[Effectiveness of using autologous mono-nuclears of the bone marrow in treatment of patients with ischemic heart disease].

The authors have analyzed their experiences with treatment of 50 patients with ischemic heart disease using transplantation of autologous mono-nuclears of the bone marrow. It was shown that this operation resulted in an improvement of indices of the heart functions and myocardium metabolism. Transplantation of stem cells as mononuclear fraction of the bone marrow is indicated in treatment of different groups of patients: in recurrent diseases after previous operations on the coronary arteries; in patients with distal lesions of the coronary bed; transplantation of autologous stem cells of the bone marrow is expedient simultaneously with coronary artery bypass grafting or coronary angioplasty (stenting).

[Mobilization of peripheral blood cells for auto- and allogenic transplantations of hemopoietic cells]. / Poluchenie stvolovykh kletok perifericheskoi krovi dlia auto- i allogennykh transplantatsii gemopoéticheskikh kletok.

AIM: To study mobilisation of peripheral blood stem cells (PBSC) via single and split subcutaneous injection of granulocytic colony-stimulating factor (G-CSF) and isolation of PBSC concentrates for their transplantation with leukapheresis (LA) and large volume leukapheresis (LVL) in patients with solid tumors and hematological diseases as well as in the group of relative donors. MATERIAL AND METHODS: LA procedures were made on cell blood fractionator COBE Spectra. In groups 1 and 2 LVL was made with apparatus perfusion of circulating blood of the patient or donor (15-33 l) vs 7-12 l in LA by standard technique in group 3. To reduce the volume of sodium citrate solution used in LVL, to prevent citrate intoxication and hypervolemia, a sharp rise of anticoagulant/blood ration was applied. RESULTS: PBSC-mobilisation with split doses of G-CSF and large volume leukapheresis in 23 patients and 11 relative donors vs mobilisation in 26 patients with single-daily dose of G-CSF and leukapheresis of 3 TBV has revealed that split administration of G-CSF increased the number of leukocytes and CD34+ cells more considerably. CONCLUSION: LVL provides PBSC dose sufficient for transplantation during one procedure in the majority of donors and relative donors. This makes the method more comfortable and cost-effective.

[Methods of autologous peripheral blood stem cell (PBSC) mobilization in oncological and hematological patients]. / Metody mobilizatsii autologichnykh stvolovykh kletok perifericheskoi krovi (SKPK) u onkologicheskikh i gematologicheskikh bol'nykh.

The potential of peripheral blood stem cell (PBSC) mobilization with granulocyte (G-CSF) and granulocyte-macrophage (GM-CSF) colony-stimulating factors of chemotherapy has been assessed in patients with tumor or hematological disease. The study was intended to aid PBSC transplantation. It was shown that G-CSF administration increased the number of leukocytes in leukemia patients dramatically while mononuclear cell and colony-forming unit levels in G-CSF-mobilised PBSC were significantly higher than those collected with GM-CSF or chemotherapy.

[A trial of using allogeneic bone marrow transplantation in children with different hematologic neoplastic diseases]. / Opyt primeneniia allogennoi transplantatsii kostnogo mozga u detei s razlichnymi onkogematologicheskimi zabolevaniiami.

AIM: To define optimal time for transplantation of bone marrow (TBM) in children with hematological malignancies. MATERIALS AND METHODS: 20 allogenic TBMs were performed in children with acute myeloblastic leukemia (6 patients, 2 of them in recurrence), acute lymphoblastic leukemia (7 patients, 4 of them in recurrence), chronic myeloid leukemia (CML) in a chronic stage (3 patients), severe aplastic anemia (3 patients), generalized neuroblastoma (1 patient). Pretransplantation preparation included cyclophosphamide and busulphane or cyclophosphamide, busulphane and vepezide. The graft-versus-host reaction (GVHR) was prevented with cyclosporin A plus methotrexate or cyclosporin A plus urbazone. Engrafting was recognized by change of karyotype and blood group. RESULTS: From 13 children with acute leukemia subjected to TBM in a complete remission 4(33%) are alive, 5 died within 100 days after TBM (TBM was made in recurrence in 4 children), 3 patients died of recurrence 12 months after TBM. One patient with CML and one with severe aplastic anemia remain in remission. The main complications and causes of death in early posttransplantation period were hemorrhagic syndrome, infectious complications, GVHR. According to a one-year follow-up, the recurrent disease caused death most frequently. CONCLUSION: Positive result of TBM is related to the disease stage at transplantation.

[The transplantation of hemopoietic cells in patients with solid tumors]. / Transplantatsiia gemopoéticheskikh kletok u bol'nykh s solidnymi opukholiami.

AIM: Evaluation of efficiency of bone marrow and peripheral stem cells transplantation in patients with solid tumors. MATERIALS AND METHODS: A total of 38 patients aged 30-40 years with stage III or IV solid tumors (15 cases of breast cancer, 5 cases of Ewing's sarcoma, 4 cases of osteogenic sarcoma, ovarian or testicular tumors, 3 cases of soft tissue sarcoma) underwent high-dose polychemotherapy with autologous hematopoietic rescue. All the patients were resistant to the first line chemotherapy or were in relapse of the disease. 21, 11 and 6 patients were transplanted bone marrow, peripheral blood stem cells and both bone marrow and peripheral blood stem cells, respectively. RESULTS: The only factor which influenced overall survival of the patients was the stage of the disease at the moment of the transplantation. 66% of patients in complete or partial remission survived 3 years versus 16.6% of those in progression or relapse of the disease. Other parameters such as the patients' age, the source of hemopoietic cells, number of chemotherapy courses were not essential for the survival. 2 patients died after transplantation. The main cause of death was relapse or progression of the disease after the transplantation. CONCLUSION: Transplantation of hemopoietic cells is a promising therapy of patients with solid tumors sensitive to chemotherapy.

[The transfusion aspects of allogeneic bone marrow transplantation]. / Transfuziologicheskie aspekty allogennoi transplantatsii kostnogo mozga.

AIM: Analysis of transplantations of allogenic bone marrow (BM) for determination of transfusiological problems arising in various types of donor's and recipient's blood ABO incompatibility. MATERIALS AND METHODS: 46 allogenic BM transplantations from relative donors are analysed. The following types of ABO incompatibility were identified: significant (12 donor-recipient pairs), insignificant (10 pairs), combined (2 pairs). RESULTS: The proposed methods of BM fractionation provided the yield of nucleated cells in minimal admixture of red cells. This allowed to minimize loss of stem cells at fractionation and to prevent acute hemolysis at infusion of BM suspension in cases of ABO group-different BM allotransplantations. CONCLUSION: The proposed modification of the "shelf" method enabled effective fractionation of small BM volumes obtained from children-BM donors with high yield of nucleated cells and small admixture of incompatible red cells. Reinfusion of erythrocytic mass obtained at fractionation of donor BM fractionation used as replacement therapy makes allogenic blood transfusion unnecessary in 66% of BM donors.

[Blood rheological disorders in patients with postthrombotic disease and the means for their correction]. / Gemoreologicheskie narusheniia u bol'nykh s posttromboticheskoi bolezn'iu i sposoby ikh korrektsii.

An analysis of results of rheological properties of blood in 45 patients with different forms of postthrombotic disease of lower extremities has shown that 78% of the patients have erythrocytosis and all the patients have hyperviscosity shifts. Correction of the hemorheological changes by the methods of transfusion therapy (plasmapheresis, exfusion of blood, hemodilution) allowed to reduce the microcirculatory disorders in the diseased extremity in this group of patients.

[Results of therapeutic use of plasma- and erythrocytapheresis in patients with arterial thromboobliterating diseases of the extremities]. / Nekotorye itogi primeneniia lechebnogo plazma- i éritrotsita- fereza u bo'lnykh s tromboobliteriruiushchimi zabolevaniiami arterii konechnostei.

The article analyzes results of using methods of plasma- and plasmoerythrocytapheresis in 120 patients with occlusive injuries of main arteries of extremities. The efficiency of the methods used both as isolated ones and in combination with surgical procedures in patients with obliterating atherosclerosis, thromboangiitis, and aorto-arteritis of the extremity vessels and the Raynaud disease is estimated.

[A method of correction of hemorheological disorders in patients with thrombobliterating diseases of the peripheral arteries of the limbs]. / Metody korrektsii gemoreologicheskikh narushenii u bol'nykh s tromboobliteriruiushchimi zabolevaniiami perifericheskikh arterii konechnostei.

Methods of plasm- and plasmoerythrocytapheresis in combination with hemodilution were used in 28 patients with thrombobliterating diseases of the extremity arteries. A conclusion is made of the necessary detection of hemorheological disturbances in this group of patients. The methods used were shown to be promising. The correlation was established between changes of the rheological properties of blood and clinical course of the disease.