RU2304968C1 - Method for treating hodgkin's lymphoma - Google Patents

Abstract

FIELD: medicine, oncology.

SUBSTANCE: it is necessary to fulfill the puncture of posterior section of iliac ala to sample 150 ml medullary suspension into the vial with 50 ml hemoconservant. The vial's content should be supplemented with 40 mg/sq. m doxorubicin, 600 mg/sq. m cyclophosphan and 1.4 mg/sq.m vincristine. The mixture obtained should be incubated at 37°C for 40 min. Then this mixture should be injected for a patient intravenously by drops. Then it is important to conduct infusion of 375 mg/sq.m dacarbazine on the 1^st d of therapy. Since the 1^st to the 10^th d they prescribe per 40 mg/sq. m prednisolone. On the 8^th d of therapy one should intravenously inject 10 mg/sq. m bleomycin. The course should be repeated in 14 d. The innovation enables to apply automyelochemotherapy on the 3d-4^th stage of systemic malignant disease as the main type of therapy by preventing the increased rate of aseptic necroses of capuit femoris in this category of patients due to the matched injection scheme.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, more specifically to oncology, and can be used in the complex treatment of patients with malignant diseases of the lymphatic system of the II-III-IV stages.

There is a method of treating patients with Hodgkin's lymphoma, which consists in treating tumor cells with a combination of several chemotherapy drugs. Their use is proposed in the form of 6 two-week cycles or in cycles of 15 days with breaks of 2 weeks. The total number of cycles usually reaches 6-12 ("Lymphogranulomatosis", under the editorship of L. L. Simbirtseva and L. L. Holsti, M., Medicine, 1985).

However, the treatment regimens used for anticancer drugs in many respects have drawbacks and cannot satisfy clinicians. Along with their main task - the destruction of tumor cells, they have a detrimental effect on the work of various organs and systems, in addition to a high degree of toxicity, adversely affect hematopoiesis, cause neuroreflexive complications.

There is a method of treating lymphogranulomatosis with the combined effect of chemotherapy on tumor foci, including those not clinically identified, and a strong local effect of ionizing radiation on large tumor formations that are not amenable to the effects of chemotherapy (Lymphogranulomatosis. / Ed. Simbirtseva L.P. and L. Canvases, M., Medicine, 1985).

The used complex of therapeutic effects allows to achieve a longer remission. However, the frequency and severity of toxic side effects of these two types of treatment often become so significant that they force interruption of both radiation therapy and polychemotherapy.

The aim of the invention is to improve the direct results of antitumor therapy.

This goal is achieved by the fact that patients with Hodgkin's lymphoma are carried out by puncture of the posterior segment of the iliac wing and the collection of 150 ml of bone marrow suspension in a bottle with 50 ml of hemoconservative, 40 mg / m ^{2 of} doxorubicin, 600 mg / m ^{2 of} cyclophosphamide and 1.4 mg / m ² vincristine, the resulting mixture was incubated at 37 ° C for 40 min and injected intravenously, followed by infusion of 375 mg / m ² dacarbazine on the first day of treatment; from the first to the tenth days, 40 mg / m ^{2 of} prednisolone is prescribed, on the 8th day of treatment, 10 mg / m ^{2 of} bleomycin is administered intravenously; after 14 days, similar therapeutic effects are repeated.

The analysis of known methods for the treatment of Hodgkin lymphoma and the proposed method for the treatment of Hodgkin lymphoma allows us to talk about the novelty and significant differences of the latter. He is not known from the level of medicine in the treatment of malignant diseases of the lymphatic system.

The novelty of the method lies in the fact that, before being introduced into the body, antitumor drugs are combined and incubated with the patient’s natural environment, and used to treat malignant diseases of the lymphatic system.

In the well-known open sources of information in Russia, the CIS countries and abroad, indications of a similar method for the treatment of Hodgkin's lymphoma are not found.

The proposed method is industrially feasible, as it can be reproduced and repeatedly repeated in specialized institutions of oncological and therapeutic profile.

The method is as follows.

After a final diagnosis is made, patients in the treatment room under local anesthesia with a 0.5% solution of novocaine are punctured with a posterior segment of the iliac wing for 150 ml of bone marrow suspension in a bottle with 50 ml of blood preservative. Then, 40 mg / m ^{2 of} doxorubicin, 600 mg / m ^{2 of} cyclophosphamide and 1.4 mg / m ^{2 of} vincristine are added to the vial, the resulting mixture is incubated at 37 ° C for 40 min and injected intravenously, after which 375 mg / m ² dacarbazine on the first day of treatment; from the first to the tenth days, 40 mg / m ^{2 of} prednisolone is prescribed, on the 8th day of treatment, 10 mg / m ^{2 of} bleomycin is administered intravenously; after 14 days, similar therapeutic effects are repeated.

An example of a specific implementation of the method can serve as an extract from the medical history.

Patient S., 35 years old, medical history No. 3370 / f, was admitted to the department on March 23, 2005 in a moderate state with complaints of chest pain behind the sternum during physical exertion; after thoracotomy, rises in body temperature daily to 37.1 ° C, general discomfort, weakness. Diagnosis at admission: Lymphogranulomatosis (Hodgkin's disease) St IIA, with damage to the mediastinum, peripheral lymph nodes (supraclavicular from 2 sides). Condition after diagnostic thoracotomy (03/14/05). From the anamnesis: I was ill for about 2 months, when I paid attention to pain behind the sternum, weakness. On the radiograph of the OGK: thymoma ?. 02/28/05 CRTS of the organs of the chest, abdominal cavity and small pelvis: in the lungs without focal and infiltrative changes, lymph nodes of the anterior mediastinum are enlarged in the superior vena cava, along the aorta from 1.0 to 3.0 cm, pleurisy to 150 ml on the left. Conclusion: systemic lymphoproliferative disease with damage to the lymph nodes of the upper anterior mediastinum. Objectively: by palpation and according to ultrasound with accurate measurement of the size in the supraclavicular areas, enlarged lymph nodes were initially determined from 2 sides: 0.9-2.6 cm on the left, single to 1.8 cm on the right. The patient noticed that the lymph nodes in the supraclavicular areas increased soon after thoracoscopy. OAK 03/24/05 NG 130 g / l, er. 4.4 * 10 ¹² / l; color code 0.88; tr 369 * 10 ⁹ / l; white blood cells 6.4 * 10 ⁹ l; ESR 30 mm / h; n 10, s 75, m 4, lf 11. 03/24/05 a patient in the treatment room under local anesthesia with 0.5% novocaine solution was punctured of the posterior segment of the iliac wing. Made a sampling of 150 ml of bone marrow suspension in a bottle with 50 ml of glugicir. 40 mg / m ^{2 of} doxorubicin, 600 mg / m ^{2 of} cyclophosphamide and 1.4 mg / m ^{2 of} vincristine were introduced into the vial. The resulting mixture was incubated at 37 ° C for 40 min, then administered intravenously, followed by infusion of 375 mg / m ² dacarbazine on the first day of treatment. From the first to the tenth days, the patient received 40 mg / m ^{2 of} prednisone, on the 8th day of treatment 10 mg / m ^{2 of} bleomycin was administered intravenously. Already on the 2nd day of treatment there was an improvement in general condition, normalization of body temperature. There were no complications. By the end of the 1st course, the patient's condition was closer to satisfactory, chest pain was not disturbed. OAK at the end of the 1st course 30.03.05 NG 136 g / l, er. 4,5 * 10 ¹² / l; color index 0.9; tr 369 * 10 ⁹ / l; white blood cells 13.2 * 10 ⁹ / l; ESR 10 mm / h; p 9, s 73, m 1.5, lf 6.5. After 2 weeks with the appearance at the 2nd course of treatment, control FLO was performed (04/12/05): in the lungs without focal and infiltrative changes, at the moment, radiological data for an increase in lymph nodes of the roots and mediastinum were not detected; on the right, in the lower sections, slight pleural overlays. With the appearance on the 3rd course by palpation and with ultrasound control on 05/05/03, there were no signs of cervical-supraclavicular lymph node hyperplasia. The treatment was well tolerated. There were no complications or toxicity. The patient, after 4 courses of automyelochemotherapy, performed a control chest CT scan to assess the effectiveness of treatment: no pathology was detected (confirmation of the achievement of primary complete remission).

The technical and economic effectiveness of the method of treatment of Hodgkin lymphoma is the possibility of:

- to carry out in full the conduct of courses of antitumor chemotherapy, minimizing its toxic side effects;

- to avoid the negative effects of antitumor chemotherapy drugs on the immune status of patients;

- improve the general condition of patients and their quality of life.

Claims (1)

A method for the treatment of Hodgkin's lymphoma, including the introduction of antitumor chemotherapy drugs connected with the body’s natural environment, characterized in that in patients by puncture of the posterior segment of the iliac wing, 150 ml of bone marrow suspension are taken into a bottle with 50 ml of blood preservative, 40 mg / m ^{2 is} added doxorubicin, 600 mg / m ² cyclophosphamide and 1.4 mg / m ² vincristine, the resulting mixture was incubated at 37 ° C for 40 min and injected intravenously, after which 375 mg / m ² dacarbazine was infused on the first day of treatment, s ne Vågå to tenth days administered 40 mg / m ² of prednisolone on the 8th day of treatment intravenously administered 10 mg / m ² of bleomycin, after 14 days is performed similar therapeutic effects.