bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.18821/0234-5730/2016-61-4-190-196bloodjour-33Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESЗначение минимальной остаточной болезни при хроническом лимфолейкозе в эру таргетных лекарственных препаратовThe meaning of the minimal residual disease in chronic lymphocytic leukemia in the era of targeted drugshttps://orcid.org/0000-0002-4341-2123КувшиновА. Ю.KuvshinovA. Yu.

Кувшинов  Алексей  Юрьевич,  младший  научный  сотрудник  научной лаборатории

191024, г. Санкт-Петербург

St. Petersburg, 191024

kuvshinovmd@gmail.comhttps://orcid.org/0000-0003-1784-0375ВолошинС. В.VoloshinS. V.

191024, г. Санкт-Петербург

Voloshin Sergey V., MD, PhD.

St. Petersburg, 191024

servolos@gmail.comhttps://orcid.org/0000-0001-5958-0490МартынкевичИ. С.MartynkevichI. S.

191024, г. Санкт-Петербург

St. Petersburg, 191024

КлеинаЕ. В.KleinaE. V.

191024, г. Санкт-Петербург

St. Petersburg, 191024

https://orcid.org/0000-0002-7569-0697ЧечеткинА. В.ChechetkinA. V.

191024, г. Санкт-Петербург

St. Petersburg, 191024

ФГБУ «Российский научно-исследовательский институт гематологии и трансфузиологии» ФМБА РоссииРоссияRussian Scientific-Research Institution of Hematology and TransfusiologyRussian Federation201628022019614190196Copyright © Кувшинов А.Ю., Волошин С.В., Мартынкевич И.С., Клеина Е.В., Чечеткин А.В., 20192019Кувшинов А.Ю., Волошин С.В., Мартынкевич И.С., Клеина Е.В., Чечеткин А.В.Kuvshinov A.Y., Voloshin S.V., Martynkevich I.S., Kleina E.V., Chechetkin A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/33

Полная ремиссия (ПР) и длительная беспрогрессивная выживаемость (БПВ) могут быть достигнуты уже после первой линии химиоиммунотерапии у большинства больных хроническим лимфолейкозом (ХЛЛ). Тем не менее в костном мозге значительного числа больных с ПР заболевания иммунологическими и генетическими методами выявляют некоторое количество опухолевых клеток (более 1 на 10 000 нормальных клеток), которые определяют суть минимальной остаточной болезни (МОБ). МОБ-негативный статус больного ассоциируется с длительной БПВ и общей выживаемостью и является единственным благоприятным прогностическим фактором, определяемым после терапии. Появление таргетных препаратов терапии ХЛЛ (ибрутиниб, иделалисиб, венетоклакс), имеющих высокую эффективность и низкий профиль токсичности, позволяет надеяться на увеличение числа МОБ-негативных ремиссий, а изменение тактики лечения – на решение проблемы контроля за остаточным опухолевым клоном.

In the majority of patients with chronic lymphocytic leukemia (CLL) the complete remission (CR) and prolonged progression-free survival (PFS) can be achieved already after the first line chemoimmunotherapy. Nevertheless, a number of tumor cells (more than one per normal 10.000 cells) which determine the essence of minimal residual disease (MRD) is revealed by immunological and genetic methods in the bone marrow of significant number of patients in CR of the disease. MRD-negative status of a patient is associated with prolonged PFS and overall survival (OS) and being the only favorable prognostic factor determined after therapy. The delivery of targeted drugs for the therapy of in CLL (Ibrutinib, Idelalisib, Venclexta) possessing of high efficiency and low toxicity, give the hope to increase the number of MRD-negative remissions, and the change in treatment strategy for the solution of problems of control of residual tumor clone.

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The authors declare that there are no conflicts of interest present.