[Tuberculosis in patients with lymphoproliferative diseases].

AIM: To study the clinical manifestations, diagnosis, and treatment of lymphoproliferative diseases (LPD) concurrent with tuberculosis. SUBJECTS AND METHODS: In 1990 to 2013, the Hematology Research Center, Ministry of Health of Russia, followed up 4422 patients with LPD. Lymphomas and leukemias were diagnosed using the universally protocols. Tuberculosis was verified by the results of a comprehensive examination involving the histological study of biopsy specimens. RESULTS: Tuberculosis was identified in 85 (2%) patients with LPD. According to the nosological entity, the tuberculosis detection rates were 3% (40/1350) in Hodgkin lymphoma (HL), 1.2% (20/1627) in aggressive lymphomas, 1.4% (16/1136) in mature cell lymphomas and chronic lymphocytic leukemia, and 2.9% (9/309) in hairy cell leukemia. In accordance with its site, pulmonary tuberculosis was 73%; extrapulmonary tuberculosis, 14%; generalized tuberculosis, 12%. In pulmonary tuberculosis, its disseminated and focal involvements were found in 71 and 18% of cases, respectively. Tuberculosis was detected in 43% of the patients with HL in remission; it occurred only in other hemoblastoses in its active phase. When tuberculosis and LPD were simultaneously found, both diseases were concurrently treated. If the chemotherapy of LPD was effective, tuberculosis was cured in all the patients. CONCLUSION: Patients with LPD are a group at increased risk for tuberculosis. The diagnosis of recurrent LPD must be histologically proven. When tuberculosis and LPD are simultaneously found, both diseases should be concurrently treated.

The relevance of cytological studies and Ki-67 reactivity to the clinical course of chronic lymphocytic leukemia.

The aim of the study was to investigate whether the growth fraction and cytology of peripheral blood and lymphoid tissues relate to response to treatment in CLL. Growth fraction was assessed using the monoclonal antibody Ki-67. Peripheral blood (PB) films and lymph node and spleen touch imprints or aspirates were examined in 35 patients (pts) with CLL: smouldering CLL (4 pts) (no therapy), progressive CLL but responsive to chlorambucil and cyclophosphamide (15 pts) and resistant CLL (16 pts). Cytological studies of lymphoid tissues showed that pts with resistant CLL had an increased proportion of prolymphocytes and blasts and the highest Ki-67 expression (mean 6,6%). PB morphology was not different between the groups of resistant and responsive CLL. However, the cases with resistant CLL showed a higher percentage of Ki-67 positive PB cells (p<0,05). Four pts with indolent CLL had typical CLL morphology in the PB and the lowest numbers of prolymphocytes and blasts with Ki-67 positive cells in lymphoid tissues.

Stable and unstable aberrations in lymphocytes of Chernobyl accident clearance workers carrying rogue cells.

Cells with multiple chromosomal aberrations, the so-called rogue cells, were found in blood samples from more than 100 Chernobyl accident clearance workers. A comparative analysis of frequencies of stable and unstable chromosomal aberrations in two worker groups--those with or without rogue cells was made. A higher level of unstable aberrations in persons carrying rogue cells was observed. No difference in the level of stable aberrations between the groups was seen. The possibility of low dose alpha irradiation causing the chromosomal damage is raised.

Cytogenetic features of leukaemias diagnosed in residents of areas contaminated after the Chernobyl nuclear accident.

A comparison of chromosomal abnormalities in bone marrow leukaemic cells and of stable and unstable aberrations in lymphocytes of patients with hematological malignancies who live in areas with or without contamination by the Chernobyl nuclear accident has been made using FISH and G-banding. Healthy residents of these areas comprised the control group. No systematic cytogenetic differences of leukaemic cells between patients from contaminated and uncontaminated areas were observed. Lymphocyte aberrations, however, were generally higher in all subjects from contaminated areas. Comparison has been made with specific cytogenetic features of leukaemic cells and a high level of stable aberrations in lymphocytes of patients with secondary leukaemias that had developed after chemo- and/or radio-therapy.