The impact of anticardiolipin antibodies and hemostasis on patients with non-Hodgkin lymphoma: Summary of the Habilitation Thesis in Medicine: 321.10 - Hematology and blood transfusion

Abstract

Thesis structure. The work was exposed on 226 pages of electronic text and is divided into: introduction, 5 chapters, discussions, 9 conclusions and 14 recommendations, bibliographic index (347 titles), 104 figures, 59 tables, 26 annexes. The results of the research were presented in 72 publications. Key words: non-Hodgkin's lymphomas, anticardiolipin antibodies, hemostasis. Field of study: 321.10. HEMATOLOGY AND BLOOD TRANSFUSION The purpose of the work: Studying the impact of anticardiolipin antibodies and hemostasis on subjects with non-Hodgkin's lymphomas to optimize medical management. The objectives of the research: 1.Determination of the frequency of IgG, IgM anticardiolipin antibodies, antiβ2 glycoprotein I IgG, IgM antibodies, lupus anticoagulant in patients with non-Hodgkin's lymphomas; 2. Research on hemostasis of patients with non-Hodgkin's lymphomas and anticardiolipin antibodies in relation to type, disease stage, age and gender; 3. Estimation of hemostasis in patients with non-Hodgkin's lymphomas and anticardiolipin antibodies according to the stage of treatment and its effectiveness; 4. Assessing the risk of thrombotic and/or hemorrhagic complications in patients with non-Hodgkin's lymphomas; 5. Researching the quality of life of the patient with non-Hodgkin's lymphomas at the stage of establishing the diagnosis and later during the specific treatment; 6. Reliability of instruments to assess quality of life, treatment compliance, satisfaction and general well-being in non-Hodgkin's lymphomas; 7. Development of the risk assessment model for thrombotic events in patients with non-Hodgkin's lymphomas and anticardiolipin antibodies. Scientific novelty and originality: For the first time in RM, the impact of anticardiolipin antibodies (aCL) and hemostasis on patients with primary diagnosed non-Hodgkin lymphomas (NHL) was evaluated, during treatment and at the end of treatment, by assessing the risk of hemostatic complications and developing an algorithm to evaluate this risk. For the first time in the Republic of Moldova, the reliability of instruments for assessing the quality of life, treatment compliance, satisfaction and general well-being of patients with NHL was assessed. The research results will contribute to reducing premature mortality and disability, ensuring higher survival and increasing the quality of life of patients with NHL. The important scientific problem solved in the thesis. Through the analysis of NHL-specific factors, the applied and individual treatment with impact on hemostasis of the patient with NHL and aCL antibodies, the evaluation algorithm for an optimal prophylaxis approach was developed. The quality of life and psychosocial well-being of patients with NHL was estimated. Practical recommendations are presented for multidisciplinary teams of hematologists and clinical psychologists. Theoretical significance. The data obtained on the impact of aCL and hemostasis on NHL patients, as well as their quality of life, will allow for scientifically determined stratification of risk groups with the association of hemostatic complications and will be actively used in the creation of algorithms and recommendations in their conduct. The applicative value of the work. By analyzing the factors with a possible impact on hemostasis in patients with NHL, the main causes with a risk of hemostasis disruption that require an optimal prophylaxis approach were identified. Based on the data obtained, an algorithm was created to assess the risk of thrombotic events in patients with NHL and aCL antibodies. Practical recommendations are presented for multidisciplinary teams of hematologists and clinical psychologists. Implementation of scientific results. The results of the study were included in the National Clinical Protocol "Non-Hodgkin's lymphomas in adults", it is applied in the teaching process of the Department of Internal Medicine, in the practice of the Hematology Discipline of "Nicolae Testemițanu" SUMPh and in the Hematology Department of the Oncological Institute.