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Oncohematology

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Vol 7, No 2 (2012)
https://doi.org/10.17650/1818-8346-2012-7-2

HEMATOLOGIC MALIGNANCIES: DIAGNOSIS, TREATMENT, SUPPORTIVE CARE

6-13 9967
Abstract

Primary myelofibrosis (PMF) is one of the diseases that cannot be cured using modern methods of conservative therapy. Therefore, treatment aimed at reducing PMF severity and improving patient’s quality of life. In this article, a comparative analysis of treatment response and quality of life depending on therapy using was shown. Partial remission rate at approximately the same level after α-interferon treatment (55.3 %) and after cytotoxic drug (48.8 %) was observed. Significant improvement in quality of life during α-interferon treatment was revealed.

14-24 9937
Abstract

Aim of the study – immunophenotype description of infant acute lymphoblastic leukemia (ALL). 64 patients (29 boys and 35 girls) with acute leukemia (AL) aged from 0 to 11 months were included in the current study. ALL was found less frequently in infants than in older children (67.19 % and 87.69 %, respectively). BI-ALL was the most common immunological ALL type (60.46 %) in infant ALL, while BII-ALL was notably less frequent compared with other age groups (30.23 %). Significant immunophenotypic differences were observed in patients with and without MLL gene rearrangements. Number of cases in those tumor cells expressed CD10, CD20, CD45, CD133, CD15, NG2 varied between MLL-positive and MLL-negative groups. CD10- and CD20-negativity, high CD45, CD15, CD65 and NG2 expression were immunophenotypic signatures of MLL-rearranged infant ALL, although NG2 had the highest diagnostic efficacy. High CD34 and CD65 expression was frequently associated with presence of MLL-AF4 fusion gene. Thus infants’ B-cell precursor ALL immunophenotype differs significantly due to the presence of MLL gene rearrangements. Diagnostic immunophenotyping of infants’ ALL allows predicting presence of MLL rearrangements and NG2 is the most applicable single marker.

22-27 9794
Abstract

In this paper analysis of anemia correction efficacy in multiple myeloma patients was shown. Patients (n = 68) treated with epoetin alfa (recombinant erythropoietin (rEPO)) 150 IU/kg subcutaneously three times per week (no more 20 weeks) were included in the study group. Patients who did not receive erythropoiesis-stimulating therapy were included in the control group (n = 31). Patients in both groups received at least 3 courses of chemotherapy and continued to receive anticancer treatment during follow-up. Baseline hemoglobin level was 5.3 g/dl – 10.0 g/dl. The increase in hemoglobin level to normal range (≥ 12.0 g/dl) during ≤ 20 weeks was considered as positive therapy response. Positive response rate was higher in patients received epoetin alfa comparing with control group (64.7 % and 25.8 %, respectively; p < 0.05). Transfusion dependence persisted in 6 from 19 study patients who received RBC transfusions along with rEPO therapy (31.6 %), whereas in 5 from 9 control group patients (55.6 %). In epoetin alfa group significant increase in reticulocytes count at 2–3 weeks of therapy
was revealed: from 27.3 × 109/l to 64.9 × 109/l (in patients with positive response) and from 13.3 × 109/l to 25.1 × 109/l (in patients without response). Changes in the reticulocytes count in the control group were not revealed. Thus in patients with positive response reticulocytes level significantly increased to 3 weeks of therapy compared with negative response patients (37.6 × 109/l versus 11.8 × 109/l, respectively; p < 0,05), it can be used as prognostic factors of rEPO response.

28-35 9866
Abstract

In 42 patients with verified Hodgkin lymphoma and confirmed metastatic skeletal lesion possibility of using specific pulse sequences in imaging of bone marrow involvement have been established. MRI pattern of bone marrow lesion, signal localization, distribution and intensity were revealed. In 33 patients with newly diagnosed bone lesions the MR images of the affected and intact bone marrow during chemotherapy were assessed during 10 months. In 2 patients MR images were assessed after radiotherapy. Several MRI patterns changes of affected bone marrow after 2, 6 and 8 chemotherapy cycles were identified.

36-41 10150
Abstract

The aim of the study was assessment of blood coagulation parameters in acute myeloid leukemia (AML) patients during disease manifestation.
Coagulation and fibrinolysis parameters, physiological anticoagulants levels and intravascular coagulation markers were detected. 44 patients with newly diagnosed AML (FAB: M0, M1, M2, M4, M5), m/f = 20/24, aged 20–76 years (median – 49.5 years) were included in the study. 18 patients without infectious complications were classified as a group 1; 26 patients with infectious complication – as a group 2. Hemorrhages were observed in 15 patients (57.7 %) from group 2 and only in 2 patients (11 %) from group 1. The patients showed elevated levels of soluble fibrin monomer complexes and D-dimer levels, decreased protein C activity, inhibition of Hageman-dependent fibrinolysis, which indicates the hypercoagulation. Infection in AML patients accompanied by increased intravascular coagulation that confirmed by positive correlation of CRP with D-dimer levels and von Willebrand factor antigen (VWF:Ag) and by negative correlation with prothrombin tests results. Thus, infection and high leucocytes count in patients with newly diagnosed AML should be considered as significant risk factors for thrombohemorrhagic complications as well as thrombocytopenia.

QUALITY OF LIFE AND FOLLOW-UP

42-50 9936
Abstract

The results of our cross-sectional bioimpedance study of children aged 7–17 years cured of cancer during follow-up (patients’ group, n = 552, remission time range 0–15 years) and of age-matched healthy controls (n = 1,500) show significant intergroup differences in body height and body composition parameters. The most pronounced alterations in the patients’ group were observed in standardized values of phase angle reflecting a sharp decrease in the percentage of metabolically active body cell mass in fat-free mass. Malnutrition, judged from the prevalence of obesity and low phase angle, was observed in 52.7 % of our patients reaching a maximum of 76.8 % in a subgroup of children with CNS tumors. In view of known association that exists between malnutrition and reduced tolerance to chemotherapy, increased susceptibility to infections and adverse outcomes rate, we recommend using bioimpedance analysis in remission of childhood cancers in order to monitoring and timely correction of nutritional state as well as for prevention of delayed cardiovascular risks.

BASIC RESEARCH

51-56 10070
Abstract

Acute megakaryocytic leukemia (AML M7) – a rare disease characterized by poor treatment response, except for t(1;22) variant in infants. Cytogenetic abnormalities in AML M7 are highly heterogeneous. We collected samples from children with AML M7 to analyze the disease cytogenetic profile. During September 2009 to March 2012 20 AML M7 patients was studied using fluorescence in situ hybridization. Complex and heterogeneous chromosomal abnormalities were revealed. It was found that no recurring abnormalities and cytogenetic markers unique to each patients. Also, the 19p13 amplification described previously only in myeloid cell lines was detected.

LITERATURE REVIEW

57-66 9977
Abstract

Myelodysplastic syndromes (MDS) are a group of heterogeneous clonal disorders of myeloid hematopoietic stem cells characterized by an ineffective hematopoiesis associated with cytopenias, morphologic dysplasia and a progression to acute myeloid leukemia. The only potentially curative MDS treatment is hematopoietic stem cell transplantation, which is usually not even discussed because most patients with advanced age at diagnosis. Currently only three drugs are approved by US Food and Drug Administration (FDA) and European Medicines Agency for therapy of MDS. For low and intermediate-1 risk MDS del(5q) the novel immunomodulatory drug lenalidomide is asserted, and for intermediate-2 and high risk the two hypomethylating agents (azacitidine, decitabine) are approved. The results of completed clinical trials demonstrating the efficacy and safety of these agents are presented. The new data indicating that the successful future of MDS treatment rests in the combination of multiple treatments modalities to achieve improved clinical outcomes are discussed in this review.



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ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)