 4, 2 Durova St., Moscow 129090

Russian Federation

T. N. Tolstykh

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0001-7308-0927

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

M. S. Orlova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0009-0009-6369-5413

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

T. S. Chudnova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0002-8012-1640

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

D. D. Ivanova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0009-0004-3632-9198

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

O. L. Kochneva

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0003-1338-8203

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

E. N. Zotina

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0001-9692-2541

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

A. B. Makeshova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0002-0414-2554

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

S. S. Andreev

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0002-9147-4636

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

D. V. Lebedev

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0009-0001-8480-5505

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

K. V. Yatskov

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0003-0125-9068

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

I. V. Samsonova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0002-1228-1765

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

M. A. Lysenko

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0001-6010-7975

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

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