Multidrug resistance (MDR) is the cell resistance to a number of drugs. Proteins from the ABC-transporter family are the most studied factors of the MDR phenomenon. According to the literature Pgp, MRP1, BCRP, and LRP are proteins involved in the development of the MDR. The authors detected the expression of these proteins in untreated patients with acute myeloid leukemia (other than M3). Expression of these proteins was observed in 64.3%, 46.4%, 64.3%, and 42.9% of patients, respectively. In all non-responders blast cells expressed more than one marker of MDR. Expression of 3 and 4 markers was found in 80% of non-responders while in responders 1—2 markers were expressed in 83%.

The results of treatment in children with acute myeloid leukemia (AML) have considerably improved in the past 15 years. Whether cranial irradiation, maintenance therapy, and hematopoietic stem cell transplantation should be used during the first remission remains unclear. This paper presents the histo- ry of development of AML treatment in children, the potentialities of current chemotherapy, and indications for allogenic and autologous hemopoietic stem cell transplantation in accordance with the data obtained by different groups of investigators, including ones from Russia. The Institute of Pediatric Oncology and Hematology (IPOH), Russian Cancer Research Cancer, Russian Academy of Medical Sciences, has developed and introduced an IPOH AML proto- col in 2002. From July 2002 to January 2006, 40 patients were enrolled in this study and stratified into 3 risk groups: 1) a standard risk group (n = 10 — 28.6%)); 2) an intermediate risk group (17 — 48,6%), and 3) a high risk group (n = 8 — 22.9%). Three-year relapse-free survival was 40±12%.

In 1990 to 2005, a total of 138 hematopietic stem cell transplantations (HSCT) were made in patients with high risk group of acute myeloblastic leukemia (AML) (auto-HSCT in 20 patients, related allo-HSCT in 18, unrelated allo-HSCT in 20) and acute lymphoblastic leukemia (ALL) (auto-HSCT in 13 patients, related allo-HSCT in 24, unrelated allo-HSCT in 43). The patients' age was 2 to 55 years. Five-year relapse-free survival after auto-HSCT in the 1st-2nd remissions in AML was 40%; 8-year one was 30% in patients with ALL (including 3 patients with Ph+). In patients aged less than 21 years with acute leukemias, 5-year overall survival after related and unrelated donor allo-HSCT was 38 and 44%, respectively. Both allo-HSCT modes had the similar spectrum of complications in the early period (as long as 100 days). In patients with AML and ALL, 5-year overall survival depended on the stage of disease at the moment of allo-HSCT performance (52 and 5.9% in ALL and 62.5 and 27.3% in AML, remission and relapse, respectively). Auto- HSCT in ALL and AML is an effective method for remission consolidation and may be regarded as an alternative if the patient has no related or unrelated donor. The efficacy of allo-HSCT from a related or unrelated donor in acute leukemia depends on the stage of disease at the moment of its per- formance, which determines the likelihood of development of a relapse and different complications (toxic, infectious, graft rejection, etc).

High-dose chemotherapy (HDC) with autologous or allogenic hemopoietic stem cell transplantation (SCT) is successfully used in refractory, relapsed or high-risk primary aggressive non-Hodgkin's lymphomas (NHL). Results on HDC employing in follicular lymphoma, is inconclusive. Recent studies has suggested that com- bining of anti-CD20 (rituximab) with HDC (HDC-R) may successfully eliminate minimal residual disease, further delaying or preventing disease relapse and potentially extending the duration of survival after autologous SCT in patient with aggressive B-cell lymphomas. The paper discusses recent dates on HDC-R treatment strategy and presents the author's own data on the use of HDC with autologous SCT in a group of 50 patients with relapsed and primary resistant NHL (22 of them received rituximab at different stages of treatment - remission induction, stem cell collection, posttransplantation period). In all patients receiving high- dose therapy, 5-year overall survival was 40.3% and 5-year relapse-free survival was 77.5%. 5-year overall survival was 52% in patients with the B-cell pheno- type treated with HDC plus rituximab, and 21% in those treated with HDC only (p = 0.014). Treatment toxicity was comparable in both groups.

Invasive aspergillosis is one of the most life-threatening complications of treatment of oncohematological diseases. In the literature there is no consensus of treatment options and indications for surgical treatment. The authors have observed 2 cases of invasive aspergillosis in patients with acute myeloid leukemia. Both patients needed pneumonectomy but the first of them received only conservative therapy because of bad general condition and died of pulmonary hemorrhage. In the second case primary lobectomy and postoperative reatment with caspofungin led to recovery and permitted to continue chemotherapy. Now this patient is in complete remission of acute myeloid leukemia.

The impact of various Hodgkin's lymphoma treatment program on the female reproductive function is discussed. The current Russian and foreign literature on this problem is reviewed. Reproductive function was estimated in 247 females with Hodgkin's lymphoma before and after treatment. The irregular menstrual cycle in untreated group of the females with Hodgkin's lymphoma was significantly more frequent when B-symptoms were present (p = 0.0004). Radiotherapy without irradiation of inguinal and iliac areas did not induce amenorrhea irrespective of age, the number of fields and the cumulative local dose per field (as high as 50 Gy). Irradiation of inguinal and iliac areas induced amenorrhea in all females even when low doses (less than 30 Gy) were used. The ABVD treatment program did not result in steady-state ovarian tissue damage. The therapy schedules containing less than 8 g of cyclophosphamide were less toxic to ovarian tissue amenorrhea occurred only in 10.5% of the women. Treatment by the schedules with doses of cyclophosphamide more than 8 g caused amenorrhea in 26.6% of the patients. A high correlation was found between the incidence of amenorrhea and the patient' age (p = 0.0002): in women above 25 years irreversible ovarian tissue damage was revealed in 48.4% of cases.