Terapija ne-Hodgkinovih limfoma u djece pomoću monoklonskih protutijela

master's thesis

• Title (english): Monoclonal antibody therapy of pediatric non-Hodgkin lymphomas
• Author: Zrinko Šalek
• Mentor: Ernest Bilić (mentor)
• Committee member: Danko Milošević (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Ernest Bilić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Limfomi su treća najčešća maligna bolest u djece. Standardno liječenje Bstaničnog
NHL u odraslih pacijenata je kemoterapija s monoklonskim
protutijelom rituksimabom (anti CD 20). Kada je rituksimab pridružen CHOP
kemoterapijskom protokolu došlo je do povećanja stope preživljenja u odraslih.
Zbog nedostatka većih studija, liječenje B-staničnog NHL uz dodatak
monoklonalnih protutijela u djece još nije nedvojbeno prihvaćeno.
U ovom radu 36 djece s novo dijagnosticiranim B-NHL praćeno je u razdoblju
od 1. siječnja 1998. do 31. prosinca 2012. Liječeni su na Klinici za pedijatriju
Kliničkog bolničkog centra Zagreb.
Uključeno je 8 djevojčica i 28 dječaka (u dobi 3-17 godina). Sveukupno
preživljenje za cijelu skupinu pacijenata je 80,6 %. Preživljenje temeljeno na
spolu prednost daje djevojčicama – 87,5 %, naspram 78,6 % u dječaka.
Prema kliničkom stadiju djeca su podijeljena u dvije skupine: A – stadij I i II i
skupinu B: stadij III i IV: Preživljenje tih dviju skupina pokazuje statistički
značajnu razliku. Preživljenje skupine A bilo je 92,0 % prema 54,5 % za
skupinu B.
Djeca liječena standardnim protokolom NHL-BFM-95 u kombinaciji s
rituksimabom imaju bolje preživljenje (85,7%) od onih koji nisu primili liječenje
rituksimabom uz kemoterapiju (73,3%). Navedeni rezultati nisu dosegli
statističku značajnost. Kako bi donijeli konačan zaključak o korisnosti
monoklonalnih protutijela u liječenju B-NHL u djece potrebna nam je veća
skupina pacijenata.

Abstract (english)

Lymphomas are the third most common malignant disease in childhood.
Standard treatment of B-cell NHL in adult patients is chemotherapy with
monoclonal antibody – rituximab (anti CD 20). Rituximab added to CHOP
chemotherapy protocol improved survival rates in adults. Treatment of B cell
NHL with monoclonal antibodies in children has not yet been determined.
In total 36 children with newly diagnosed B-NHL were followed from January
1, 1998 to December 31, 2012. They have been treated at the Department of
Paediatrics University Hospital Centre Zagreb.
There were 8 girls and 28 boys (3-17 yrs). Overall survival (OS) for the entire
group was 80.6%. Gender based survival is in favour of girls - 87,5% versus
boys 78,6%. According to clinical stage children were divided in two groups: A:
stage I and II, and group B: stage III and IV. Survival time of those two groups
showed statistically significant difference. Survival rate of group A was 92,0 %
versus 54,5 % for group B.
Children treated with standard protocol NHL-BFM-95 combined with rituximab
have higher survival rate (85,7%) than those who did not receive rituximab
treatment together with chemotherapy (73,3%). But there were no statistical
significance.
To make definitive conclusion of usefulness of monoclonal antibodies in
treatment of paediatric B-NHL we need larger cohort of patients.

• Keywords: limfomi; monoklonalna protutijela
• Keywords (english): lymphomas; monoclonal antibodies
• Language: croatian
• URN:NBN: urn:nbn:hr:105:153617
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-02 16:13:08