Preview

Oncohematology

Advanced search
Vol 9, No 2 (2014)
https://doi.org/10.17650/1818-8346-2014-9-2

HEMATOLOGIC MALIGNANCIES: DIAGNOSIS, TREATMENT, SUPPORTIVE CARE

6-12 9915
Abstract

Presents data of the health of 411 children (I generation) and 23 children (II generation) born to 340 women received chemotherapy or radiotherapy due to Hodgkin’s lymphoma. Most children were born healthy. Congenital pathology were registered in 19 (14.6 %) children
of I generation and 1 (4.3 %) – of II generation. In 3 children of I generation Hodgkin,s lymphoma was diagnosed.

13-19 10241
Abstract

We present the results of a multicenter study of 445 patients with “proven” and “probable” invasive aspergillosis (EORTC/MSG, 2008). Invasive aspergillosis usually occurs in patients with hematological malignancies (88 %), main underlying diseases were acute myeloid and acute lymphoblastic leukemia. The risk factors: prolonged agranulocytosis (64 %), cytostatic chemotherapy (57 %), corticosteroid treatment (45 %), and allogeneic hematopoietic stem cells transplantation (29 %). The pathogens – A. fumigatus (42 %), A. niger (33 %), and A. flavus (21 %). The main site of infection were lungs (86 %). 12 week overall survival was 83 %. Bronchoscopy use for the early diagnosis (p = 0.01), adequate
therapy with voriconazole (p = 0.002) and secondary antifungal prophylaxis (p = 0.0003) were positive prognostic factors for survival of patients with invasive aspergillosis.

20-28 13633
Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired clonal blood disorder caused by somatic mutation of the phosphatidylinositol
glycan complementation group A gene (PIG-A) in a hematopoietic stem cell. PNH is characterized by chronic intravascular hemolysis, bone marrow failure, thrombosis, renal dysfunction and other severe clinical syndromes. These clinical guidelines include definition, classification, methods and diagnostic criteria of PNH, indications for screening, optimal treatment including targeted therapy with eculizumab, bone marrow transplantation and symptomatic therapy.

HEMATOPOIETIC STEM CELL TRANSPLANTATION

29-36 10528
Abstract

Quantitative monitoring of chimerism after allogeneic hematopoietic stem cell transplantation (HSCT) by molecular methods has become
a significant diagnostic tool in detection of engraftment / graft failure, predicting rejection and disease relapse. Despite the great utility of chimerism analysis there is not a unique standard method for its quantification. The objective of the present investigation was to compare perspective methods multiplex short tandem repeat polymerase chain reaction (STR-PCR) and real-time PCR insertion / deletion polymorphisms (InDel-PCR) for the quantification of chimerism after HSCT. We performed a study analyzing the chimerism status in 60 patients by STR-PCR and by InDel-PCR. Recipient / donor discrimination was possible with STR-PCR in all patient-donor pairs (100 %), whereas informative alleles for recipient were found in 88 % pairs with InDel-PCR. The sensitivity (detection limit) of STR-PCR and InDel-PCR was 1–5 % and more than 0.01 % donor cells correspondingly. The accuracy of quantification was higher for STR-PCR than for InDel-PCR, when level of donor chimerism was 3–97 %. These methods can be successfully used to determine chimerism after allogeneic HSCT. Considering the higher sensitivity and quantification accuracy of InDel-PCR it should be chosen if donor chimerism level less 5 % or more 95 % and in other cases STR-PCR should be chosen.

37-44 10193
Abstract

Autologous hematopoietic stem cell transplantation (HSCT) is the standard treatment for patients with relapsed and primary refractory
Hodgkin's lymphoma (HL). According to current recommendations HSCT must be performed in first relapse or after registration of primary resistance disease. However, the HSCT in optimal time for all patients with HL who need it is impossible, due to insufficient capacity of national transplant centers. Analysis of the HSCT results from 369 HL patients treated in Russia and other CIS countries clinics showed that intensive long-term standard chemotherapy prior to transplantation is a poor prognostic factor regarding to mobilization efficacy, hematopoiesis recovery and late HSCT results. In this regard, to achieve best results HSCT must be performed no later than the second relapse or immediately after registration
of primary resistance disease. Treatment results in patients received a lot of chemotherapy before transplantation is worse. But they still
have a chance for a cure and should be considered as potential candidates to HSCT if obtained sufficient graft quality and hematopoietic response to induction chemotherapy is achieved.

45-52 10100
Abstract

Risk factors of CMV replication in early period after allo-HSCT (D0‑D100) were – myeloablative conditioning – HR 3.74 (1.67–8.37), р = 0.001; unrelated donor – HR 2.18 (0.86–5.26), р = 0.10; HLA-matched donor – HR 0.24 (0.05–1.06), р = 0,06. In late posttransplant period (from D+100) significant risk factors of CMV-reactivation were (according to multivariate analysis) myeloablative conditioning – HR 13.17 (3.00–57.86), р = 0.001; combination of pretransplant remission of leukemia and using cyclosporine and methotrexate – HR 0.13 (0.03–0.50), р = 0.003; combination of aGVHD and CMV reactivation in early posttransplant period – HR 2.71 (0.86–8.50), р = 0.088; using of bone marrow – HR 0.37 (0.12–1.19), р = 0.095. We revealed the significant association of aGVHD and CMV-reactivation –OR 2.91 (1.07–7.92), р=0.006, and increased rate of cGVHD in patients with CMV replication at third month after allo-HSCT OR – 2.29 (1.03–5.08), р = 0.066. We revealed a tend to decreasing relapse risk in patients who had CMV-replication – HR 0.07 (0.004–1.17), р = 0.06. Cumulative incidence of CMV-disease was 28 %. CMV-disease was lethal in 44 % patients.

PHARMACOTHERAPY

53-57 10153
Abstract

A standard fractional Colistimethate sodium dosing regimen does not allow in most cases reach the target values of AUC / MIC index, determining the Colistine pharmacological efficacy. Use of the proposed algorithm for daily dose calculating increases the incidence to achieve Colistine concentration providing AUC values, sufficient for A. baumannii, P. aeruginosa and K. pneumoniae with Colistine MIC
0.75–1 mg / l. Using fractional administration of recommended daily dose target AUC values for MIC 1 g / l achieved only in 19 % cases,
whereas using the proposed algorithm of intravenous injection with long-time constant rate of daily dose 100.000 ME / kg Colistimethate
sodium – in 60 % (in 3 of 5 patients).

BASIC RESEARCH

58-64 10189
Abstract

The review provides information about immune response initiation against foreign agents. Significance of separate molecules of major histocompatibility complex in antibodies formation after blood transfusion, during pregnancy, after organ transplantation due to incompatibility of the antigenic structures of donor and recipient, mother and child was shown. Detailed description of platelet antigens protein structure significance in immunocompetent cells recognition of them is provided.

65-73 12052
Abstract

Platelets are anuclear cell fragments playing important role in hemostasis, termination of bleeding after damage, as well as in pathological thrombus formation. The main action of platelets is the formation of aggregates, overlapping the injury. They obtained the ability to aggregate by the transition process called activation. Despite the relatively simple and definite function platelet structure is very difficult: they have almost a full set of organelles, including the endoplasmic reticulum, mitochondria and other entities. When activated platelets secrete various granules interact with plasma proteins and red blood cells and other tissues. Their activation is controlled by multiple receptors and complex signaling cascades. In this review platelet structure, mechanisms of its functioning in health and disease, diagnostic methods of platelet function and approaches to their correction were considered. Particular attention will be given to those areas of the science of platelets, which still lay hidden mysteries.



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)