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Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="ru"></institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница No 52 Департамента здравоохранения г. Москвы»</institution></aff></aff-alternatives><aff-alternatives id="aff7"><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова Минздрава России&#13;
(Сеченовский Университет)</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff8"><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><aff><institution xml:lang="en">Federal Center of Brain Research and Neurotechnologies, Federal Medical and Biological Agency</institution></aff></aff-alternatives><aff-alternatives id="aff9"><aff><institution xml:lang="ru">ФГБУ «Федеральный центр мозга и нейротехнологий Федерального медико-биологического агентства»</institution></aff><aff><institution xml:lang="en">Moscow International Oncology Center</institution></aff></aff-alternatives><aff-alternatives id="aff10"><aff><institution xml:lang="ru">ООО «Московский международный онкологический центр»</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff11"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff></aff-alternatives><aff-alternatives id="aff12"><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff13"><aff><institution xml:lang="ru"></institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff14"><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff></aff-alternatives><aff-alternatives id="aff15"><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff16"><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution></aff></aff-alternatives><aff-alternatives id="aff17"><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff-alternatives id="aff18"><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><aff><institution xml:lang="en">Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia</institution></aff></aff-alternatives><aff-alternatives id="aff19"><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России</institution></aff><aff><institution xml:lang="en">Moscow City Clinical Hospital No. 52</institution></aff></aff-alternatives><aff id="aff20"><institution>ГБУЗ г. Москвы «Городская клиническая больница №52 Департамента здравоохранения г. Москвы»</institution></aff><pub-date date-type="pub" iso-8601-date="2024-12-10" publication-format="electronic"><day>10</day><month>12</month><year>2024</year></pub-date><volume>19</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>52</fpage><lpage>72</lpage><history><date date-type="received" iso-8601-date="2024-12-09"><day>09</day><month>12</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-12-09"><day>09</day><month>12</month><year>2024</year></date></history><permissions><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://oncohematology.abvpress.ru/ongm/article/view/974">https://oncohematology.abvpress.ru/ongm/article/view/974</self-uri><abstract xml:lang="en"><p>Classical Hodgkin’s lymphoma (cHL) is a lymphoproliferative disease characterized by the presence of Hodgkin anderezovsky–Reed–Sternberg cells and a tumor microenvironment. Currently, much attention is paid to the microenvironment in cLH. A detailed understanding of the interaction between the tumor and its microenvironment opens up prospects for the cHL diagnosis and treatment. Innovative immunotherapeutic agents such as nivolumab make it possible to control and activate the immune response. Despite the high efficiency of standard protocols in young patients, therapy intensification is associated with organ toxicity and the development of secondary malignant neoplasms. At the same time, in elderly patients, the results of generally accepted antitumor treatment protocols should be considered suboptimal. In the last decade, the treatment of refractory cHL has improved significantly due to the use of immune checkpoint inhibitors.</p><p>Taking into account the above, the priority issue in modern clinical hematology is to improve cHL treatment strategies not only in elderly but also in young patients by maintaining a balance between high efficacy and low toxicity. Moreover, the inclusion of nivolumab in first-line therapy is not only pathogenetically justified and effective, but also safe. The article presents data from clinical observations of the successful nivolumab use in combination with chemotherapy in patients with newly diagnosed cHL.</p></abstract><trans-abstract xml:lang="ru"><p>Классическая лимфома Ходжкина (кЛ) – лимфопролиферативное заболевание, характеризующееся наличием клеток Ходжкина и Березовского–Рид–Штернберга и опухолевого микроокружения. В настоящее время микроокружению при кЛХ уделяется большое внимание. Детальное понимание взаимодействия опухоли и ее микроокружения открывает перспективы в диагностике и лечении кЛХ. За счет инновационных иммунотерапевтических агентов, таких как ниволумаб, представляются возможными контроль и активация иммунного ответа. Несмотря на высокую эффективность стандартных протоколов у молодых пациентов, интенсификация терапии ассоциирована с органотоксичностью, развитием вторичных злокачественных новообразований. При этом в группе пожилых пациентов результаты общепринятых протоколов противоопухолевого лечения следует признать неоптимальными. В последнее десятилетие значимо улучшились результаты лечения рефрактерных форм кЛХ за счет применения ингибиторов иммунных контрольных точек. Приоритетной задачей в современной клинической гематологии является усовершенствование стратегий терапии кЛХ не только у пожилых, но и у молодых пациентов за счет сохранения баланса между высокой эффективностью и низкой токсичностью. При этом включение ниволумаба в терапию 1‑й линии не только патогенетически обоснованно и эффективно, но и безопасно. В статье представлены данные клинических наблюдений успешного применения ниволумаба в комбинации с химиотерапией у пациентов с впервые диагностированной кЛХ.</p></trans-abstract><kwd-group xml:lang="en"><kwd>Hodgkin’s lymphoma</kwd><kwd>nivolumab</kwd><kwd>PD-1</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>лимфома Ходжкина</kwd><kwd>ниволумаб</kwd><kwd>PD-1</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The work was carried out with financial support under grant No. 1603-45/23 “Study of the possibility of reproductive and menstrual function preserving in oncological, in particular, oncohematological patients using methods of cryopreservation of oocytes, embryos and ovarian tissue with subsequent autotransplantation”.</funding-statement><funding-statement xml:lang="ru">Работа выполнена при финансовой поддержке в рамках гранта № 1603-45/23 «Исследование возможности сохранения репродуктивной и менструальной функции у онкологических, в частности онкогематологических, пациенток с использованием методов криоконсервации ооцитов, эмбрионов и овариальной ткани с последующей аутотрансплантацией».</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Stark G.L., Wood K.M., Jack F. et al. Hodgkin’s disease in the elderly: a populationbased study. Br J Haematol 2002;119(2): 432–40. DOI: 10.1046/j.13652141.2002.03815.x</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Bhurani D., Nair R., Rajappa S. et al. Realworld outcomes of Hodgkin lymphoma: a multicentric registry from India. Front Oncol 2022;11:799948. DOI: 10.3389/fonc.2021.799948</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>André M.P.E., Carde P., Viviani S. et al. Longterm overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: a pooled analysis of four randomized trials. Cancer Med 2020;9(18):6565–75. DOI: 10.1002/cam4.3298</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Cheng P.T.M., Villa D., Gerrie A.S. et al. The outcome of older adults with classic Hodgkin lymphoma in British Columbia. Blood Adv 2022;6(22):5924–32. DOI: 10.1182/bloodadvances.2022008258</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Evens A.M., Hong F. How can outcomes be improved for older patients with Hodgkin lymphoma? J Clin Oncol 2013;31(12): 1502–5. DOI: 10.1200/JCO.2012.47.3058</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Evens A.M., Hong F., Gordon L.I. et al. The efficacy and tolerability of adriamycin, bleomycin, vinblastine, dacarbazine and Stanford V in older Hodgkin lymphoma patients: a comprehensive analysis from the North American intergroup trial E2496. Br J Haematol 2013;161(1):76–86. DOI: 10.1111/bjh.12222</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Engert A., Ballova V., Haverkamp H. et al. Hodgkin’s lymphoma in elderly patients: a comprehensive retrospective analysis from the German Hodgkin’s Study Group. J Clin Oncol 2005;23(22):5052–60. DOI: 10.1200/JCO.2005.11.080</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Evens A.M., McKenna M., Ryu Tiger Y.K., Upshaw J.N. Hodgkin lymphoma treatment for older persons in the modern era. Hematology Am Soc Hematol Educ Program 2023;2023(1):483–99. DOI: 10.1182/hematology.2023000449</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Herrera A.F., LeBlanc M.L., Castellino S.M. et al. SWOG S1826, a randomized study of nivolumab (N)AVD versus brentuximab vedotin (BV)AVD in advanced stage (AS) classic Hodgkin lymphoma (HL). J Clin Oncol 2023;41(17 suppl):LBA4. DOI: 10.1200/JCO.2023.41.17_suppl.LBA4</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Weniger M.A., Küppers R. Molecular biology of Hodgkin lymphoma. Leukemia 2021;35(4):968–81. DOI: 10.1038/s41375021012046</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Straus D.J., DługoszDanecka M., Connors J.M. et al. Brentuximab vedotin with chemotherapy for stage III or IV classical Hodgkin lymphoma (ECHELON1): 5year update of an international, openlabel, randomised, phase 3 trial [published correction appears in Lancet Haematol 2022;9(2):e91]. Lancet Haematol 2021;8(6):e410–21. DOI: 10.1016/S23523026(21)001022</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Evens A.M., Advani R.H., Helenowski I.B. et al. Multicenter phase II study of sequential brentuximab vedotin and doxorubicin, vinblastine, and dacarbazine chemotherapy for older patients with untreated classical Hodgkin lymphoma. J Clin Oncol 2018;36(30):3015–22. DOI: 10.1200/JCO.2018.79.0139</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Menéndez V., Solórzano J.L., Fernández S. et al. The Hodgkin lymphoma immune microenvironment: turning bad news into good. Cancers (Basel) 2022;14(5):1360. DOI: 10.3390/cancers14051360</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Carreau N.A., Diefenbach C.S. Immune targeting of the microenvironment in classical Hodgkin’s lymphoma: insights for the hematologist. Ther Adv Hematol 2019;10:2040620719846451. DOI: 10.1177/2040620719846451</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Ansell S.M., Bröckelmann P.J., von Keudell G. et al. Nivolumab for relapsed/refractory classical Hodgkin lymphoma: 5year survival from the pivotal phase 2 CheckMate 205 study. Blood Adv 2023;7(20):6266–74. DOI: 10.1182/bloodadvances.2023010334</mixed-citation></ref><ref id="B16"><label>16.</label><citation-alternatives><mixed-citation xml:lang="en">Lepik K.V., Mikhailova N.V., Kondakova E.V. et al. Efficacy and safety of nivolumab in the treatment of relapsed/refractory classical Hodgkin’s lymphoma: Pavlov First Saint Petersburg State Medical University experience. Onkogematologiya = Oncohematology 2018;13(4):17–26. (In Russ.). DOI: 10.17650/1818834620191341726</mixed-citation><mixed-citation xml:lang="ru">Лепик К.В., Михайлова Н.Б., Кондакова Е.В. и др. Эффективность и безопасность ниволумаба в лечении рецидивирующей и рефрактерной классической лимфомы Ходжкина: опыт ПСПбГМУ им. акад. И.П. Павлова. Онкогематология 2018;13(4):17–26. DOI: 10.17650/1818834620191341726</mixed-citation></citation-alternatives></ref><ref id="B17"><label>17.</label><citation-alternatives><mixed-citation xml:lang="en">Mamedova A.A., Mochkin N.E., Sarzhevskiy V.O. et al. Combined immunochemotherapy in patients with refractory/relapsed classical Hodgkin’s lymphoma as a 2nd line treatment before autologous hematopoietic stem cell transplantation (preliminary results). Onkogematologiya = Oncohematology 2022;17(3):40–7. (In Russ.). DOI: 10.17650/1818834620221734047</mixed-citation><mixed-citation xml:lang="ru">Мамедова А.А., Мочкин Н.Е., Саржевский В.О. и др. Комбинированная иммунохимиотерапия у больных рефрактерной/ рецидивирующей классической лимфомой Ходжкина как лечение 2й линии перед аутологичной трансплантацией кроветворных стволовых клеток (предварительные результаты). Онкогематология 2022;17(3):40–7. DOI: 10.17650/1818834620221734047</mixed-citation></citation-alternatives></ref><ref id="B18"><label>18.</label><mixed-citation>Lynch R.C., Ujjani C.S., Poh C. et al. Concurrent pembrolizumab with AVD for untreated classic Hodgkin lymphoma. Blood 2023;141(21):2576–86. DOI: 10.1182/blood.2022019254</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>McKenna M., Ryu Tiger Y.K., Rutherford S.C., Evens A.M. The Management of older patients with Hodgkin lymphoma: implications of S1826. Semin Hematol 2024;61(4):236–44. DOI: 10.1053/j.seminhematol.2024.05.004</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Lee A.J., Kim K.W., Cho Y.C. et al. Incidence of immunemediated pseudoprogression of lymphoma treated with immune checkpoint inhibitors: systematic review and metaanalysis. J Clin Med 2021;10(11):2257. DOI: 10.3390/jcm10112257</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Cheson B.D., Ansell S., Schwartz L. et al. Refinement of the Lugano Classification lymphoma response criteria in the era of immunomodulatory therapy. Blood 2016;128(21):2489–96. DOI: 10.1182/blood201605718528</mixed-citation></ref><ref id="B22"><label>22.</label><citation-alternatives><mixed-citation xml:lang="en">State Register of Medicines. Safety of Medicines. Available at: https://grls.minzdrav.gov.ru/Default.aspx (In Russ.).</mixed-citation><mixed-citation xml:lang="ru">Государственный реестр лекарственных средств. Безопасность лекарственных препаратов. Доступно по: https://grls.minzdrav. gov.ru/Default.aspx</mixed-citation></citation-alternatives></ref></ref-list></back></article>
