PROGNOSIS OF ACUTE LEUKEMIA DEPENDING ON THE IRON METABOLISM PARAMETERS IN CHILDREN AFTER CHORNOBYL NUCLEAR POWER PLANT ACCIDENT. / PROGNOZ PEREBIGU GOSTRYKh LEIKEMII U DITEI PISLIa AVARIÏ NA ChAES ZALEZhNO VID OBMINU ZALIZA.

OBJECTIVE: To determine the influence of iron metabolism on the prognosis of acute lymphoblastic (ALL) and (AML)myeloblastic leukemia at the different phases of chemotherapy in children after Chоrnobyl accident. MATERIALS AND METHODS: 333 children (295 - ALL, 38 - AML) were examined at the stages of chemotherapy. Thecomparison group included 93 children without leukemia. Acute leukemia variants, patients survival, relapses, thenature of disease (live child or died), iron methabolism (morphometric parameters of erythrocytes, SI, SF, STf, TS),manifestations of dyserythropoiesis, bone marrow sideroblast and patients radiation dose were taken into account. RESULTS: In 295 patients with ALL the following variants of leukemia were established: pro-B-ALL in 23, «common¼type of ALL in 224, pre-B-ALL in 29, T-ALL in 19. Thirty eight patients were diagnosed with AML (11 - M1, 19 - M2,8 - M4). Doses of radiation in patients with AL were (2.78 ± 0.10) mSv and they did not correlate with clinical andhematological parameters, disease variant. Relapse rates and shorter survival were in patients with T-ALL, pro-B-ALLand AML with SF levels > 500 ng/ml (p < 0.05). The amount of children with normochromic-normocytic anemias andmanifestations of dysplasia of erythroid lineage elements was greater in the AML than in ALL. SF content in patientswas elevated during chemotherapy and was lower than the initial one only in the remission period. Transferrin wasreliably overloaded with iron: TS (70.2 ± 2.3) % compared with the control group (32.7 ± 2.1) %. Correlationbetween TS and survival of patients was detected (rs = -0.45). Direct correlation between the number of iron granules in erythrocariocytes and SF level (rs = 0.43) was established, indicating the phenomena of ineffective erythropoiesis. CONCLUSIONS: The negative influence of iron excess in the patients body on the hemopoiesis function, manifestations of ineffective erythropoiesis and the course of acute leukemia in children have been established. Changes inferrokinetic processes in children can be the basis of leukemоgenesis development.

CLINICAL, HEMATOLOGICAL CHARACTERIZATION AND POLYMORPHISM OF ABO AND Rh BLOOD GROUP SYSTEMS IN PLASMA CELL MYELOMA PATIENTS. / KLINIKO-GEMATOLOGIChNA KhARAKTERYSTYKA TA POLIMORFIZM SYSTEM GRUP KROVI AVO TA Rh U KhVORYKh NA PLAZMOKLITYNNU MIIeLOMU.

Objective to study the peculiarities of clinical characteristics and polymorphism of ABO and Rh blood group systemsin relation to the natural history of plasma cell myeloma in the ChNPP accident survivors. MATERIALS AND METHODS: Peculiarities of the disease natural history were reviewed in the 111 plasma cell myeloma(PCM) patients receiving medical management at the Department of Radiation Oncohematology of the NRCRM dur-ing 2010-2017. Principal clinical and laboratory characteristics of PCM, namely the values/levels of LDH, ß2-mic-roglobulin, albumin, serum calcium, urea, creatinine and hemoglobin were assessed, taking into account the gender,radiation history (ChNPP accident clean-up workers, evacuees from areas of obligatory resettlement, inhabitants ofcontaminated territories, and the comparison group) and the PCM stage codenamed by Durie-Salmon et al. (1975)and the ISS (1985) classifications. Distribution of polymorphic variants on ABO and Rh blood systems was studiedin the 106 PCM patients. RESULTS: It was found that the level of ß2-micro-globulin and calcium was increased significantly in male (p = 0.02and p = 0.04, respectively), whereas serum urea content was elevated in female (p = 0.04) PCM patients featuring acompromised radiation anamnesis in comparison to non-irradiated patients. Some probable differences were foundfor urea level (F = 3.58, p = 0.05) and serum albumin (F = 4.00, p = 0.05) in the examined group of PCM patients.Probable (p < 0.05) incidence increase of the B phenotype was established as a predictor of complicated natural his-tory of PCM with abnormal genetic equilibrium resulted from the increased incidence of IB allele in chronic renal fail-ure (CRF) patients. Significant (p < 0.05) prolongation of the remission period upon a standard PCT application wasfound in PCM patients being the A phenotype carriers having a preserved gene and phenotypic equilibrium comparedwith carriers of O and B phenotypes. CONCLUSIONS: Clinical and hematological parameters are different in PCM patients survived after the ChNPP accidentand those with favorable radiation history. Distribution of polymorphic variants of ABO antigenic structures inpatients with complicated natural history of the disease is also different, that can be a background for predictingthe effectiveness of treatment. Further research is required in this field.