Vol 11, No 3 (2016)

Oncohematology. 2016;11(3):8-19

8-19

Risks of postmetachronous malignancies in patients with Hodgkin lymphoma after radio- and chemotherapy

Danilenko A.A., Shakhtarina S.V., Pavlov V.V.

Abstract

Oncohematology. 2016;11(3):20-28

20-28

Extranodal NK/T-cell lymphoma: a review of literature and case report

Chernova N.G., Nareyko M.V., Sinitsyna M.N., Sidorova Y.V., Yatsy G.A., Kovrigina A.M., Zvonkov E.E., Dvirnyk V.N., Kuz’mina L.A., Parovichnikova E.N., Savchenko V.G.

Abstract

Extranodal NK/T-cell lymphoma – a rare lymphoproliferative disease characterized predominantly by extranodal localization, aggressive course and low efficiency of conventional chemotherapy. Clinical presentation is diverse and depends on tumor lesion localization. In this article, a literature review and case report of patient with generalized extranodal NK/T-cell lymphoma with bone marrow involvement, unusual intracranial tumor localization, tumor leukemization and central nervous system-leukemia were presented. Adequate treatment strategy made it possible to achieve long-term complete remission in a patient with poor prognosis.

Oncohematology. 2016;11(3):29-39

29-39

Comparison of diagnostic effectiveness of X-ray computed tomography, magnetic resonance imaging and diffusion-weighted magnetic resonance imaging in the differentiation of residual tumors and posttherapeutic masses in patients with lymphoma after treatment

Khoruzhik S.A., Zhavrid E.A., Sachivko N.V.

Abstract

We conducted prospective study of the effectiveness of X-ray computed tomography (CT), magnetic resonance imaging (MRI) and MRI with diffusion-weighted imaging (MRI-DWI) with apparent diffusion coefficient (ADC) maps calculation for the differentiation of residual tumors and posttherapeutic masses in 40 adult patients with lymphoma. Whole body CT and MRI-DWI were performed before and after treatment.
The effectiveness of lesions size criterion for CT and MRI, visual and quantitative criteria for MRI-DWI were investigated. Residual lesions signal intensity on DWI images and ADC maps was compared with paraspinal muscles signal intensity. The accuracy of the overall tumor response estimation was 38 % for CT, 48 % for MRI, 68 % for MRI-DWI with visual assessment of DWI images, 93 % for MRI–DWI with visual assessment of ADC maps. CT density of the lymph node lesions before treatment and residual masses after treatment did not differ significantly – 40.4 ± 9.4 and 37.2 ± 10.5 Hounsfield units respectively (p = 0.08), whereas ADC (×10–3 mm2/s) increased significantly from 1.04 ± 0.40 to 2.01 ± 0.82 (p < 0.0001). ADC of postherapeutic masses was significantly higher than that of residual tumors – 2.32±0.62 and 1.04 ± 0.66 respectively (p < 0.0005). MRI-DWI with visual assessment of ADC maps is the most effective method for differentiation of residual tumors and posttherapeutic masses in patients with lymphoma after treatment. Usefulness of quantitative analysis of ADC values requires further investigation.

Oncohematology. 2016;11(3):40-48

40-48

Should to all patients with febrile neutropenia and colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae carbapenems be appointed?

Okhmat V.A., Klyasova G.A., Korobova A.G., Parovichnikova E.N., Fedorova A.V., Troitskaya V.V., Gribanova E.O., Savchenko V.G.

Abstract

Objectives. The objective of this study was to evaluate epidemiology of febrile events (FE) and efficacy of antibiotic treatment in neutropenic patients with newly diagnosed acute myeloid leukemia (AML) with and without colonization of gut by extended-spectrum β-lactamaseproducing Enterobacteriacae (ESBL-E).
Materials and methods. The prospective study (2013–2015) included 66 patients with AML. These patients received 208 chemotherapy cycles within 6 month. Rectal swabs were obtained from all patients prior to antibiotic administration. ESBL-E were isolated on chromogenic ESBL selective medium CHROMagarТМESBL (CHROMagar, France) and confirmed by double disk synergy test.
Results. FE occurred in 193 (93 %) of chemotherapy cycles. The analysis was performed in 173 FE, including 68 – with colonization and 105 – without colonization with ESBL-E.
Epidemiology of FE was similar in patients colonized by ESBL-E and non-carriers group, except cases of bacteremia, caused by ESBL-E that occurred only in patients colonized by the same bacteria (7.5 %; p = 0.009). Patients colonized by ESBL-E and non-carriers had comparable efficacy of first-line non-carbapenem regimens (38 % vs 44 %), rate of carbapenem administration (62 % vs 55 %), efficacy of carbapenems alone (36 % vs 52 %) and in combination (64 % vs 41 %), duration of all antibiotics (14 days vs 13 days) and carbapenems (10 days vs 10 days). All cases of bacteremia caused by ESBL-E were successfully treated by carbapenems.
Conclusion. Colonization of gut with ESBL-E is a predictor of bacteremia caused by the same bacteria. There were no differences in the use of antibiotics in patients colonized by ESBL-E and non-carriers group.

Oncohematology. 2016;11(3):49-57

49-57

Clinical and microbiological characteristics of bloodstream infections in hematological cancer patients

Chebotkevich V.N., Bessmel’tsev S.S., Kiseleva E.E., Stizhak N.P., Kaytandzhan E.I., Burylev V.V.

Abstract

Introduction. Bloodstream infections (BSI) are life-threatening illness for immunocompromised patients with hematological malignancies.
The aim of the study was to compare epidemiology, causative pathogens and outcome of hospital-acquired BSI and clarifying the role of herpes group of viruses in their development.
Materials and methods. During the period 1991–2013 438 bacterial strains obtained from 360 patients (pts) with hematological malignancies wеre studied. All blood cultures were incubated in the continuous monitoring system for 7 days before discard. The real-time PCR was used for human herpesviruses DNA detection: Herpes simplex viruses types 1 and 2 (HSV 1, 2), Cytomegalovirus (CMV), Epstein–Barr virus
(EBV) and Herpesvirus 6 (HHV-6). In this study 64 hematological cancer patients with infectious complications who fulfilled criteria of systemic inflammatory response syndrome with positive peripheral blood cultures were investigated. All pts received empirical anti-infectious therapy with subsequent correction based on the bacteriological, virological and mycological analyses.
Results and discussion. A total Gram-positive (G+) accounted for 69.2 % of BSI, Gram-negative (G–) for 30.8 %. Among G+ BSI Coagulase Negative Staphylococci and Staphylococcus aureus were the most frequent pathogens (58.8 %), among G– BSI Escherichia coli (13.0 %) was predominant. It is shown that the development of bacteremia were significantly more frequently occurs in the case of cytomegalovirus
and the Epstein–Barr virus detection.
Conclusion. Further epidemiological surveillance is warranted in order emerging resistant strains and related mortality. Reactivation of CMV and EBV is significantly associated with higher incidence of bacterial BSI.

Oncohematology. 2016;11(3):58-67

58-67

Results of external quality control study in flow cytometric acute lymphoblastic leukemia diagnostics

Popov A.M., Verzhbitskaya T.U., Zueva E.E., Anan’eva O.V., Babenko E.V., Baydun L.V., Belyakova E.A., Boyakova E.V., Bortnikova O.G., Gorchakova M.V., Grivtsova L.Y., Grinkevich E.N., Davydova Y.V., Zakhar’ko E.I., Illarionova O.I., Kaprano N.M., Koroleva E.A., Kochengina S.A., Kuz’mina E.G., Kustova E.A., Makarova T.A., Mirolyubova Y.V., Murashkina O.E., Mushkarina T.Y., Nisheva E.S., Novikova I.A., Osipova E.Y., Pluzhnikova G.E., Pochtar M.E., Pronkina N.V., Rusanova E.V., Rybkina E.B., Seliverstova O.V., Tupitsin N.N., Uleyskaya G.I., Urazalieva N.T., Fechina L.G., Khoroshikh O.V., Tsareva O.E., Shchekina L.A., Plyasunova S.A., Lugovskaya S.A.

Abstract

Comparison of interpretation of acute lymphoblastic leukemia (ALL) flow cytometric diagnostics data was the aim of the study. Immunophenotyping data obtained from 10 patients with ALL were analysed separately in 26 laboratories from Russian Federation and Kazahstan. Results comparison showed four main type of discordance: B-lineage ALL diagnostics during heavy bone marrow regeneration, great variability of T-ALL interpretation, complexity of ambiguous lineage acute leukemia and, finally, very different report types, unique for each laboratory. All these problems are the serious obstacles for standardization of flow cytometric ALL diagnostics in multicenter setting. Continuation of similar QC rounds following by consecutive discussions with further development of consensus diagnostic algorithm could be the first step for standardization of ALL immunophenotyping in Russian Federation and CIS countries.

Oncohematology. 2016;11(3):68-75

68-75

RARE DISEASES

Genetic diagnosis of Fanconi anemia. Literature review

Panferova A.V., Timofeeva N.M., Ol’shanskaya Y.V.

Abstract

The literature review provides information on genetic diagnosis of Fanconi anemia: currently used methods of genetic analysis, spectrum and frequency of mutations, including in different populations, and order of molecular genetic methods are described. Problems of genetic diagnosis of Fanconi anemia in the world and in particular in the Russian Federation are also presented.

Oncohematology. 2016;11(3):76-85

76-85

PHARMACOTHERAPY

Proteasome inhibitors: situation and prospects (literature review and own data)

Rukavitsyn A.A., Rukavitsyn O.A.

Abstract

Multiple myeloma is a clonal B-cell malignancy characterized by proliferation of plasma cells that accumulate mainly in bone marrow and usually secrete monoclonal Ig and/or Ig light chains. The history of therapy development in this disease has more than 50 years. After ubiquitin-proteasome system of apoptosis become apparent bortezomib has been included in the mains therapy regimes. Simultaneously, the group of proteasome-inhibitor drugs is continually developing and opening more therapeutic options in refractory or relapse forms.

Oncohematology. 2016;11(3):86-89

86-89