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Follicular lymphoma is a tumor of mature B-lymphocytes, characterized by a predominantly indolent course. Despite advances in first-line therapy, disease relapses still occur, and with an increase in the follow-up period, the risk of transformation into diffuse large B-cell lymphoma also increases. The choice of a further anticancer therapy is based on the results of a comprehensive examination and repeated biopsy. In addition, previous remission duration, previous treatment, clinical manifestation of relapse, the patient's somatic condition and comorbidity are taken into account. A clinical observation of a 57-year-old patient with relapsed follicular lymphoma, who received various chemotherapy regimens in combination with rituximab in the 1st and subsequent lines, is presented. After repeated biopsy and exclusion of transformation into diffuse large B-cell lymphoma, the patient received lenalidomide therapy in combination with obinutuzumab. A partial antitumor response after 4 cycles with decrease in tumor volume by more than 80 % by the end of induction was achieved. The absence of severe adverse events, together with a pronounced antitumor effect, significantly improved the patient's quality of life.

Monoclonal anti-CD20 antibodies in lymphomas therapy during the COVID-19 pandemic: pro and contraThe review presents the results of a combined analysis of literature data and own clinical observations regarding the safety and feasibility of using monoclonal anti-CD20 antibodies in the treatment of B-cell lymphoproliferative diseases during the COVID-19 pandemic. The main points of the pathogenesis of the influence of monoclonal anti-CD20 antibodies on the course of COVID-19 are described. The current trends in the modification of the accepted algorithms of lymphoproliferative diseases therapy with the inclusion of monoclonal anti-CD20 antibodies are summarized, and the possibilities of specific prevention by vaccination against COVID-19 are also considered.

Purpose of the study: to systematize published data on the effectiveness of drugs used to treat patientswith chronic lymphocytic leukemia.Material and Methods. A literature search was conducted using Medline, Pubmed databases. 93 publications were selected to write this review.Results. General information about chronic lymphocytic leukemia (biological features, criteria for establishing diagnosis, staging, criteria for evaluating antitumor therapy response) was presented. The focus was made on antitumor drugs used as monotherapy and in combination with other anti-cancer agents. The use of drugs belonging to the classes of cytostatics, monoclonal antibodies, as well as drugs that affect the signaling pathways of the B-cell receptor, BCL -2 inhibitors, immunomodulators was discussed. The gold standard for first-line therapy remains the RFC scheme. With a positive Coombs test, bendamustine is an equivalent alternative to the FC regimen. The use of chlorambucil is limited in situations in which the goal of therapy is the palliative treatment of older people with serious comorbidity. In subsequent lines of therapy, molecular action drugs are beginning to take an increasingly important place.Conclusion. During the past twenty years, significant advances have been made in understanding biological features of chronic lymphocytic leukemia, the synthesis of several dozen new therapeutic drugs of targeted action, some of which are already undergoing clinical testing. These drugs may lead to serious complications. The review is devoted to new drugs, the efficacy and safety of which has already been tested in a clinical setting.