Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya10987810.26442/18151434.2022.3.201816CLINICAL ONCOLOGYКЛИНИЧЕСКАЯ ОНКОЛОГИЯReview ArticleModern approaches in relapsed and refractory Hodgkin lymphoma treatment: literature review and own experienceСовременные подходы к лечению рецидивов и рефрактерных форм лимфомы Ходжкина: обзор литературы и собственные данныеhttps://orcid.org/0000-0002-3511-357XTsaplinaNatalia S.ЦаплинаНаталия Сергеевна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, врач – детский онколог отд-ния онкологии и гематологии (химиотерапии гемобластозов №1) Научно-исследовательского института детской онкологии и гематологии

natalia_kulichkina@mail.ruhttps://orcid.org/0000-0002-1469-2365ValievTimur T.ВалиевТимур Теймуразович
Russian Federation

D. Sci. (Med.)

д-р мед. наук, зав. отд-нием онкологии и гематологии (химиотерапии гемобластозов №1) Научно-исследовательского института детской онкологии и гематологии

timurvaliev@mail.ruhttps://orcid.org/0000-0003-4207-2822PetrovaGalina D.ПетроваГалина Дмитриевна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, врач-гематолог, зав. отд-нием трансплантации костного мозга и гемопоэтических стволовых клеток отд. гематологии и трансплантации костного мозга

galina_petrova@bk.ruhttps://orcid.org/0000-0002-2945-284XKirgizovKirill I.КиргизовКирилл Игоревич
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, зам. дир. по научной и образовательной работе Научно-исследовательского института детской онкологии и гематологии

k.kirgizov@ronc.ruhttps://orcid.org/0000-0001-6131-1783VarfolomeevaSvetlana R.ВарфоломееваСветлана Рафаэлевна
Russian Federation

D. Sci. (Med.), Prof.

д-р мед. наук, проф., дир. Научно-исследовательского института детской онкологии и гематологии

s.varfolomeeva@ronc.ruBlokhin National Medical Research Center of OncologyФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России2511202224331932415082022Copyright ©; 2022, Consilium MedicumCopyright ©; 2022, ООО "Консилиум Медикум"2022Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://modernonco.orscience.ru/1815-1434/article/view/109878

An advance of Hodgkin lymphoma (HL) diagnostic and treatment protocols promoted between fatal and high-curative disease. Modern treatment programs can reach many-year survival rate in 80–97% even in patients with advanced (III–IV) HL stages and unfavorable prognostic factors pre- sence. Nevertheless, relapses and refractory (r/r) HL appears in 8–30% patients and depend on treatment scheme, prognostic factors and comorbi- dity. Second-line therapy (ViGePP and ICE) is a common platform for r/r HL treatment in pediatric patients, but results of 3-year relapse-free survival (RFS) not to exceed 70–75%. For increase RFS rate in patients with r/r HL as combinatorial partners to schemes ViGePP and ICE add monoclonal antibodies (brentuximab vedotine) and immune chekpoint inhibitors (nivolumab), cell (auto-/allogenic stem cell transplantation) and genetically engineered (CAR-T) products. In the current issue literature and own experience in r/r HL treatment presented. It is showed, that inclusion a brentuximab vedotine in ViGePP scheme increased 3-year RFS up to 83±11.2%.

Совершенствование протоколов диагностики и лечения лимфомы Ходжкина (ЛХ) позволило перевести это злокачественное новообразование из категории фатального в высококурабельное заболевание. Современные программы терапии позволяют достичь показателей многолетней выживаемости 80–97% даже при поздних (III–IV) стадиях ЛХ и наличии неблагоприятных факторов прогноза. Тем не менее рецидивы и рефрактерные формы (р/р) ЛХ регистрируются у 8–30% больных в зависимости от выбранной схемы лечения, прогностических факторов и сопутствующей патологии. Схемы полихимиотерапии 2-й линии (ViGePP и ICE) являются общепринятой платформой для лечения р/р ЛХ у детей, но результаты 3-летней безрецидивной выживаемости (БРВ) не превышают 70–75%. С целью повышения показателей БРВ больных с р/р ЛХ в качестве комбинаторных партнеров к схемам ViGePP и ICE используется конъюгат моноклонального антитела с лекарственным препаратом (брентуксимаб ведотин), ингибиторы иммунных контрольных точек (ниволумаб), клеточные (трансплантация ауто-/аллогенных гемопоэтических стволовых клеток) и генно-инженерные (CAR-T) препараты. В настоящей работе представлен литературный и собственный опыт лечения р/р ЛХ. Показано, что включение брентуксимаба ведотина в схему ViGePP позволило повысить 3-летнюю БРВ до 83±11,2%.

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