Vol 9, No 4 (2014)

Unsuccessful mobilization of hematopoietic stem cells (HSCs) before apheresis in allograft donor is a factor adversely affecting the characteristics of the obtained cell product and, as a consequence, the therapy outcome. This study investigates the efficacy and safety of plerixafor as an additional alternative drug for HSCs mobilization after nsuccessful mobilization using G-CSF. Mobilization of HSC in all cases was performed using a preparation of G-CSF during 5 days. The ineffectiveness of this in 17 donors was revealed on the fourth day from the beginning of the mobilization, and therefore plerixafor was administered to all donors in this cohort 11–12 hours before cytapheresis. Use of plerixafor allowed obtaining a transplant with good cellular characteristics in all cases. Plerixafor safety profile comparable with GCSF has also been demonstrated. Based on the results of this study it was concluded about efficacy and feasibility of plerixafor as “rescue” therapy after unsuccessful mobilization
with G-CSF.

Modern research techniques allows tumor studying in almost any level: protein expression, structural changes of DNA, RNA, epigenetic changes, activity of signaling pathways, microenvironment, interaction with the immune system, etc. However, tumor samples are obtained as 100 years ago – by tumor biopsy prior to treatment. Based on available data about intratumoral heterogeneity and tumor changes during treatment, it may be one of the factors braking to obtain required information of tumor biology. According to study, the analysis of circulating tumor DNA (ctDNA) allows to hope to overcome the key limitations of routine biopsy. One of the key benefits of ctDNA analysis is the ability to a more comprehensive tumor investigation, while maintaining a high level of specificity, almost as well as a routine biopsy. Detection sensitivity of ctDNA continues to increase due to the development of new technology. The study of ctDNA may lead to breakthrough results in understanding of tumors molecular heterogeneity, development of resistance to anticancer therapy and ways to overcome it, screening and a number of other key areas of modern oncology.

The number of patients achieved continuous complete remission constantly increasing as a result of pediatric hematology development. Improvement and optimization of treatment protocols includes both efficacy increase and toxicity reduction, but today any type therapy is associated with risk of long-term adverse effects.
Children and adolescents who have received anticancer treatment – is a special cohort whose health requires a special observation. This
monitoring program should be aimed at both remission control and early detection of possible treatment long-term side effects. Some side effects have long (five, ten or more years) latent period and observation of such patients should be carried out for a long time, respectively. This article provides a brief overview of international recommendations for monitoring children and adolescents after anticancer therapy, analyzed the situation with follow-up in Russia, and offers the variant of follow-up service organization in the clinic, based on the own experience. The article also considers issues about relapse and secondary tumors diagnosis. Using international recommendations the main side effects of chemo- and radiation therapy systematized. In conclusion, an example of a monitoring program designed for the individual patient, based on age, gender, previous disease and treatment is shown.