[Current approach to diagnosis and treatment of acute leukemia in adults]. / Suvremeni pristup dijagnostici i lijecenju akutnih leukemija u odraslih.

Current classification of acute leukemia is based on morphology, immunophenotyping, cytogenetic and molecular abnormalities of leukemic cells. All these techniques have a diagnostic and prognostic value. Molecular abnormalities in many cases suggest the pathogenesis of acute leukemia, but also point to the key site of genetic abnormalities that may be targeted with the therapy. Treatment approach in acute leukemia is still chemotherapy. The probability of long-term disease-free survival after intensive chemotherapy for younger patients with acute lymphoblastic leukemia and acute myeloid leukemia is 30%-40% and 40%-50%, respectively. Allogeneic stem cell transplantation is associated with better disease-free survival compared to other cytotoxic regimens. In recent years, targeted therapy seems to improve the chemotherapy outcome. This therapy targets only leukemic cells while sparing normal cells. Immunotherapy, differential agents and especially drugs acting on the key molecular abnormalities are currently being used together with chemotherapy as a treatment approach for acute leukemia. It is expected that techniques such as gene expression profiling will identify genetic abnormalities and their proteins as a targeted site for new drugs. This might increase the efficacy of leukemia treatment and control.

Clinical study on the effect of simvastatin on butyrylcholinesterase activity.

Although the physiological function of serum butyrylcholinesterase (BuChE) has not yet been clarified, there is evidence that this enzyme is involved in serum lipoprotein metabolism. It has been suggested that serum BuChE is positively correlated with LDL (low-density lipoprotein) and negatively with HDL (high-density lipoprotein) levels. The objective of this study was to determine whether the activity of BuChE changes during treatment with simvastatin (CAS 79902-63-9). The effects of simvastatin therapy on serum lipoproteins and plasma BuChE activity were studied in 15 patients with type IIa and 17 patients with type IIb hyperlipoproteinemia. Beside the expected influence on serum lipid concentration, a statistically significant decrease in BuChE activity in patients with hyperlipoproteinemia type IIa and IIb during treatment with simvastatin was not observed.