Preoperative patient management protocol in the complex anesthetic support of minimally invasive interventions in pediatric oncology is described. Choice of general anesthesia method was determined by the specific clinical situation by analyzing all of the following factors: airway management, necessity and anticipated duration of unconsciousness, the need for analgesia, necessity and duration of immobilization, prevention of hypothermia, the presence and severity of disturbances in the hemostatic system, comfort for the child and his representatives (parents). Basic techniques of child preoperative examination, as well as the methodology for predicting the risk of perioperative adverse events are described.

Extracorporeal photopheresis (ECP) has been used as a component of combined immunosuppressive therapy in 53 patients with steroid-refractory
acute “graft-versus-host” disease. Overall response was observed in 35 patients (66 %; 95 % CI 52.6–77.3): complete response (CR) in 15 pts (28.3 %; 95 % CI 18–41.6) and partial response (PR) in 20 pts (37.7 %; 95 % CI 25.9–51.2). 3-year OS was 39 % in patients with clinical response (CR or PR); in the absence of clinical response OS was 8 % during the first year (p < 0.0001). Median methylprednisolone dose before ECP was 2 mg/kg/day, and at the end of ECP course – 0.7 mg/kg/day (p < 0.0001).

Traditionally, the concern of fatal complication is a major obstacle to transfer patients with unfavorable course of Hodgkin’s lymphoma to
national transplantation centers. Early mortality after high-dose chemotherapy with autologous hematopoietic stem cell transplantation
(HSCT) in the Russia, Ukraine and Belarus was assessed in this retrospective multicenter study.

Patients and methods. The study included 372 patients with unfavorable course of Hodgkin’s lymphoma received HSCT between 01.1990
and 06.2013: 35.5 % patients with primary resistance, 30.6 % with early relapse, 33.1 % with late relapse and 0.8 % during consolidation of
first complete remission.

Results. During first 100 days after HSCT died 14 (3.8 %) patients, during first year – 31 (8.4 %) patients. During the study period a significant decrease in the 100-day and 1-year mortality rate was observed (p < 0.0001 for both). Among patients received HSCT in 1990–
1995, 1996–2000, 2001–2005 and 2006–2013 the 100-day mortality was 19.4 %, 6.3 %, 1.1 % and 0.6 %, respectively. 1-year mortality for the same intervals was 32.3 %, 14.7 %, 4.5 % and 1.9 %, respectively.

Conclusions. Currently HSCT in patients with unfavorable course of Hodgkin's lymphoma in national transplant centers, accompanied by an extremely low risk of fatal toxicity.

The indications for transfusion of blood components support after stem cell transplantation (SCT) usually do not differ form other clinical situations, but the rules for such therapy have a number of features. One of them is the possibility of inconsistence of AB0 group between donor and recipient of hematopoietic stem cells, which is not only fraught with the development of various alloimmune complications, but also fundamentally changes the standards for the selection of blood components for transfusion. A major problem after HSCT is a secondary immunodeficiency, which is important to consider for ensuring prevention of transfusion-transmitted infections (eg, CMV), as well as to carry out activities aimed for the prevention of transfusion- associated graft-versus-host disease. HSCT is a medical technology today, the effectiveness of which is often dependent on the accuracy and integrity of its implementation. So, serious attitude to various supportive therapy, including transfusions of blood components is an important component which determines the success of the treatment.

Hematopoietic stem cell transplantation (HSCT) is widely used in the treatment of malignant and autoimmune diseases. Various complications often develop during the post-transplantation period that can significantly impair the clinical outcomes, so the ability to predict the
risk of severe complications is of great practical importance. Predictive value of some anthropometric indices and bioimpedance analysis
(BIA) measured before conditioning to assess the risks of serious complications and graft hypofunction in the early post-transplant period
(100 days) were analyzed. Anthropometry and BIA used in a comprehensive assessment of nutritional status in order to optimize the nutritional support of these patients. 101 patients were examined before conditioning and at different times during the early post-transplant period: 50 children (5–17 years of age) were examined using BIA and anthropometry, 61 children (6 months – 4 years of age) – using only anthropometry without BIA due to age restrictions. The prognostic value of the phase angle (FA), ratio of the active cell mass to lean body mass (ACM/LBM) and shoulder muscle circumference (SMC) was shown. Thus, in patients with FA ≤ 4, ACM/LBM < 0.45 and SMC ≤ 10th percentile before conditioning risk of severe complications during early post-transplant period was significantly higher (p < 0.05). Also, in patients with FA ≤ 4 and ACM/LBM < 0.45 a significantly higher risk of graft hypofunction developing was observed (p < 0.05).

Most anemia cases associated with iron deficiency. There are various therapeutic approaches to compensate iron deficiency. In some cases,
a rapid restore of body iron is required, which is only possible with intravenous administration. Now a number of intravenous iron preparations are available, and each of them has not only advantages. Considering the drugs side effects, there was a need for drugs with high efficiency, low immunogenicity, and minimal toxicity. One of the decisions was to create preparations based on maltose and isomaltose. Such new intravenous iron preparations are ferric carboxymaltose and iron isomaltoside. Currently, there are no available clinical data that isomaltose and maltose preparations differ significantly with respect to adverse reactions associated with their immunogenicity. Based on study results isomaltose preparations in patients with dextran sensibilization should be used with caution. This is not completely exclude the possibility that both of these drugs can be an immune response trigger with a different specificity than the one on dextran develops. Preparations based on maltose, sucrose and gluconate were neutral in immunoprecipitation assay with dextran-reactive antibodies that determines their preference for patients with dextran sensibilisation. Other important properties of ferric carboxymaltose are: convenience of application and lack of oxidative stress that are determined by the slow iron release.

Platelet antigens structure, role of platelet antibodies in the pathogenesis of various clinical conditions, characteristic of modern antibodies detection methods are presented in this article.