Natural and medical sciences

2019 Issue №1

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Case study: treatment of a patient with Т- cell lymphoma (delta-gamma-variant)



In this article, we present a clinical case of a patient with T-cell lympho­ma (delta-gamma variant) complicated by neuroleukemia. We performed a dif­ferential diagnosis from other lymphoproliferative diseases. Our diagnosis was based on trepanobiopsy and immunophenotyping data: delta-gamma-T/NK-cell lymphoma, hepatolienal form. The first NHL-BFM 90 protocol block was obtained. We performed a whole body PET/CT scan and a myelogram to con­firm the diagnosis. Since therapy was ineffective, we conducted two courses of second-line therapy (R-ICE) and received a partial response. Further, alloge­neic hematopoietic stem cell transplantation was recommended. After two R-ICE courses, the patient received supportive polychemotherapy (Rituximab + + Gem­zar), without progression. Six months later, the patient's condition wors­ened. We performed spinal puncture and diagnosed neuroleukemia. It was recom­mended that the patient received a specific course of polychemother­apy. There­fore, patients diagnosed with hepatolienal T-cell lymphoma, in view of the highly aggressive disease course, are recommended to undergo allogene­ic trans­plantation of hematopoietic stem cells as early as possible.


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