ГЕМА Т ОЛОГ И Я HEM AT O L OGY

ABSTRACT Background. The article describes a rare case of grade 3В follicular lymphoma (FL) with a nodular-diffuse growth; it also presents a literature review. Grade 3В follicular lymphoma with a nodular-diffuse growth is a rare lymphoid neoplasm, and no optimal therapeutic strategies have been developed for it. In addition to the absence of the classic t(14;18), com-bined deletions of 17p13 ( TР53 gene locus) and 3q27 ( BCL6 gene locus) are observed in a very few cases. This combina-tion may negatively affect the FL prognosis. The unique abil-ity of bendamustine to induce ТР53 -independent apoptosis offers new opportunities for the high-dose chemotherapy of lymphomas. Objective. To evaluate efficacy and tolerance of the ВеЕАМ conditioning regimen using high-dose bendamustine followed by autologous HSCT in a patient with 3B FL relapse and com-bined 17p13 and 3q27 deletion. Methods. A 58-year-old man was diagnosed with 3B grade FL. After 8 R-CHOP courses and a two-year maintenance therapy with Rituximab, he developed a generalized enlarge-ment of lymph nodes, and a neoplasm in left liver lobe. A liver biopsy confirmed the relapse of grade 3B FL with a nodular-diffuse growth and a high Ki-67 level (60 %). Cytogenetic analysis identified 17p13 and 3q27 deletions.