[Viral mucosal lesions of the gastrointestinal tract organs in patients with lymphoma].

Infectious complications are one of the main causes of the lower efficiency of chemotherapy in hematologic oncology. The common infectious pathogens are herpes group viruses. The manifestations of herpesvirus infection or reactivation may be extremely diverse; just the same, digestive tract injury is rarely associated with herpesvirus infection in clinical practice. Viral mucosal injury of the intestine and pharynx is described in 2 patients with lymphomas during agranulocytosis. Virus-specific DNA was absent in blood; however, it was detected at high titers (the number of copies of 10(3) 10(5) genome-equivalent/mI) in feces and mucosal biopsy specimens. Addition of antiviral therapy could rapidly abolish infectious complications in both cases. Virological examination of material from the injury focus makes it possible to reveal a pathogenic virus even though the latter is undetectable in blood.

[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.

[Diagnosis of lymphoproliferative diseases by bone marrow trepanobiopsy specimens].

Based on the study of 2000 bone marrow trepanobiopsy specimens from patients with different types of lymphoproliferative diseases, the authors present the incidence and specific features of specific bone marrow lesion and the state of normal hemopoiesis and stroma. They also give data of bone marrow immunohistochemical studies using a many mono- and polyclonal antibody panels. The criteria for the differential diagnosis of reactive polyclonal lymphoid proliferation in the bone marrow that may accompany many hematological and non-hematological diseases with specific bone marrow lesion in lymphoproliferative diseases are outlined. The high diagnostic value of a study of bone marrow trepanobiopsy specimens is shown in the diagnosis of lymphoproliferative diseases.

[The 1st results of the combined therapy of recurrent and refractory forms of lymphogranulomatosis (polychemotherapy, radiation therapy and the removal of the residual mediastinal formation)]. / Pervye rezul'taty kombinirovannoi terapii retsidivnykh i refrakternykh form limfogranulematoza (polikhimioterapiia, luchevaia terapiia, udalenie ostatochnogo mediastinal'nogo obrazovaniia).

AIM: To achieve a maximal complete remission rate in patients with recurrent and refractory Hodgkin's disease. To find out a group of patients in whom surgical removal of the residual mediastinal mass would be most effective. MATERIAL AND METHODS: 46 patients with Hodgkin's disease received Dexa-BEAM chemotherapy followed by radiotherapy. Surgical removal of the residual mediastinal mass was made in 12 patients. RESULTS: Second-line Dexa-BEAM therapy produced a 50% complete remission rate. Overall survival was 45.5%, the disease-free survival--43.5%. Removed mediastinal masses were indicative of Hodgkin's disease in 7 cases and fibrosis in 4 cases. CONCLUSION: Dexa-BEAM is an effective program in the treatment of recurrent and refractory Hodgkin's disease. Surgical removal of the residual mediastinal mass with radiotherapy and high-dose chemotherapy improves prognosis in very unfavorable, primary progressive form of Hodgkin's disease.

[Transfusion- and infusion-related iatrogenesis]. / Transfuzionno-infuzionnye iatrogenii.

Posttransfusion and postinfusion side effects and complications resulting occasionally in lethal outcomes are still available in clinical practice in spite of apparent safety and high efficiency of blood transfusions and infusions. These may be caused by the donor-recipient erythrocytic incompatibility, poor quality of the transfusion medium, disregard of contraindications to transfusion. Pathologic features of complications emerging in response to transfusion of incompatible blood or its substitutes are indicated as well as morphologic characteristics specific for posttransfusion shock and consequent acute hepatorenal insufficiency. For the substitutes there are occasional observations of the shock similar in its development to an anaphylactic one. Wide introduction of transfusion and infusion therapy into clinical practice dictates the necessity of adequate evaluation of the above therapy role in combined treatment of varying-type patients, in thanatogenesis basing on the initial patient status and previous treatment.