[Primary lymphomas of bones and soft tissues: comparative assessment of treatment results].

AIM: To evaluate the efficiency of intensive polychemotherapy (PCT) in adult patients having diffuse large B-cell lymphoma (DLBL) of bones and soft tissues with and without poor prognostic factors (PPF). SUBJECTS AND METHODS: Out of 58 enrolled patients, 51 were diagnosed as having DLBL. Burkitt's lymphoma (BL) was diagnosed in 6 patients. One patient had marginal zone B-cell lymphoma. Thirty-five patients with DLBL (10 patients with PPF and 25 without PPF) and 3 patients with BL were treated with the CHOP/R-CHOP regimen. The NHL-BFM-90 program was used in 3 patients with BL and 16 with DLBL (15 patients with PPF and 1 patient without PPF). RESULTS: After radiotherapy, the patient with marginal zone B-cell lymphoma achieved a 20-month remission; three BL patients receiving CHOP died. All the BL patients receiving NHL-BFM-90 achieved complete remissions of 48 to 72 months. In 9 patients having DLBL without PPF, who received CHOP, five-year overall and event-free survival rates were 100%; in 22 patients with PPF, these were 50 and 45%, respectively. In the patients with and without PPF, who received CHOP/R-CHOP, the survival rates differed statistically significantly (p = 0.01; logrank test). In the group of 15 patients having DLBL with PPF, who were treated with the NHL-BFM-90 protocol, 14 achieved an average remission of 17 months. In the patients having DLBL with PPF who used NHF-BFM-90, therapeutic efficiency was significantly higher (p = 0.05; Fisher's exact test). CONCLUSION: Differential therapy for primary lymphomas of bones and soft tissues indicated that the NHL-BFM-90 protocol used in the PPF group was significantly more effective than the CHOP regimens.

[Fibrinolysis system in patients with sepsis in state of myelotoxic agranulocytosis].

PURPOSE: Hemostasis disorders are the part of multiple organ failure (mOF) in sepsis. This work objective is to evaluate the system parameters in septic patients. PATIENTS AND METHODS: 55 oncohaematological patients were included in study: 45 with sepsis and 10 patients in control group (no signs of infection). Septic patients were subdivided into septic patients without multiple organ failure, patient with multiple organ failure and patients with septic shock. The C-reactive protein (CRP), procalcitonine (pCT), interleukine-6 (IL-6) serum concentration and fibrinolysis parameters were measured Patients were examined daily during first 5 days, later once a week during 28 days, control group was examined one time. RESULTS: Levels of CRP IL-6 and PCT were raised since 1st day. PCT and IL-6 concentrations were higher in sepsis and MOF group and septic shock group, than in sepsis without MOF group. CRP was raised in all patients. PCT went to normal at 7th day, CRP and IL-6 have started to decrease after 7th day, but both were higher than in control group. T-PA and plasmin inhibitors were comparable to control group and haven't changed significantly. Septic shock patients and patients with MOF have shown a decrease of plasminogen activity. Patients without MOF have shown an initially decreased plasminogen activity, but after 2 days it was similar to control group. PAI-I activity was increased only in septic shock and MOF groups in first days, and was similar to control group in cases of no MOF. Exended XIIa-dependent fibrinolysis time in average was present in all septic patients since 1st day, and extended twice in MOF and septic shock groups. Clot lysis time tended to decrease starting from 8th day, but it was longer than in control group till 28th day. A raised D-dimer concentration compared to control group was present in 75% of patients, but no difference was found among subgroups. A raised D-dimer serum concentration was relevant for prognosis. CONCLUSION: The most sensitive diagnostic test in sepsis is XIIa-dependent fibrinolysis. Plasminogen and PAI-I activity changes are mostly present inpatient with MOF and septic shock. The 28-day survival rate was 60% in MOF and septic shock groups and 95% in no MOF groups. A raised D-dimer concentration was found in 75% of septic patients.

[The value of monitoring of qualitative content of onco-antigens in serum in diagnostics of malignant tumors].

The results of monitoring of qualitative content of 8 onco-antigens (CK, CA-242, CA-19-9, CA-125, REA, AFP, SCC, NSE) in serum of 414 patients are presented. The examination of 62 patients with tumors of different localization was carried our in dynamics before and after treatment. The monitoring of concentration of onco-antigens in serum permitted to apply early diagnostics of malignant process to 9 out of 28 patients with unclear clinical symptomatic. The technique informativeness is demonstrated in pre-clinical diagnostic and prognosis of course of oncological diseases. The possibility of transitory increase of concentration of certain onco-antigens under non-oncologic diseases returning to normal values after application of corresponding pharmaceutical treatment is revealed. The broader implementation of this technique into practice of public health is recommended.

[Approbation of a new test system determining the activity of a plasmin inhibitor in patients with sepsis].

Plasmin inhibitor (PI) determination is an essential diagnostic method. The purpose of the study was to develop an amidolytic assay for estimating PI activity, by applying the test system made by RENAM (Moscow). The new system is based on purified plasmin (human plasma) with the activity attested by the international standards. The developed method shows precision and accuracy with low and normal PI activity. The pilot clinical trial in patients with sepsis had demonstrated that the PI activity determined by this method is associated with some hemostatic parameters (prothrombin index, thrombin generation) and a patient's status (septic shock, hepatic dysfunction).

[The prevention of reproductive disorders occurring during the chemotherapy of women of child-bearing age suffering from Hodgkin's disease]. / Profilaktika reproduktivnykh narushenii, voznikaiushchikh v protsesse khimioterapii u zhenshchin detorodnogo vozrasta, stradaiushchikh bolezn'iu Khodzhkina.

A menstrual function was studied in 24 females treated by drugs for advanced stages of Hodgkin's disease. 17 of them received oral contraceptives for preventing gonadotoxic effect of cytostatic agents (the study group). 7 women did not use contraceptives (the control group). After chemotherapy menstrual cycle was normal in 88.2% of patients of the study group, whereas in 71.4% of controls artificial menopause developed. Oral contraceptives can be recommended to protect the ovaries in the course of chemotherapy.