Chukur P. Dynamics of changes in the state of bone tissue in patients with diffuse large B-cell lymphoma who received prednisolone-containing courses of chemotherapy

The dissertation provides a theoretical generalization and a new solution to a scientific and practical task – increasing the effectiveness of radiological diagnostics of changes in the structural and functional state of bone tissue (SFSBT) using computer tomography (CT), forecasting the development of secondary osteoporosis (SO) with the development of a diagnostic algorithm and prevention of osteoporotic disorders in patients with diffuse large B-cell lymphoma (DLBCL) receiving prednisone-containing chemotherapy courses. Based on the results of a comprehensive examination of patients, a differentiated approach to the management of patients with DLBCL receiving prednisone-containing chemotherapy courses is presented for the first time. The work theoretically summarizes and determines the effectiveness of X-ray diagnosis of changes in SFSBT with the use of CT in patients with DLBCL. Differential radiological criteria of osteopenia and OP have been developed for the determination of BMD using CT, which is an informative method for evaluating SFCT and can be recommended for screening OP in patients with DLBCL. A diagnostic algorithm for the screening of osteoporotic disorders was proposed when combining questionnaires for assessing the risk of osteoporotic fractures according to FRAX and QFracture with BMD indicators and morphometric indicators of the height of lumbar vertebral bodies using layer-by-layer CT. Correlations of BMD indicators with all parameters of fracture risk prediction have been proven. The correlational relationships of BMD indicators of the lumbar vertebrae (L1-L5) with treatment protocols (CHOP/R-CHOP), the number of courses of chemotherapy, the total dose of prednisone received during the entire treatment period, which are reliable risk factors for the development of SO, were investigated and established in patients with DLBCL who receive chemotherapy. A model for predicting the development of OA in patients with DLBCL on the background of PCT was developed with the determination of the risk factor for changes in SFSBT, and recommendations for doctors regarding accompanying therapy for the prevention of osteoporotic fractures in patients with DLBCL were proposed.