[Use of subgrafting doses of peripheral stem cells is a new approach to overcoming hematological toxicity of multiple intensive courses of chemotherapy in children]. / Ispol'zovanie subtransplantatsionnykh doz perifericheskikh stvolovykh kletok - novyi podkhod k preodoleniiu gematologicheskoi toksichnosti mnogokratnykh intensivnykh kursov khimioterapii u detei.

The authors examined 8 patients with pretreated relapsing or resistant solid tumors (Wilms'--4, rhabdomyosarcoma--3, synovial sarcoma--1) who received 16 courses of chemotherapy: iphosphamide, 1800 mg/m2/day (days 1-5), vepeside, 100 mg/m2/day (days 1-5), and carboplatin 500 mg/m2/day (day 1) (IVC) and 18 courses of therapy wherein iphosphamide was replaced by cyclophosphanum, 400 mg/m2/day (days 1-5) (CVC). The patients received 2-4 induction courses (n = 18) and 1-5 consolidation courses (n = 16) with reinfusion of peripheral stem cells (PSC). All PSC separations were performed after the first or second courses of IVC/CVE. There were no significant increases in the duration of leukopenia and thrombocytopenia, in the incidence of infection with a higher ordinal of a course performed by PSC maintenance. The findings suggest that the small doses of PSC stimulated by colony-stimulating factor can maintain hemopoiesis and decrease the rate of the estimated bone marrow depletion long after repeated courses of chemotherapy in patients with prognostically poor solid tumors.

[The autotransplantation of hematopoietic stem cells from the peripheral blood]. / Autotransplantatsiia gemopoéticheskikh stvolovykh kletok perifericheskoi krovi.

The authors discuss the existence of polypotent hemopoietic stem cells in the peripheral blood as well as a possibility of restoring hemopoiesis by means of the given cells after the lethal myelotoxic exposure. In 5 patients with hemoblastoses, suspension of mononuclear leukocytes in an amount of 0.5 X 10(9) per kg bw was obtained using short-interval leukocytapheresis on blood cell separator. After carrying out different schemes of pretransplantation preparation the defrosted suspension of mononuclear cells was injected without wash out to the patients' central vein. The recovery of the peripheral blood indicators was attained on days 10-30 after the autotransplantation of stem blood cells.

[The role of high-dose chemotherapy with hemopoietic stem cell transplantation in the treatment of breast cancer with unfavorable prognosis]. / Rol' vysokodoznoi khimioterapii s transplantatsiei kletok- predshestvennikov gemopoèza pri lechenii prognosticheski neblagopriiatnykh form raka molochnoi zhelezy.

High-dose chemotherapy using transplantation of hemopoietic precursor cells offers much advantage for treatment of prognostically unfavorable cancers of the breast. Both experimental and clinical evidence points to a potential of raising antitumor effect by increased dosage of chemical drugs. Clinical studies using high-dose chemotherapy for treating patients with stage II-III tumors or with greater than or equal to 10 positive axillary lymph nodes, and locally-advanced and disseminated tumor established a relative rise in overall and recurrence-free survival, as compared with standard treatment. Hazardous cytopenia and related complications can be significantly reduced when hemopoietic precursor cells are transplanted from peripheral blood.

[Use of Mabtera (rituximab) in treating patients with refractory courses of B-cell lymphoma, along with high-dose chemotherapy and autologous transplantation of hematopoietic stem cells]. / Primenenie mabtery (rituksimab) u bol'nykh refrakternym techeniem B-kletochnym limfom, poluchaiushchikh vysokodoznuiu khimoterapiiu s autologichenoi transplanttatsiei kletok-predshestvennits gemopoéza.

AIM: To study efficacy of rituximab in patients with resistant B-cell lymphoma on high-dose chemotherapy. MATERIAL AND METHODS: From September 2000 to April 2002 we studied efficacy and tolerance of rituximab at different stages of high-dose chemotherapy. The treatment was given to 10 patients with histologically verified CD20+ non-Hodgkin's lymphoma: diffuse large-cell (n = 4), Berkitt's (n = 2), follicular (n = 3), mantle-cell (n = 1). Five patients with diffuse large-cell lymphoma and Berkitt's lymphoma had a primary resistant course of the disease, one patient with diffuse large-cell lymphoma had a refractory recurrence. Follicular and mantle-cell lymphomas were characterized by a resistant course and large tumor masses. The patients received 1-2 courses of induction chemotherapy with dexa-BEAM with collection of peripheral stem cells followed by high-dose chemotherapy (BEAM-9, CBV + mitoxantron-1) with transplantation of autologous stem blood cells. Rituximab infusion (375 mg/m2) was conducted before the collection of the stem cells, prior to high-dose chemotherapy and in posttransplantation period after recovery of hemopoiesis. RESULTS: 4 patients achieved complete remission, 3-partial remission, 2 had progression and 1-stabilization. In mean follow-up 11 (2-20) months 7 of 10 patients were alive, overall survival being 15 +/- 2.4 months (95% confidence interval 10-19.7), median was not reached. 5 patients are in complete remission: 2 of them without further treatment, 3-after progression and repeat therapy including rituximab and interferon-alpha or rotuximab and CHOP chemotherapy. CONCLUSION: The addition of rituximab can improve the results of high-dose chemotherapy of patients with non-Hodgkin's lymphoma resistant to standard doses of cytostatics. Repeat use of this drug can be effective in some patients with progression after high-dose chemotherapy with rituximab.

[Superhigh-dosage chemotherapy with the transplantation of autologous hemopoietic precursor cells in patients with a prognostically unfavorable relapse and resistant course of lymphogranulomatosis]. / Sverkhvysokodoznaia khimioterapiia s transplantatsiei autologichnykh kletok predshestvennikov gemopoéza u bol'nykh s prognosticheski neblagopriiatnym retsidivom i rezistentnym techeniem limfogranulematoza.

Eighteen patients with relapsed or refractory Hodgkin's disease (HD) have been treated with high-dose chemotherapy (BEAM regimen) followed by autologous peripheral stem cells and/or bone marrow rescue. There were no treatment-related deaths. Overall response rate was 82%. With a median follow-up of 10 months (3-24 months) overall survival and freedom from progression were 100 and 94% (95% confidence interval 58-97%), respectively. The use of peripheral stem cells in addition to bone marrow resulted in a significant shortening of the time to engraftment (p < 0.01). The BEAM regimen is an effective conditioning schedule which is well tolerated.

[Use of autologous hematopoietic stem cells from peripheral blood for transplantation in patients with hematologic and solid neoplasms after high-dose chemotherapy]. / Primenenie autologichenykh kletok-predshestvennikov gemopoéza ia perifericheskoi krovi dlia transplantatsii u bol'nykh s gematologicheskimi i solidnymi novoobrazovaniiami posle vysokodoznoi khimioterapii.

Peripheral mononuclears under normal hemopoiesis and after chemotherapy or/and cytokin were isolated on blood cell separator and cryopreserved. The cells from 22 patients with different hematological and solid malignancies were examined. Mononuclears with high content of hemopoiesis precursors may be collected rapidly after stimulation. Fast and persistent recovery of hemopoiesis in transplantation of this material after superhigh-dose chemotherapy of prognostically unfavourable patients is demonstrated. Cytokin (granulocytic and granulocytic-macrophagal growth factors) promoted fast and reliable production of sufficient quantities of peripheral blood hemopoiesis cells precursors.