11q23/MLL rearrangements in adult acute leukemia.

AIM: To detect the frequency, diagnostic and prognostic significance of 11q23/MLL rearrangements and to determine the chromosomes that are most frequently involved in 11q23/MLL abnormalities in adult acute leukemia (AL). MATERIALS AND METHODS: Cytogenetic investigations of bone marrow and/or peripheral blood cells from 140 patients with acute myeloid leukemia (AML) and 57 patients with acute lymphoblastic leukemia (ALL) were performed. The methods of conventional cytogenetics (GTG-banding) and fluorescence in situ hybridization were used. RESULTS: Chromosomal abnormalities in leukemia cells were found by conventional cytogenetic methods in 80 (57%) and 37 (65%) adult patients with AML and ALL, respectively. 11q23/MLL rearrangements were found in 7 (5%) and 8 (14%) patients with AML and ALL, respectively. Among them, 8 (53.4%) patients had translocations, 2 (13.3%) - had deletions and 5 (33.3%) patients had trisomies or tetrasomies of chromosome 11. With respect to the distribution of partner chromosomes involved in 11q23/MLL translocations chromosome 4 was found to participate in 3 (37.5%) cases of 11q23/MLL translocations, 9 - in 2 (25%) cases and chromosomes 10, 14 and non-identified chromosome were involved in 1 (12.5%) case each. Nine patients (60%), besides abnormal ones, had 9-86% normal metaphases in their karyotypes. Of 15 patients with 11q23/MLL rearrangements, 5 (33%) patients had only 11q23/MLL rearrangements, whereas other 10 (67%) - had additional cytogenetic abnormalities, besides 11q23/MLL rearrangements. CONCLUSIONS: Chromosomal abnormalities of various kinds were found in 57% and 65% adult patients with AML and ALL, respectively. The frequency of 11q23/MLL rearrangements in patients with AML and ALL was 5% and 14%, respectively. Since AL patients with 11q23/MLL rearrangements are attributed to cytogenetic categories of AL with a poor or intermediate risk prognosis, cytogenetic methods should be included in the standard examination of AL patients for diagnosis, prognosis and selection of the optimal treatment strategy.

Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment.

The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. MATERIALS AND METHODS: Treatment response and survival of 83 patients with CLL complicated by immune cytopenia (IC) were analyzed. Treatment schedules in 58 medicated patients included corticosteroids; chemotherapy (COP, CHOP regimens), immunotherapy (rituximab alone), immunochemotherapy (rituximab-containing regimens - R-COP, R-CHOP). Twenty-five patients underwent splenectomy. RESULTS: The use of corticosteroids, as the first line of treatment, resulted in short-term remission in most patients. Chemotherapy was effective in a half of CLL patients, but duration of the remission did not exceed 32 months in CLL associated with autoimmune hemolytic anemia and immune thrombocytopenia. After rituximab monotherapy (10 patients) the stable remission was reached in 60% of the patients with median relapse-free survival of 40 months. Rituximab containing chemotherapy (22 patients) caused the long-term remission in 72% of the patients with median relapse-free survival of 76 months. Splenectomy performed in 25 patients with CLL complicated by IC was effective in 70% of the patients. The outcome of splenectomy depends on IC entity. The best response was registered in associated immune thrombocytopenia (median overall survival 118 months), the worst - in Fisher - Evans syndrome (15 months). CONCLUSIONS: The treatment of patients with CLL complicated by ICs should be individualized. For CLL patients without significant enlargement of lymph nodes and spleen, low lymphocytosis, associated with autoimmune hemolytic anemia or immune thrombocytopenia, the monotherapy with rituximab is optimal. In case of occurrence of autoimmune hemolytic anemia, immune thrombocytopenia or Fisher - Evans syndrome in CLL patients with enlargement of lymph nodes, spleen, significant lymphocytosis, the use of R-COP or R-CHOP schemes, 4-6 courses, is the most effective. Splenectomy is indicated in patients with massive splenomegaly, the resistance to medication, recurrent relapses after adequate therapy.

Study of cytogenetic abnormalities in G-CSF stimulated peripheral blood cells and non-stimulated bone marrow cells of patients with myelofibrosis.

UNLABELLED: The aim of the study was to improve cytogenetic diagnostics and monitoring of myelofibrosis and to reveal the spectrum of cytogenetic abnormalities in patients from Ukraine. MATERIALS AND METHODS: A total of 42 patients (23 females and 19 males) with myelofibrosis was studied using different cytogenetic methods. Granulocyte colony-stimulating factor (G-CSF) was added by the new method during cultivation of peripheral blood (PB) cells from 31 patients for specific stimulation of mitotic divisions. Two patients underwent examination by fluorescent in situ hybridization method. RESULTS: In cell cultures of PB stimulated in vitro with G-CSF and in non-stimulated bone marrow chromosome abnormalities were found in 19 (45.2%) of all the patients. The spectrum of cytogenetic abnormalities of bone marrow and PB was the same in all of the patients. Aspiration of bone marrow was unsuccessful due to significant fibrosis in 10 (29.4%) of 34 patients. The study by fluorescent in situ hybridization method confirmed cytogenetic abnormalities revealed by G-method and discovered additional possibly normal subclone. CONCLUSIONS: Cytogenetic study of PB using in vitro G-CSF as a specific stimulant of mitosis instead of phytohemagglutinin revealed significant variety of chromosomal abnormalities in Ukrainian patients with myelofibrosis. This method could be a less invasive alternative to cytogenetic examination of bone marrow in the subgroup of patients with considerable fibrosis and consecutive changes. The usage of fluorescent in situ hybridization method supplemented karyotyping by G-banding method.

[THE DYNAMICS OF IMMUNOLOGICAL RESULTS OF PATIENTS WITH T-CELL SKIN LYMPHOMAS AND PSORIASIS BY THE THERAPY OF ACTIVATION MECHANISMS SANOGENESIS METHODS].

The therapy T-cell skin lymphoma and psoriasis by the application of activation mechanisms sanogenesis methods, such as: original--a treatment plasmapheresis, a standard heparin infusion; used for the first time--wobenzym; solutions of acid acetic food and sodium bicarbonate; known--the basic sanitations of concomitant diseases, photopheresis caused remissions in 79.6% patients with different stages T-cell skin lymphoma (observed over an 8-year span), and in 67% of patients with psoriasis (observed over an 6-year span). Depuration reactions (phagocytosis, pinocytosis, toxin neutralization) has been activated by detoxication of treatment plasmapheresis and heparin infusions. The topical therapy with wobenzym, solutions of acid acetic food and sodium bicarbonate renewed natural immune barrier of skin. Basic therapy of concomitant diseases enhanced of patient state of health and mobilized compensatory resources. Photopheresis initiated autoimmunization processes by malignant CD4+ lymphocytes. When remission was achieved, the parameters of cellular and humoral immunity returned to normal levels, or the parameters made worse in the absence of remission.

[The indices of quality of the donor's plasma, obtained by the methods of plasmapheresis and primary fractionation, using various hemopreservatives and leukocytic filters].

There was estimated quality of the plasm indices; so in comparison with the fractioning methods, using two regimens of the donor's blood centifugating, harvested with the help of various conservants, the most secure and functionally adequate plasm preparation was determined such, which is obtained with the help of plasmapheresis procedures. The expediency of application and introduction of the differentiated centrifugation technology, providing rational usage of a donor's blood, was determined. After conduction of leukofiltration of the conserved blood and plasm the residual cells content is reducing significantly, while preserving activity of the blood coagulation factors.

[Peculiarities of cytogenetic changes in different types of myelodysplastic syndrome].

We carried out the cytogenetic investigation of bone marrow aspirate from 32 patients with different types of MDS. The patients were from 8 regions of Ukraine. 11 patients had abnormal karyotype, and the transformation to AML were observed in 5 of them (45.5%). 27% of all patients had chromosomal changes with 3 or more chromosomes involved. The highest percentage of the patients with chromosomal anomalies (66.7%) was in cases of RAEB. Chromosome deletions were the most frequently detected karyotype abnormalities. We consider the phenomenon of chromosome fragmentation as the cytogenetic approval of the increased level of apoptosis in patients with MDS. The risk of the transformation to AML was measured using new international score system IPSS.

[Methodological approaches toward higher safety of hemotransfusion therapy]. / Metodologiia pidvyzhennia bezpeky gemotransfuziinoï terapiï.

Safety of haemotransfusions remains a challenge in modern transfusion medicine. Methodological approaches toward eliminating risks for haemotransfusion complications include a wider employment of principles of haemocomponent therapy, prevention of a possibility of infections contamination of blood and its components, deleukocytation of blood components, categorizing of donors by phenotypes, registering those donors having been phenotyped, categorizing of potential recipients by phenotypes, screening of alloimmune antierythrocytic antibodies in donors, sick and pregnant women, introduction of autodonation on a wide scale.

[The use of a fatty emulsion for determining blood lipids in parenteral nutrition]. / Ispol'zovanie zhirovoi émul'sii dlia opredeleniia lipidov krovi pri parenteral'nom pitanii.

The author has investigated the possibility of using as the reference agent in estimation of the resorption rate from vascular bed of fatty emulsions the very agent that is introduced or the oil, one of the ingredients of this agent. Fatty emulsions for parenteral nutrition intralipid (Sweden), lipofundin-C (Finland), venolipid (Japan), lipidin and lipidin-2 (USSR), and specially purified sunflower oil were used to plot the calibration curve.

[Determination of the sensitivity of Pseudomonas aeruginosa to antibiotics using a synthetic liquid culture medium]. / Opredelenie chuvstvitel'nosti Pseudomonas aeruginosa k antibiotikam v zhidkoi sinteticheskoi pitatel'noi srede.

Antibiotic sensitivities of 120 Ps. aeruginosa strains isolated from patients and environmental objects have been studied by microdilutions in modified Jorgensen's liquid synthetic nutrient medium. Use of "transitional" concentrations of antibiotics permits a simultaneous examination of the sensitivities of 7-8 Ps. aeruginosa cultures to 6-11 antibiotics. The simplicity, low price, low consumption of nutrient medium, sufficient accuracy and good reproducibility of the results recommend this method for laboratory practice.

[Comparative characteristics of the adhesive properties of microorganisms isolated from the urine of children with chronic obstructive pyelonephritis]. / Sravnitel'naia kharateristika adgeviznykh svoistv mikroorganizmov, vydelennykh iz mochi u detei s khronicheskim obstruktivnym pielonefritom.

The adhesive properties of 215 cultures, including 215 Escherichia coli strains, 43 Klebsiella pneumoniae strains and 60 Pseudomonas aeruginosa strains isolated from the urine of 124 children with chronic obstructive pyelonephritis were studied in the direct hemagglutination test simultaneously with those of 30 E. coli strains and 20 K. pneumoniae strains isolated from the feces of 50 healthy children, as well as 60 P. aeruginosa strains isolated from children with parenteral infections of other localization. E. coli and K. pneumoniae strains isolated from the urine of children with chronic obstructive pyelonephritis were found to have D-mannose-resistant hemagglutinins (68% and 37.2%) and a combination of mannose-sensitive and mannose-resistant adhesins (44.6% and 13.3% respectively). P. aeruginosa strains isolated from the urine of urological patients in the postoperative period showed the presence of mannose-resistant hemagglutinins to a greater extent (76.6%) than those isolated from children with parenteral infections of other localization (45%).

[Surface architectonics of peripheral blood erythrocytes of the rat according to scanning electron microscopy findings]. / Poverkhnostnaia arkhitektonika éritrotsitov perifericheskoi krovi krysy po dannym skaniruiushchei élektronnoi mikroskopii.

Proceeding from the G. I. Kozinets et al. (1977) classification of human red cells, 9 types of red cells were distinguished with scanning electron microscopy in peripheral blood of Wistar male rats: discocytes, discocytes with processes on their surface, mulberry-like red cells, dome-like red cells, spherical red cells with smooth and rough surface, red cells similar to a flat ball, degeneratively altered red cells. Percentage of different shapes of the erythrocytes was determined.