To date, the impact of the tumor microenvironment on the prognosis of patients with classic Hodgkin lymphoma (cHL) during anti-PD-1 therapy has been studied insufficiently. This retrospective study included 61 primary samples of lymph nodes from patients who had relapsed/refractory (r/r) cHL and were treated with nivolumab. Repeated samples were obtained in 15 patients at relapse or disease progression after immunotherapy. Median follow-up was 55 (13–63) months. The best overall response rate and progression-free survival (PFS) were analyzed depending on the expression of CD68, CD163, PD-1, LAG-3, TIM-3, CTLA-4, TIGIT, CD163/c-maf in the tumor microenvironment in primary and sequential biopsies. The combination of CD163/c-maf antibodies was used for the identification of M2 macrophages (M2). A low number of macrophages in primary samples was associated with inferior PFS during nivolumab treatment (for CD163-positive cells p = 0.0086; for CD68-positive cells p = 0.037), while a low number of M2 with higher PFS (p = 0.014). Complete response was associated with a lower level of M2 (p = 0.011). In sequential samples (before and after nivolumab therapy) an increase in PD-1 (p = 0.011) and LAG-3 (p = 0.0045) and a depletion of CD68 (p = 0.057) and CD163 (p = 0.0049)-positive cells were observed. The study expands understanding of the cHL microenvironment structure and dynamics during nivolumab therapy in patients with r/r cHL.

Introduction. The risk of developing Hodgkin lymphoma (HL) with HIV infection is higher than in the general population, and the course of the disease itself is more aggressive. Currently, there is no unified approach to the treatment of HIV-related HL, and data on its epidemiology in the Russian Federation are limited.The objective was to study epidemiological characteristics, the used therapeutic tactics and the results of treatment for HIV-related HL.Methods and materials. The multicenter retrospective study included 46 patients with HIV- related HL treated in 9 centers of the Russian Federation. Descriptive statistics methods were used, the analysis of overall survival (OS) and progression-free survival (PFS) was performed using the Kaplan–Meier method.Results. HIV-related HL is more often represented by an advanced stage, B-symptoms, and extranodal lesions. The ABVD regimen was used as the first-line therapy in 60 % for HIV-related HL. The overall response to therapy was 81.6 %, and the 2-year OS and PFS were 85 % and 49 %, respectively. Factors that worsened OS were CD4+˂266 cells/mcL and general somatic status ECOG≥2.

Введение. Лимфома Беркитта (ЛБ) ― высокоагрессивная В-клеточная неходжкинская лимфома, составляет до 40% лимфом у пациентов с ВИЧ-инфекцией. Широкое применение антиретровирусной терапии (АРВТ) способствовало улучшению результатов противоопухолевой химиотерапии (ПХТ) лимфом на фоне ВИЧ-инфекции, в том числе ЛБ. Терапии ЛБ в РФ посвящено только несколько работ, а публикаций о ЛБ у пациентов с ВИЧ-инфекцией нет. Цель работы: изучить клинико-эпидемиологические характеристики и оценить результаты терапии ЛБ у пациентов с ВИЧ-инфекцией в РФ. Материалы и методы. В исследование было включено 37 пациентов с ЛБ на фоне ВИЧ-инфекции, проходивших лечение в 10 центрах РФ в период с 2010 по 2021 гг. Результаты. ЛБ у пациентов с ВИЧ-инфекцией диагностируется в молодом возрасте, с медианой 37 лет (21–58 лет), чаще у мужчин (75,7%), в распространенной стадии (IV стадия Ann Arbor ― 64,7%) и с экстралимфатическими проявлениями (73,5%), включая поражение центральной нервной системы (ЦНС) (16,1%). Основная терапия: EPOCH-подобные курсы (54,1%), блоковые схемы (32,4%). У 76% пациентов противоопухолевая ХТ включала ритуксимаб, у 91,4% ― одновременно с АРВТ. Медиана количества курсов терапии составила 4 (1–8). Общая выживаемость (ОВ) в течение 1 года составила 64% (95% ДИ 38–82%), выживаемость без прогрессирования (ВБП) ― 59% (95% ДИ 34–77%). Поражение ЦНС (p=0.0064), и проведение ПХТ без АРВТ ухудшает ОВ (p=0,00016) и ВБП (p=0,00012). Заключение. Для улучшения результатов терапии и прогноза необходимы проспективные м Введение. Лимфома Беркитта (ЛБ) ― высокоагрессивная В-клеточная неходжкинская лимфома, составляет до 40% лимфом у пациентов с ВИЧ-инфекцией. Широкое применение антиретровирусной терапии (АРВТ) способствовало улучшению результатов противоопухолевой химиотерапии (ПХТ) лимфом на фоне ВИЧ-инфекции, в том числе ЛБ. Терапии ЛБ в РФ посвящено только несколько работ, а публикаций о ЛБ у пациентов с ВИЧ-инфекцией нет. Цель работы: изучить клинико-эпидемиологические характеристики и оценить результаты терапии ЛБ у пациентов с ВИЧ-инфекцией в РФ. Материалы и методы. В исследование было включено 37 пациентов с ЛБ на фоне ВИЧ-инфекции, проходивших лечение в 10 центрах РФ в период с 2010 по 2021 гг. Результаты. ЛБ у пациентов с ВИЧ-инфекцией диагностируется в молодом возрасте, с медианой 37 лет (21–58 лет), чаще у мужчин (75,7%), в распространенной стадии (IV стадия Ann Arbor ― 64,7%) и с экстралимфатическими проявлениями (73,5%), включая поражение центральной нервной системы (ЦНС) (16,1%). Основная терапия: EPOCH-подобные курсы (54,1%), блоковые схемы (32,4%). У 76% пациентов противоопухолевая ХТ включала ритуксимаб, у 91,4% ― одновременно с АРВТ. Медиана количества курсов терапии составила 4 (1–8). Общая выживаемость (ОВ) в течение 1 года составила 64% (95% ДИ 38–82%), выживаемость без прогрессирования (ВБП) ― 59% (95% ДИ 34–77%). Поражение ЦНС (p=0.0064), и проведение ПХТ без АРВТ ухудшает ОВ (p=0,00016) и ВБП (p=0,00012). Заключение. Для улучшения результатов терапии и прогноза необходимы проспективные многоцентровые исследования по лечению ЛБ у пациентов с ВИЧ. ногоцентровые исследования по лечению ЛБ у пациентов с ВИЧ.

Dose-intensive cytostatic therapy and antibiotic treatment in allogeneic hematopoietic stem cell transplantation (allo-HSCT) cause severe abnormalities in a composition of gut microbiota as well as the emergence of antibiotic resistance. The data on the longitudinal recovery of major bacterial phyla and the expansion of genes associated with antibiotic resistance are limited. We collected regular stool samples during the first year after allo-HSCT from 12 adult patients with oncohematological disorders after allo-HSCT and performed 16SrRNA sequencing, multiplex PCR, conventional bacteriology and CHROMagar testing. We observed a decline in Shannon microbiota diversity index as early as day 0 of allo-HSCT (p = 0.034) before any administration of antibiotics, which persisted up to 1 year after transplantation, when the Shannon index returned to pre-transplant levels (p = 0.91). The study confirmed the previously shown decline in Bacillota (Firmicutes) genera and the expansion of E. coli/Shigella, Klebsiella and Enterococci. The recovery of Firmicutes was slower than that of other phyla and occurred only a year post-transplant. A positive correlation was observed between the expansion of E. coli/Shigella genera and bla_KPC, bla_CTX-M-1 and bla_TEM (p < 0.001), Klebsiella spp. and bla_OXA-48-like, bla_NDM, bla_CTX-M-1, bla_TEM, and bla_SHV (p < 0.001), Pseudomonas spp. and bla_NDM (p = 0.002), Enterococcus spp. and bla_OXA-48-like, bla_NDM, bla_CTX-M-1, bla_SHV (p < 0.01). The correlation was observed between the expansion of Enterobacterales and and carbapenemase-positive CHROMagar samples (p < 0.001). Samples positive for carbapenem-resitant bacteria were at their maximum levels on day +30, and were gradually diminishing one year after allo-HSCT. From day +30 to +60, all isolated K. pneumoniae strains in fecal samples proved to be resistant to the main antibiotic groups (carbapenems, aminoglycosides, fluoroquinolones, third-generation cephalosporins). One year after HSCT, we documented the spontaneous decolonization of K. pneumoniae. The sensitivity of molecular biology techniques in the search for total and antibiotic-resistant Klebsiella seems to be superior to common bacteriological cultures. Future studies should be focused on searching for novel approaches to the efficient reconstitution and/or maintenance of strictly anaerobic microbiota in oncological patients.

Introduction.The biological heterogeneity of chronic lymphocytic leukemia (CLL) is reflected in the rate of progression, the need for therapy, and the response to treatment. Analysis of prognostic factors contributes to improving the quality of treatment and rational distribution of healthcare resources.Materials and methods.Among 890 patients with documented stage of CLL, 405 (45.5 %) received treatment. As the first-line of treatment, 173 patients received intensive regimens (FCR or BR), 6 – new agents, and 226 – all other regimens. The initial stage of the disease, mutation status of IGHV, del17p with or without complex karyotype were analyzed as prognostic markers.Results.Immunochemotherapeutic regimens were shown to be highly effective in case planned amount of treatment was completed. The combination of such prognostic parameters as the initial stage of the disease, the mutation status of IGHV, and the presence of del17p and/or complex karyotype allows us to clearly identify a group of patients with an unfavorable prognosis, for which it is advisable to use either intensive programs or new agents in the first-line therapy.