MODERN APPROACH TO THE TREATMENT OF T-CELL LYMPHOMA: A CLINICAL CASE OF USING HIGH-DOSE CHEMOAND TARGETED THERAPY

A. Jazyltayeva, S. Gabbasova, Zaure Dushimova, E. SATBAEVA, Elvira Satbayeva, Raigul Ramazanova, G. A. Sagindykov, Xeniya Dissayenko

2025

Closed access Metadata (CSL-JSON)
DOI 10.52532/2521-6414-2025-3-77-572
Data confidence 85 high
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Relevance: T-cell lymphomas are rare, aggressive non-Hodgkin lymphomas. Therapy for T-cell lymphomas remains a challenge for oncologists. In recent years, immunotherapy has developed greatly in the treatment of cancer. PD-L1 expression correlates with an unfavorable prognosis in many cancers; therefore, the prognostic value of PD-L1 levels in non-Hodgkin lymphomas is relevant. The study aimed to determine the level of PDL-1 expression in T-cell lymphomas using TPS and CPS analyses, and to analyze the correlation between expression levels and clinical and pathological features, as well as patient treatment outcomes. Methods: A retrospective study of pathomorphological material from primary patients with T-cell lymphomas was conducted from 2015 to 2020. PD-L1 expression was determined using a modified combined positive score (CPS) and tumor share index (TPS). Clinical, laboratory, and instrumental data, as well as the results of therapy for patients included in the study, were collected. Results: The study included 40 patients; the average age was 48 years (range 18-76). 55% of patients were men, 45% were women. In 60% of cases, patients were under 60 years old. All patients received therapy according to the CHOP regimen (cyclophosphamide 750 mg/m2 on Day 1, doxorubicin 50 mg/m2 on Day 1, vincristine 1.3 mg/m2 on Day 1, and prednisolone 60 mg/m2 on Days 1-5). Complete remission was achieved in 12 patients, disease progression was observed in 19 patients, and 6 patients died from disease progression. PDL-1 overexpression was detected in 37 patients. Statistical correla-tion of PDL-1 expression with late-stage disease (p=0.001), high IPI index (p=0.001), high re-lapse rate (p=0.001), and high serum LDH level (p=0.001) was observed. PD-L1 expression was a prognostic factor affecting therapy outcome and prognosis. Conclusion: The significant increase in PDL-1 expression is a key prognostic factor and a predictor of poor response to standard therapy. The combination of two research types, CPS and TPS, more effectively detects PDL-1 expression, which is optimal given the biology of the tumor process. Im-mune therapy is a promising therapeutic option