OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press47110.17650/1818-8346-2021-16-2-21-27HEMATOLOGIC MALIGNANCIES: TREATMENTЛЕЧЕНИЕ ГЕМОБЛАСТОЗОВCurrent trends in pediatric aggressive B-cell lymphomas treatmentСовременные тенденции в лечении агрессивных В-клеточных лимфом у детейhttps://orcid.org/0000-0002-8482-1863KorkinaYu. S.КоркинаЮ. С.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-1469-2365ValievT. T.ВалиевТ. Т.
Russian Federation

Timur Teymurazovich Valiev

24 Kashirskoe Shosse, Moscow 115478

Тимур Теймуразович Валиев

115478 Москва, Каширское шоссе, 24

timurvaliev@mail.ruPediatric Oncology and Hematology Research Institute, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaНаучно-исследовательский институт детской онкологии и гематологии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России0706202116221270306202103062021https://oncohematology.abvpress.ru/ongm/article/view/471

Nowadays due to modern risk-adapted treatment protocols high survival rates have been achieved in patients with aggressive B-cell lymphomas, even at stages III–IV these indicators overrun 90 %. Mainly these successes were associated with the inclusion of rituximab in the standard chemotherapy regimens. As the follow up period of the patients is lengthened, it has become clear that ongoing treatment is associated with the development of immediate and long-term adverse effects of chemoimmunotherapy. In Russia and the world, there are multicenter studies aimed at studying prognostic factors that make it possible to reduce single and/or total doses of chemotherapy drugs, and therefore, to reduce chemotherapy toxicity. The obtained data allow considering the early complete antitumor effect (after 2 courses of therapy) as an advantage factor, so it is possible to reduce program chemoimmunotherapy intensity without reducing high patients survival rates.

В настоящее время благодаря современным риск-адаптированным протоколам лечения получены высокие показатели выживаемости больных агрессивными В-клеточными лимфомами, которые даже при III–IV стадиях превышают 90 %. Во многом данные успехи были связаны с включением в стандартные режимы полихимиотерапии ритуксимаба. По мере увеличения периода наблюдения за пациентами стало понятно, что проводимое лечение сопряжено с развитием непо- средственных и отдаленных неблагоприятных эффектов химиоиммунотерапии. Во всем мире, и в России в том числе, проводятся многоцентровые исследования, направленные на изучение факторов прогноза, позволяющих редуцировать разовые и/или суммарные дозы химиопрепаратов, а значит, уменьшить токсические проявления химиотерапии. Полу- ченные данные позволяют считать ранний (после 2 курсов терапии) полный противоопухолевый ответ благоприятным фактором, при котором возможно уменьшение интенсивности программной химиоиммунотерапии без снижения высоких показателей выживаемости больных.

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