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Method of predicting of process activation in patients with hodgkin's lymphoma

IPC classes for russian patent Method of predicting of process activation in patients with hodgkin's lymphoma (RU 2405454):
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FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to biochemical investigations in oncology, and can be used in determination of activation or stabilisation of pathologic process in patients with primary-resistant Hodgkin's lymphoma. In patients with primary-resistant Hodgkin's lymphoma at stages of treatment, by radioimmune method determined is content in blood of thyroid gland hormones - triiodothyronine and thyroxine, and adrenocortical hormone - cortisol, their concentration is summed up and in case of total level of hormones is within 278.2 nmole/l - 0 333.0 nmole/l conclusion about activation of malignant process is made, if total level of said hormones is 432.4 nmole/l - 833.2 nmole/l conclusion about absence of process activation is made.

EFFECT: prediction of process activation or stabilisation in patients with primary-resistant Hodgkin's lymphoma is an informative test for evaluation of pathologic process state and can be recommended for monitoring of patients at treatment stages.

1 tbl, 2 ex

 

The invention relates to medicine, namely to biochemical research in Oncology and can be used to determine the activation or stabilization of the pathological process in patients with primary refractory Hodgkin's lymphoma.

Despite the fact that Hodgkin's lymphoma (Hodgkin's disease) are related to neoplastic diseases of the blood forming organs, which are most often exposed to successful recovery, nevertheless the actual problem in the field of Oncology remains the treatment of patients with primary resistant (refractory) forms of the process. In particular, this applies to situations where, in the absence of clinical effect of the applied treatment in patients marked activation of malignant growth that can lead to generalization of the disease and require changes to the schemes and tactics of therapeutic interventions. In this regard, given the high importance of timely detection of the activation direction of the process, one of the important tasks is to support search of additional laboratory tests, the use of which during the treatment period, usually long-term in patients with Hodgkin's lymphoma, will identify possible changes in the course of the disease.

Known "Way to determine the clinical factors of poor prognosis for lymphoma X is Gcina": age over 45 years, increased levels of alkaline phosphatase in serum by more than 50% of the upper limit of normal, the number of zones lesions more than 5, conglomerated lymph nodes of size 5 cm or more, male gender, serum albumin less than 4.0 g/DL, hemoglobin less than 10.5 g/DL, lymphocytopenia less than 0.6×109/l (Kanaev SV and others, 2005). However, female patients with this pathology to unfavorable prognostic signs include a decrease in blood estradiol, progesterone and testosterone.

Listed prognostic factors are summarized and analyzed in the individual planning treatment tactics for patients with Hodgkin lymphoma. It is known, however, that the tumor development, even with the same source factors can vary significantly in each case. This is due to the biological properties of the tumor and to a large extent a particular state of the body, affecting the nature of the interaction in the system between the tumor and the body. In this regard, clinical prognostic factors may not be used for individualization of the state of the malignant process in patients with Hodgkin's lymphoma.

There is a method of prognosis in patients with Hodgkin's lymphoma on the content in the serum of lymphocytes s25 at the beginning of the disease (Puri C.H. et al. Zeukemia, 1993), selected the us as a prototype. The authors found that in this category of patients in the initial stages of development of malignant lymphoproliferative process serum levels s25 differ significantly. The researchers found a link of the specified index with the prognosis of the disease - it turned out to be favorable at low concentrations s25 in the blood and adverse when it is elevated values. The disadvantages of this method include low information content of the proposed test in relation to the characteristics of the activity of the pathological process that is important in the treatment of patients with refractory forms of Hodgkin's lymphoma.

According to modern concepts of thyroid hormones and cortisol are in the body of the main regulators of all types of metabolism - protein, carbohydrate, lipid, mineral. This function Dolny bioactive compounds provides the control, regulation and maintenance of adequate levels of General homeostasis of the organism. However, in addition to the regulation of metabolism, thyroid hormones and adrenal glands play a multifunctional role as a multipurpose bioregulators systemic effects at the cellular, tissue and organ levels, determining the development of numerous and diverse physiological effects. Gorani control about Icemist membranes, synthesis of highly specialized proteins, the activity of cellular organelles, the state of lymphoid organs and in the whole immune system, oxygen supply to tissues, the intensity of energy metabolism, improve blood. One of the important properties of these hormones is also their participation in the mechanisms of resistance of the organism and its adaptation to changing how exogenous and endogenous conditions. All of the above suggests that the status of thyroid hormones and cortisol in patients with cancer can have a significant impact on the characteristics of the reaction to the development of malignant tumors.

The aim of the invention is to determine the state of activation or stabilization of the pathological process in patients with Hodgkin's lymphoma during treatment.

This objective is achieved in that in patients with primary refractory Hodgkin's lymphoma during treatment, radioimmunoassay method determines the blood levels of thyroid hormones - triiodothyronine and thyroxine, the hormone of the adrenal cortex - cortisol, summarize their concentration and total amount of hormones in the borders 278,2 nmol/l 333,0 nmol/l state activation malignant process, and with the General level of these hormones 432,4 nmol/l 833,2 nmol/l note the absence of the activation process.

The image is giving "a Method for predicting the activation process in patients with Hodgkin lymphoma" is a new, as it is unknown the level of medicine in the field of biochemical research for predicting the course of the pathological process in patients with primary refractory Hodgkin's lymphoma.

The novelty of the invention lies in the fact that for the assessment of the pathological process in patients with Hodgkin's lymphoma using the overall content in the blood of the basic multi-hormone regulators - triiodothyronine, thyroxine and cortisol. Total concentration in the blood of patients triiodothyronine, thyroxine and cortisol in the borders 278,2 nmol/l 333,0 nmol/l indicates the activation of a malignant process, and with the General level of these hormones within the boundaries 432,4 nmol/l 833,2 nmol/l note the absence of the activation process.

The invention of "a Method for predicting the activation process in patients with Hodgkin's lymphoma is promissao applicable, as may be used in health care, in hospitals specialized profile for the treatment of cancer patients with this malignant process.

"A method for predicting the activation process in patients with Hodgkin's lymphoma as follows.

The study included 5 patients with Hodgkin lymphoma (HL) with 2B-3b-stage disease at the age of 29-39 years.

By the time of the study serum hormones ill the e received several courses of chemotherapy + remote gamma-therapy radical programme. In the blood of patients radioimmunoassay method was determined by the content of the thyroid hormones thyroxine (T4) and triiodothyronine (T3and the main glucocorticoid hormone of the adrenal cortex cortisol. Then calculate the overall level of hormone regulators by adding their concentrations (T3+T4+cortisol).

Determination of total concentration in the blood of patients with HL thyroid hormones and cortisol showed that 3 out of 5 women total content of hormones controls ranged from 432,4 nmol to 833,2 nmol/l and in 2 other patients, the figure was 273,2 and 338,0 nmol/L. Held simultaneously with the study of the hormonal profile of the control patients revealed in the last two cases, the activation of the pathological process and the lack of activation in the first 3 cases.

Thus, the obtained data indicate that activation of the malignant process in women with LH is associated with low overall level in the blood of patients with thyroid hormones and cortisol, equal 273,2-338,0 nmol/L. In contrast, the hormones in the absence of the activation process is characterized by high values of the total amount of hormones in the borders 432,4-833,2 nmol/L.

The results presented indicate the high relevance of the proposed test assessment of the pathological process in Bo is lnyh with LH on the size of the total content in the blood of thyroid hormones and cortisol. The test can be recommended as additional laboratory factor evaluation in the monitoring of patients on LH stages of treatment.

The total content of thyroid hormones and cortisol in the blood of patients with HL, depending on the state of the malignant process
Patients with activation process Patients without activation process
1. 273,2 nmol/l 1. 43 2.4 nmol/l
2. 338,0 nmol/l 2. 811,5 nmol/l
3. 833,2 nmol/l

Clinical examples of the application of the Method for predicting the activation process in patients with Hodgkin lymphoma"

Example No. 1. B-I D., born in 1979, istby. No. 9418/08, on treatment with December 2008 Diagnosis: LGM Art. IIIB (IGR) with peripheral l/y (neck lymph nodes on the left), the lymph nodes in the mediastinum, zabroshenyj l/y. Left-sided pleural effusion. G/a from 03.12.08 - Hodgkin's lymphoma (No. 7328-7332). Source: had enlarged cervical lymph nodes on the left up to 2-3 cm in diameter, dense, sedentary, sensitive to palpation, itchy skin, night sweats, subfebrile body temperature, weakness, SKT SSB and ultrasound SSB - uvelicheny zaproszenie lymph nodes (many small) on SKT UCP - an enlarged lymph node mediastinal, left-sided pleural effusion. The patient received 2 courses of 45 mm/hour, PCT ABVB - clinically insignificant improvement - l/have not diminished, disappeared skin itching, sweating is not decreased, l/mediastinal and retroperitoneal l/y is unchanged.

At this stage, the patient carried out the determination in blood content of thyroid hormones and cortisol, their total concentration (T3+T4+cortisol) is 833,2 nmol/L.

Thus, the patient with the lack of activation of the process at the stage of treatment is high level in the blood of the main hormones of the controllers.

Example No. 2. B-I D., born in 1969, East. bol. No. 1522/91. Diagnosis: LGM STB (ex) mixed-cell variant, with peripheral l/u (cervical-over-subclavian, axillary l/u), mediastinal l/y. Is being treated since 1991. Received mnogochasovuyu PCT+DHT radical programme. In 2008, the activation process. Complaints at admission: weakness, constant sweating, itching, subfebrile body temperature in the evening. St. localis: increased cervical-over-subclavian lymph nodes up to 2.5 cm in diameter, dense, sedentary palpation, axillary l/u - up to 1.5 cm in diameter, dense, sedentary, sensitive to palpation with both sides.

23.XII.08, estimation of blood sick content of thyroid hormones and to the Tizol, their total concentration (TK+T4+cortisol) was 278,2 nmol/L.

Thus, the activation process of the patient combined with low overall levels of thyroid hormones and adochnikov.

Technical and economic efficiency of the Method for predicting the activation process in patients with Hodgkin lymphoma" is that the prediction of activation or stabilization process in patients with primary refractory Hodgkin's lymphoma in blood levels of thyroid hormones and cortisol is informative test for the assessment of the pathological process and can be recommended for monitoring patients during treatment.

A method for predicting the activation process in patients with Hodgkin's disease, including biochemical, characterized in that in patients with primary refractory Hodgkin's lymphoma during treatment radioimmunoassay method determines the blood levels of thyroid hormones - triiodothyronine and thyroxine, the hormone of the adrenal cortex - cortisol, summarize their concentration and total amount of hormones in the borders 278,2 nmol/l 333,0 nmol/l state activation malignant process, and with the General level of these hormones 432,4 nmol/l 833,2 pmol/l note the absence of the activation process.

 

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