49 patients aged 28 to 81 years old (median age of 55 years old) with relapsed or refractory multiple myeloma (MM) were enrolled in the study. The relapse was diagnosed in 25 (51 %) patients, the refractory disease was determined in 24 (49 %) patients (including primary refractory disease in 14 (28.6 %) patients). The prior therapy for all patients included bortezomib-based treatment in combination with thalidomide and autologus stem cell transplantation (8.1 %). Lenalidomide had not been used in the previous therapeutic regimens. All patients were given the original treatment regimen, which included lenalidomide, bortezomib, and prednisolone (RVP). The therapy was made up of seven induction cycles with each one lasting for 48 days. Length of courses was 14 days. After seven cycles of RVP therapy were over, such results were achieved: complete response (CR) in 1 (2 %) patient; very good partial response (VGPR) in 4 (8 %) patients; partial response (PR) in 26 (53 %) patients; minimal response (MR) in 2 (4 %) patients; stable disease (SD) in 8 (16.3 %) patients, and progressive disease (PD) in 8 (16.3 %) patients. The objective response rate, including CR+VGPR+PR, was obtained in 31 (63.1 %) patients. The objective response rate, including MR, was seen in 33 (67.1 %) patients. Hematological and non-hematological toxicities were moderate. Taking into account the above, the RVP therapeutic regimen has demonstrated its efficacy as a second-line therapy for MM, and its clinical use can solve the problem of relapsed/refractory to bortezomib-based regimens MM management.

The results of two consecutive multicenter clinical trials enrolled 241 patient with childhood mature B-cells non-Hodgkin lymphomas/leukemia are presented. Patients received treatment according B-NHL 2004mab protocol (n = 83) and B-NHL 2010M (n = 158) with combined immunochemotherapy (ICT) in Russian and Belarus pediatric clinics from 2004 to 2015 years. Primary patients with different mature B-NHL (Burkitt lymphoma/leukemia, diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma (DLBCL and PMBCL)) aged from 2 to 18 years are included in the studies.

Protocol B-NHL 2004mab for treatment of children and adolescents with B-NHL/B-AL, stage III and IV, includes a combination of chemotherapy (PCT) and rituximab – an antibody against the B-cells receptor CD20. PCT courses similar to those in the B-NHL BFM90 protocol (group III) with the exception of methotrexate dose in induction courses, reduced to 1 g/m2 /24 h in order to reduce toxicity. Rituximab (Mabthera, 375 mg/m2 /h) used for the first time in the treatment of children and adolescents with B-NHL. Of the 83 patients included, clinical remission was achieved in 77 (92.8 %). With a median follow time of 51.6 months, remission continued in 23 (85.2 %) patients with B-AL, in 32 (88.9 %) patients with LB and 19 (95.0 %) patients – with DLBCL. With median follow time of 65.2 months, event-free and overall survival was 84 ± 6 and 82 ± 8 %, respectively.

Based on previous experience in order to further optimize B-NHL treatment, new protocol B-NHL 2010M with effect-adapted therapy and improvement of stratification risk group criteria was proposed. Overall survival in patients of 1st and 2nd risk groups with full implementation of diagnosis and treatment is approaching 100 %. In interim analysis of 3rd risk group patients, pOS was 88 ± 3 %. The incidence of induction death (infections, metabolic complications) remains within 2.7 % (n = 4); refractory cases (n = 2; 1.3 %) and relapses (n = 4; 2.7 %) developed after 2–4 months of remission, were observed only in patients with Burkitt lymphoma/leukemia. In this cases 2nd line therapy and auto-HSCT is not allowed to achieve remission. All PMBCL and DLBCL patients were achieved remission, but in 50 % of cases only after second line, radio- and cell therapy.

The authors conclude that a combined immunochemotherapy of B-NHL in children and adolescents, including the target drug (rituximab) and 5-day courses of cytostatic therapy, highly effective, despite a reduce induction intensity. Therapy for the analyzed protocol requires qualitative dynamic efficacy monitoring and timely correction of therapy. In order to solve a refractory problem and further reduce the toxicity, necessary to continue research using fundamental discoveries in recent years.

Glomerulonephritis associated with marginal zone B-cell lymphoma at the onset of disease is rarely diagnosed. In this article we reported two patient of the extranodal marginal zone B-cell lymphoma with kidney damage. The first patient with the extranodal marginal zone B-cell lymphoma involved the stomach, lymph nodes, bone marrow and associated with mesangioproliferative glomerulonephritis and renal failure. The second patient with the splenic form of marginal zone B-cell lymphoma associated with fibrillary glomerulonephritis and hepatitis C and involve the lymph nodes, liver, bone marrow, and synthesis monoclonal immunoglobulin (IgMκ), cryoglobulin type II. Glomerulonephritis of the both cases were established on the renal biopsies by the morphological investigation, immunofluorescence, and electron microscopy.

Both patients received therapy with bendamustine and rituximab, which has resulted in complete remission for lymphatic tumors and improve of kidney function. Overall and event-free survival in the first case corresponds to 21 and 16 months, the second 29 and 20, respectively.

These cases illustrates that the kidney may be initially involved by extranodal marginal zone B-cell lymphoma, and the need for expanded investigation of the possible dissemination. Combination of bendamustine and rituximab were effective and safety treatment in these cases.

Splenic B-cell marginal zone lymphoma (SMZL) – a rare B-cell non-Hodgkin, s lymphoma, which is represented morphologically by mature lymphoid cells, corresponding to lymphocytes of secondary follicles marginal zone by immunological characteristics. Plasma cell differentiation can be in marginal zone lymphoma, but we described a single case of abundance of Mott cells as a tumor substrate in splenic B-cell marginal zone lymphoma.

We present the first case of SMZL represented by Mott cells. This was the second case of Mott cells tumor described in Russia.

This observation is the only case among the collected material of splenic lymphomas. The morphological pattern is characterized by marked proliferation of monoclonal lymphoid cells with plasma cell differentiation with presence of Mott cells and is evidence of intense intracellular secretion of immunoglobulins.

The development of dose-limiting toxicities, including myelotoxicity, can significantly limit cytostatic therapy of malignant tumors. Neutropenia associated with high risk of febrile neutropenia (FN) and infectious complications that may interfere with therapy intensity and significantly increases the cost of diagnosis and treatment. With the development of recombinant forms of human granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor, therapy of iatrogenic neutropenia has undergone significant changes. The use of G-CSF (filgrastim, lenograstim, pegfilgrastim) reduces FN incidence in patients receiving myelosuppressive chemotherapy. Until recently, the only original preparation of G-CSF with prolonged action was pegfilgrastim. Lipegfilgrastim (Lonquex, Teva) is a new highly effective long-acting pegylated G-CSF, which has been approved by European Medicines Agency experts for FN prevention in patients receiving chemotherapy. This review summarizes the characteristics of chemical structure, pharmacokinetics, safety and efficacy of lipegfilgrastim.

191 consecutive unselected children with acute lymphoblastic leukemia aged from 1 to 16 years were enrolled in the study. Bone marrow samples were obtained at the time of initial diagnostics as well as at days 15 (n = 188), 36 (n = 191), and 85 (n = 187) of remission induction. Minimal residual disease (MRD) was assessed by 6–10-color flow cytometry. Flow cytometry data at day 15 allowed distinguishing three patients groups with significantly different outcome (p ˂ 0.0001): 35.64 % patients with MRD < 0.1 % represented 5-year event-free survival (EFS) of 100 %; 48.40 % cases with 0.1 % ≤ MRD< 10 % had EFS 84.6 ± 4.2 %; 15.96 % patients with very high MRD (≥ 10 %) belonged to group with poor outcome (EFS 56.7 ± 9.0 %). At the end of remission induction (day 36) 36 children (18.85 %) with MRD higher than 0.1 % had significantly worse outcome compared to remaining ones (EFS 49.4 ± 9.0 and 93.5 ± 2.1 % respectively; p ˂ 0.0001). From a clinical standpoint it is relevant to evaluate both low-risk and high-risk criteria. Multivariate analysis showed that day 15 MRD data is better for low-risk patients definition while end-induction MRD is the strongest unfavorable prognostic factor.

In present study were compared characteristics of rituximab produced by Hoffmann–La Roche (Mabtera®) and first domestic biosimilar Acellbia® from Biocad Company. Concentration of protein was measured using Bradford, s method. According to our results, protein concentration in formulations was the same. We electrophoresed formulations in denaturing conditions. Protein from formulations was denatured into fragments. Heavy and light chains of immunoglobulin were observed in gel. Finally, we performed flow cytometry where rituximab was used as primary antibody to detect CD20-positive B-cells of patients with B-cell chronic lymphocytic leukemia. Both Mabtera® and Acellbia® recognized the same number of cells. Thus, assays performed in vitro submitted identity of Mabtera® and Acellbia® characteristics.

In this article literature review of the causes of allosensibilisation to erythrocyte antigens are presented. It is shown that the ability to produce antierythrocyte antibodies is affected by many factors, principal of whom it is difficult to identify. For the allosensibilisation development requires genetically determined differences in erythrocyte antigens phenotypes of donor and recipient, mother and fetus, which can lead to immune response and antibodies production. The biochemical nature of erythrocyte antigens, antigen dose (the amount of transfused doses, the number of antigens determinants on donor and fetus erythrocytes, the number of pregnancies) are important. Individual patient characteristics: age, gender, diseases, the use of immunosuppressive therapy and the presence of inflammatory processes, are also relevant. Note that antibody to one erythrocyte antigens have clinical value, and to the other – have no. The actual data about frequency of clinically significant antibodies contribute to the development of post-transfusion hemolytic complications prophylaxis as well as the improvement of laboratory diagnosis of hemolytic disease of the newborn in the presence of maternal antierythrocyte antibodies.

С 22 по 23 октября 2015 г. в Москве состоялась XII ежегодная конференция с международным участием «Злокачественные лимфомы» под председательством чл.-корр. РАН, проф. И.В. Поддубной, проф. Emanuele Zucca (Швейцария) и Carin Smand (Нидерланды). Организаторами конференции были Российское общество онкогематологов, Российская медицинская академия последипломного образования и Российский онкологический научный центр им. Н.Н. Блохина. Конференция проводилась совместно с Европейской гематологической ассоциацией (European Hematology Assotiation, EHA), организационным комитетом Международной конференции по злокачественным лимфомам (International Conference on Malignant Lymphoma, ICML) и Международным обществом гериатрической онкологии (Société Internationale d, Oncologie Gériatrique, SIOG).

In memory of Professor Günter Schellong.