The doctor spoke about new treatment options for oncohematological diseases

Oncohematological diseases cover tumors of hematopoietic and lymphoid tissue (leukemia, lymphoma, myeloproliferative and plasmocellular diseases) and affect people of all ages. Maxim Solovyov, PhD, Head of the Department, Senior Researcher at the National Research Medical Center of Hematology of the Russian Ministry of Health, told Izvestia on February 11 about how the approach to the diagnosis and treatment of such pathologies is changing.

According to the expert, oncogematological diseases are often associated with childhood, but many of them are more common in adults. In particular, the peak incidence of multiple myeloma occurs in middle and old age. Collectively, such pathologies account for about 6-7% of all malignant neoplasms in adults, and in recent years there has been an increase in the detection of tumors of the lymphatic system. In Russia, in 2024, the diagnosis of multiple myeloma was first established in more than 4,000 patients.

"The symptoms are usually nonspecific, but their persistent combination is a reason for examination: for leukemia, weakness, pallor, frequent infections, bleeding and bruising; and for lymphomas, painless enlargement of lymph nodes, night sweats, weight loss, prolonged fever; for myeloma, bone pain, pathological fractures, an increase in calcium in the blood, kidney damage, a decrease in normal antibodies with a risk of pneumonia, as well as signs of "hyperviscosity" of the blood (shortness of breath, short—term neurological episodes, visual disturbances, a tendency to bleeding)," Solovyov explained, stating that a separate symptom in itself does not mean cancer, but their long-term preservation requires treatment. to see a doctor and conduct laboratory tests.

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The expert stressed that in recent years, approaches to the treatment of oncohematological patients have changed significantly. Previously, chemotherapy was primarily the basis of therapy, but today medicine is moving towards personalized strategies, when treatment is tailored to a specific patient, taking into account the molecular characteristics of the tumor and the assessment of minimal residual disease. According to him, it was hematology that became a platform for the introduction of cellular and immune technologies, which then began to spread to other areas of oncology.

An illustrative example of such innovations, Solovyov noted, is multiple myeloma, where due to the presence of well-studied surface tumor markers and the availability of tissue for analysis, in this case bone marrow, it is possible to accurately target therapy and quickly evaluate its effectiveness. The high frequency of relapses and the development of resistance to standard treatment stimulate the search for new approaches, and it was with multiple myeloma and other B-cell diseases that long-term remissions were obtained in some patients who exhausted the usual treatment options.

The expert called CAR-T cell therapy one of the most promising areas, which uses the patient's own immune cells, modified to accurately recognize and destroy the tumor. These T-lymphocytes are first extracted from the body, then a special gene is inserted into them in the laboratory and then returned to the patient to fight the disease. Since 2017, several such drugs have been approved worldwide, and now they are gradually being introduced into clinical practice.

According to the Candidate of Medical Sciences, such technologies are already going beyond oncohematology and are beginning to be used in solid tumors. Although there are more biological barriers, the general vector of development is obvious: oncology is gradually moving away from average treatment regimens and moving towards targeted treatment at the cellular level, which opens up new prospects for patients in the coming decades.

Svetlana Varfolomeeva, director of the Research Institute of Pediatric Oncology and Hematology at the N.N. Blokhin National Research Medical Center of Oncology, said on February 2 that the survival rate for childhood oncological diseases in Russia as a whole exceeds 85%, and in some forms of cancer it reaches 98%. She added that in recent years, treatment technologies have become much more accessible: for example, total body irradiation before bone marrow transplantation has become a routine procedure for most patients.

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