Bacteremia caused by Streptococcus viridans may be fulminant in neutropenic patients. The clinical signs of streptococcal bacteremia
in neutropenic patients are obvious, but non-specific, and are characterized by fever, pulmonary symptoms (pneumonia, respiratory distress syndrome) in 20–25 % of cases, hemodynamic instability (about 30 % of cases), rash and followed desquamation, in rare cases – neurological disorders (encephalopathy). Perhaps the main difference from other bacteremia in immunocompromised patients is approximately 10 times higher risk of rapid (during the first two days) development of acute lung injury with hypoxemia often requiring oxygen subsidies and respiratory support. Frequency, clinical characteristics and outcomes of streptococcal bacteremia, as well as the spectrum of antibiotics sensitivity was retrospective analyzed in this study. From 2003 to 2009 in children with various oncological and hematological diseases and febrile neutropenia 265 microorganisms were isolated from blood cultures, including Gram-positive in 113 (42 %) patients. Strains of Streptococcus viridans, isolated at least once from blood (central venous catheter and / or peripheral veins), are included in analysis. Streptococcus viridans were isolated from the blood of 20 patients, accounting for 7.5 % of the total number of bacteremia and 17.7 % of gram-ositive bacteremia. Patients with acute myeloid leukemia (AML) accounted for 45 % of all patients with streptococcal bacteremia, but the incidence of streptococcal bacteremia in AML patients was 8.7 % and did not differ from patients with other diagnoses. 11 (55 %) from 20 patients have mucositis at diagnosis of bacteremia, in 14 patients (70 %) prior chemotherapy included high dose of cytosine arabinoside. All patients with streptococcal bacteremia have severe neutropenia (median 70 cells / mkl) and characterized by fever (100 %), septic shock (8 patients, 40 %) and RDS (7 patients, 35 %) required high doses of steroids (7 patients; 100 %) and ALV (2 patients; 10 %). All patients survived. In 13 (65 %) patients primary empirical therapy contained antibiotics effective against Streptococcus viridans. All strains were susceptible to vancomycin, linezolid and levofloxacin; 90 % and 95 % of strains – to ceftriaxone and cefepime, respectively; 80 % – to penicillin; 50 % – to oxacillin and 35 % – to trimethoprim / sulfomethoxazol.

Introduction. Chronic lymphoproliferative disease (CLPD) are common hematologic malignancies, accompanied by highly variable clinical course, different prognosis and understudied survival as one of the main criteria for long-term treatment efficacy, especially outside of clinical trials.

Materials and methods. Patients with CLPD (n = 310) treated in hematology center of Burdenko Main Military Clinical Hospital from June 2003 to September 2014 are included in the study. The diagnosis of specific nosology verified in accordance with national and international recommendations. Analysis of study outcomes was based on overall survival (OS) using the Kaplan–Meier method.

Results and discussion. Most patients (mainly with non-Hodgkin»s lymphoma (NHL) – 75 %, or multiple myeloma (MM) – 80.6 %) had advanced disease (III–IV), and 20.3 % admitted to the hospital in poor general condition (ECOG somatic status – 3–4). A significant proportion of patients (38.3 %) with NHL and Hodgkin lymphoma (HL) had a large tumor masses. Median of OS in patients with CLPD was 81.1 months. 5-year survival of total patients from time of diagnosis was 62 %, 10-year survival rate – 37 %. Patients with MM have shortest median of OS – 39 months, while patients with chronic lymphocytic leukemia (CLL) have the longest – 117.8 months. Median OS for NHL patients was 68.1 months, for HL patients – 99.3 months. When comparing survival for two time intervals (2003–2009 and 2009–2014), a tendency to increase
the survival rate for certain groups of patients with CLPD was revealed, that could be due to target therapy and new therapeutic approaches.

Conclusion. New drug efficacy for certain diseases has led to renewed interest in the results of CLPD therapy. In our study, most CLPD patients have long-term OS, but the subsequent therapy lines influence on OS requires further study. These results will contribute to new developments in the organization and planning of therapy, changes in therapeutic practice and individualization of treatment.

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.

To date different techniques of platelet concentrates (PC) preparation and processing are proposed to achieve the best efficiency of transfusions and to minimize the risks post-transfusion reactions. However, data on the impact of different approaches to PC preparation and processing on morphological and functional characteristics of platelets and, as a consequence, the clinical efficacy of transfusions is controversial. In this paper we analyzed the impact of the platelet storage solution and different methods of pathogen inactivation (X-rays, UV-irradiation after photosensitization with riboflavin) on morphological and functional parameters of platelets. Our findings allow optimizing the technology of preparation and processing of PC to achieve greater effectiveness of transfusion therapy.

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.

The appearance of anticancer drugs dramatically changed cancer treatment, allowing patients with a number of previously fatal diseases to achieve cure and prolong life in patients with incurable tumors. More than 100 anticancer drugs registered to date, many of which have been
developed in recent years using the latest advances in tumors molecular biology. At the same time the price of new anticancer drugs increases
much faster than efficacy of anticancer therapy. The situation is due largely to the fact that the current system of introduction of new anticancer drugs not performing initial tasks.