title: [Diffuse large B-cell lymphoma with monoclonal immunoglobulin secretion].
abstract: OBJECTIVE
  to provide the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) with monoclonal immunoglobulin secretion and to evaluate the efficiency of intensified mNHL-BFM-90 or R-DA-EPOCH/R-HMA therapy programs in patients with Ig-secreting DLBCL.
  
  
  METHODS
  A clinical trial was conducted in 93 patients with newly diagnosed DLBCL, among whom 21 (22.6%) were found to have monoclonal immunoglobulin secretion.
  
  
  RESULTS
  Ig-secreting DLBCL is shown to be characterized by bone marrow involvement (p<0.001), as well as generalized injury (Ann Arbor Stage 4) and a high risk in accordance with the international prognostic index (p=0.001 and p=0.026, respectively). Analysis of overall and event-free survival rates has indicated that the patients have a poor prognosis versus those with non-Ig-secreting DLBCL and poor prognostic factors even when implementing intensified therapy programs, such as mNHL-BFM-90 or R-DA-EPOCH/R-HMA ones.
  
  
  CONCLUSIONS
  The investigation has demonstrated that there is a high association of the secretion of monoclonal paraproteins with bone marrow involvement in DLBCL (p<0.001). The intensified therapy using the mNHL-BFM-90 and R-DA-EPOCH/R-HMA programs involving autologous hematopoietic stem cell transplantation also permits the patients with Ig-secreting DLBCL to achieve long-term sustained remissions in not all cases.
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: O A
authors.initials: OA
authors.lastname: Gavrilina
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E N
authors.initials: EN
authors.lastname: Parovichnikova
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E E
authors.initials: EE
authors.lastname: Zvonkov
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Troitskaya
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: S K
authors.initials: SK
authors.lastname: Kravchenko
authors.affiliation: National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia.
authors.forename: V G
authors.initials: VG
authors.lastname: Savchenko
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000494:pharmacology*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009194:Myeloma Proteins / Q000378:metabolism*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012720:Severity of Illness Index; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins