vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-3-306-314vestim-440Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEПЕРВАЯ ЛИНИЯ ЛЕЧЕНИЯ ХРОНИЧЕСКОГО МИЕЛОИДНОГО ЛЕЙКОЗА У ДЕТЕЙ И ПОДРОСТКОВ В РЕСПУБЛИКЕ БЕЛАРУСЬFIRST LINE OF TREATMENT OF CHRONIC MYELOID LEUKEMIA IN CHILDREN AND ADOLESCENTS IN THE REPUBLIC OF BELARUSБорисевичМ. В.BorisevichM. V.

Борисевич Марина Владимировна – заместитель директора по организационно-методической работе

ул. Фрунзенская, 43, 223053, Минский р-н, д. Боровляны

Marina V. Borisevich – deputy director for organizational and methodological work

43, Frunzenskaya Str., v. Borovliany, 223053, Minsk Region

borisevich10@mail.ruРеспубликанский научно-практический центр детской онкологии, гематологии и иммунологииRepublican Research Center for Pediatric Oncology, Hematology and Immunology201816092018153306314Copyright © Борисевич М.В., 20182018Борисевич М.В.Borisevich M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/440

Включение иматиниба в первую линию лечения хронического миелоидного лейкоза (ХМЛ) у детей позволило кардинально повысить их выживаемость. Однако примерно у 20–30 % пациентов при лечении иматинибом в первой линии развивается первичная или вторичная резистентность. С целью выявления прогностических факторов, определяющих характер течения ХМЛ, проведен мониторинг минимальной остаточной болезни на фоне длительного приема иматиниба, определены варианты химерного онкогена BCR/ABL у 22 пациентов 0–17 лет. Показано, что более раннее наступление большого молекулярного ответа достоверно улучшает бессобытийную выживаемость, снижая риск прогрессирования ХМЛ, а результаты лечения у пациентов с b3a2 вариантом молекулярного транскрипта лучше, чем у пациентов с b2a2 вариантом.

Таким образом, своевременная коррекция терапии в соответствии с данными мониторинга глубины молекулярного ответа позволила достичь высоких показателей общей выживаемости детей с ХМЛ.

Survival was cardinally increased after introducing Imatinib into the first line of therapy of chronic myeloid leukemia (CML) in children. However primary or second resistance was observed in 20–30 % of patients. For the purpose of detection of prognostic factors, a minimal residual disease was monitored in 22 patients at an age of 0–17 years. Furthermore, different variants of BCR/ABL transcript were identified. The results showed that patients with an early major molecular response and a b3a2 variant of the BCR/ABL transcript had significantly better results of treatment. In conclusion, a regular monitoring of a deep molecular response and a further correction of therapy allowed one to increase long-term overall survival in children with CML.

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