Форма документа : Стаття із журналу Шифр видання : Автор(и) : Yevstakhevych Yu. L., Semerak M. M., Yevstakhevych I.Yo., Vyhovska Ya. I., Lebed H. B., Tumak I. M., Petronchak O. A., Loginsky V. E. Назва : Splenectomy in the treatment of diffuse large B cell lymphoma and its results Місце публікування : Онкология. - Київ, 2018. - Том 20, N 4. - С. 269-274 (Шифр ОУ3/2018/20/4) Примітки : Бібліогр. наприкінці ст. MeSH-головна: ЛИМФОМА B-КРУПНОКЛЕТОЧНАЯ ДИФФУЗНАЯ -- LYMPHOMA, LARGE B-CELL, DIFFUSE СПЛЕНЭКТОМИЯ -- SPLENECTOMY ЛЕЧЕНИЯ РЕЗУЛЬТАТОВ АНАЛИЗ -- TREATMENT OUTCOME ВЫЖИВАЕМОСТИ АНАЛИЗ -- SURVIVAL ANALYSIS Анотація: Objective: to analyze the immediate and long-term results of splenectomy in pa-tients with diffuse large B cell lymphoma and, as based on the results, to specify indications for splenectomy, surgical approach and outcomes. Object and methods: among 114 splenectomies in patients with non-Hodgkin’s lymphomas (NHL), 29 splenectomies were performed in patients with diffuse large B cell lymphoma (DLBCL). Among them there were 15 men and 14 women 21–75 years old (me-dian age — 57 years). The indications for splenectomy in patients with DLBCL were: splenomegaly, leukopenia, immune thrombocytopenia, autoimmune hemo-lytic anemia, regional portal hypertension, absence of diagnosis. The statistical processing was performed by means of software package Statistica for Windows 6.0 (StatSoft, USA). Parametric data was presented as median (minimum-maximum) [lower-upper quartiles]. The results of splenectomy were assessed in the immedi-ate post-splenectomy period (on the fourteenth–sixteenth day) pursuant to crite-ria described in the references and during follow-up control. The overall patients’ survival was determined by the Kaplan — Meier method and described as a medi-an survival (lower-upper quartiles) and 3- and 5-year survival was also estimated constructing tables of cumulative survival. The survival curves were compared using the log-rank and Cox tests. Results: splenectomy was effective in 25 (86.2%) pa-tients with DLBCL: abdominal discomfort, anemia, leukopenia were eliminated, hemolysis associated with autoimmune hemolytic anemia stopped, and the num-ber of platelets associated with immune thrombocytopenia increased or norma-lized, and hemorrhagic syndrome disappeared. One patient died immediately af-ter splenectomy. Early postoperative mortality after splenectomy in patients with DLBCL was 3.4%. The analysis of long-term results of splenectomy in DLBCL patients showed that the median survival according to Kaplan — Meier curve was 31.9 months (observation period 1.0–192.0 months, the lower quartile and the upper quartile are 5.6–72.5 months) with 3-year cumulative survival 48.7% of patients and with 5-year — 32.9%. In patients with concomitant immune cytope-nias median survival was 6.5 months in contrast to 56.5 months in their absence. The difference with between the groups was highly significant — p 0.01 by log-rank criterion and Cox’s F Test. Multivariate analysis by Cox regression method showed that in addition to cytopenia, an independent predictor of less survival is an earlier onset of relapses, age and duration of the disease did not affect survival. Conclusions: as a result of splenectomy in patients with DLBCL, the direct clini-cal and hematological effect occurred in 86.2% of cases. In DLBCL patients who did not have concomitant immune cytopenias, the median survival after opera-tion was 56.5 months, in contrast to 6.5 months in the presence of immune cyto-penias. The best results of splenectomy in DLBCL were recorded in patients with isolated spleen lesions: patients lived from 72 to 186 month Дод.точки доступу: Yevstakhevych, Yu. L. Semerak, M. M. Yevstakhevych, I.Yo. Vyhovska, Ya. I. Lebed, H. B. Tumak, I. M. Petronchak, O. A. Loginsky, V. E.