Aim: To identify incidence and prognostic impact of different IHC and molecular genetic markers in Diffuse Large B-cell lymphoma. Methods: We analyzed 215 patients with DLBCL who received treatment from 2008 to 2016. We assess expression of different IHC markers, defined DLBCL to GCB and non-GCB subtypes by Hans-algorithm and performed FISH to evaluate MyC, BcL2 and BCL6 translocations. Results: Median follow-up was 29 months. Non-GCB DLBCL were identified in 44 pts (62,9%), GCB-subtype in 26 pts (37,1%). Median PFS in non-GCB DlBCL was 46,0 months, in GCB DLBCL median PFS and 75% quartile was not reached (p=0,171). Traslocations of MYC, BCL2 and BCL6 were found in 10/48 pts (20,8%). Double expression of c-myc and bcl-2 was identified in 21 of 71 пациентов (29,6%). СD5-expression were determined in 19/55 (34,5%), CD30+ DLBCL - in 24/66 pts (36,4%). In pts with DLBCL without CD-10 expression PFS was 6,0 months, in group with CD 10 expression median of PFS was not reached (р=0,122). Pts with CD 10 expression had lower risk of relapse compared to those without expression (р=0,049). Absence of CD 10 expression was negative prognostic factor for PFS in multivariate analysis (р=0,015). Conclusion: Patients with DLBCL and GCB subtype have tendency to better prognosis in PFS rates and lower risk of relapse compared to non-GCB subtype. Dividing to GCB or non-GCB subtypes in DLBCL and assessment of different IHC markers can potentially determine DLBCL with worse prognosis.

High dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) is suggested as the standard of treatment of patients with relapsed or refractory Hodgkin’s lymphoma (HL) providing long-term disease-free survival in over 50 % of patients. The insufficient number of Russian medical centers, which can provide HDCT with ASCT, result into a broken chain of treatment. The main goal of this thesis is the evaluation of a timely mannered qualified medical help as potential independent prognosis factor. Our study included data of patients with refractory or relapsed HL who underwent treatment between 2013 and 2017 in our Center. Due to our data the negative prognostic factors affecting progression-free survival are: primary refractory disease (60 % vs 94 %; HR 2,1 [95 % CI 1.20-3.56], p=0.041); response for the 1st line of salvage therapy less than complete remission (CR) (35 % vs 91 %; HR 2,4 [95 % CI 1.81-3.24], p=0.022), presence of chain treatment disruption (41 % vs 90 %; HR 2,9 [95 % CI 2.43-4.2], p=0.029), disease status less than CR prior ASCT (29 % vs 87 %; HR 4,3 [95 % CI 2.9-6.1], p=0.009). Our results demonstrate that timely mannered qualified medical care is a key component that improves the survival of patients with relapses and refractory forms of Hodgkin’s lymphoma.

Currently there is no single approach to treatment for aggressive diffuse large-cell B-cell lymphoma (Double-HIT and Triple-HIT). Accumulated world data remain controversial and, given the unfavorable prognosis in this subgroup, high-dose chemotherapy with autologous stem cell transplantation in the first line of treatment is a therapeutic option.

Despite the success of standard front-line chemotherapy for classical Hodgkin lymphoma in part of these patients relapse or resistance are developed. During last years standard therapeutic approach for relapse or refractory disease is still «salvage» following high-dose chemotherapy with autologous stem cell transplantation. Brentuximab vedotin made great revolution in Hodgkin’s lymphoma treatment demonstrated high efficacy not only in relapse treatment but also as consolidation after autologous stem cell transplantation in high-risk group of patients. In the era of new agents for patents with relapses following autologous stem cell transplant there are multiple treatment options including single-agent and polychemotherapy, combination chemotherapy strategies, the immunoconjugate brentuximab, checkpoint inhibitors nivolumab and pembrolizumab. Allogeneic stem cell transplantation could be considered in young patients with chemosensitive tumor in the presence of a bone marrow donor. Therapeutic choice should be always based on age, comorbidities, previous treatment, patient’s preferences and drug availability.

In 1947 for the first time in the USSR in the Leningrad Institute of Oncology L.F. Larionov and and V.G. Nemets have developed and clinically tested the first domestic cytostatic embihin. Since that time more than 150 different anti-cancer agents and supportive care medications were widely investigated and used in current clinical practice in oncology and hematology in the frames of domestic and international studies. Nowadays basing on results of fundamental, clinical and experimental trials new high-effective medical approaches to systemic treatment such as targeted therapy and immunotherapy for patients with different malignant tumors are successfully studied and implemented.