[Multiple myeloma: response to treatment and survival of patients according to the interim analysis of the Russian observational, retrospective-prospective, multicenter cohort study (MULTISPECT)].

AIM: The primary objective of the interim analysis of the MULTISPECT study was to evaluate the short-term efficacy of the treatment and long-term outcomes in cohorts of primary and pretreated patients with multiple myeloma (MM) receiving treatment in actual clinical practice in various regions of the Russian Federation. Secondary objectives were a description of the main characteristics of patients; analysis of the most commonly used therapy regimens of the 1st and later lines and the sequence of their changes; evaluation of the response to therapy. Additional objectives included evaluation of the effect of the new COVID-19 coronavirus infection on the course of MM in patients. MATERIALS AND METHODS: The study is an observational retrospective-prospective multicenter cohort study. For its implementation, a structured database of patients with MM was used, provided by hematologists of the centers affiliated for the study. RESULTS: The study included 1,294 patients (cohort 1 806, cohort 2 488). In both cohorts, patients aged 6069 years were in the majority. 3 lines of therapy (L1, L2, L3) were used for cohort 1; in cohort 2, the 4th line of therapy was also used in 2 patients. The therapy regimens were analyzed for 290 (22.41%) of all patients in the study. Responses to therapy were analyzed for 214 patients of cohort 1 and 109 patients of cohort 2. Autologous and allogeneic hematopoietic stem cell transplantations were carried out for a limited proportion of patients in both cohorts. At the end of the study and upon presentation of its results, the status of patients was the following: 96% of patients in cohort 1 and 89% in cohort 2 were alive. The therapy regimens in both cohorts were characterized by variability. The most commonly used regimens in each of the lines of therapy have been identified. The most used therapy regimen in patients with MM of both cohorts was the VCD-regime. Rd-regime in cohort 1 and RD-regime in cohort 2 were the second most frequent used regimens. In patients of both cohorts, the therapy regimens including Bortezomib were most often used. CONCLUSION: The variety of therapy regimens used to treat MM in actual clinical practice may be due to the factors of availability of new medicines and updated recommendations for the treatment of the disease. Further, in the context of this study, a more detailed analysis of the efficacy of certain therapy regimens in the 1st and later lines on progression free survival and overall survival of MM patients should be carried out.

[Comparison of the clinical benefits of second-line drugs modifying the course of multiple sclerosis]. / Sravnenie klinicheskikh preimushchestv preparatov vtoroi linii, izmenyayushchikh techenie rasseyannogo skleroza.

This review aims at describing clinical benefits and characteristics of the main highly effective disease modifying drugs (DMD) for multiple sclerosis (MS): alemtuzumab, cladribine tablets, ocrelizumab, natalizumab, fingolimod based on the efficacy and safety. The authors highlight that all MS DMDs have certain benefits and features that shall be considered in prescribing pharmacotherapy. Cladribine in tablets are comparable by the efficacy to other modern highly effective second-line drugs, have a high level of evidence and a favorable safety profile, as well as the most preferred benefit/risk ratio among other MS DMDs indicated for the treatment of highly active MS, which offers an advantage to the drug. The use of cladribine in tablets will contribute to further study of the efficacy and safety of this highly efficient drug for MS treatment.

[The patterns of alteration of content of growth-stimulating and growth-inhibiting factors in blood serum under ß-cell chronic lymphatic leukemia and their diagnostic value.]

The article evaluates balance of growth-stimulating and growth-inhibiting factors in blood serum of patients with different stages of B-cell chronic lymphatic leukemia residing on examination and hospital treatment in Saratov clinic of occupational pathology and hematology in 2007-2016. The indices of content of VEGF165, PDGF-AB, pRb, p53 and p73 in blood serum was detected using solid-phase enzyme-linked immunosorbent assay. The specific characteristic of B-cell chronic lymphatic leukemia became stably higher content of growth-stimulating cytokines of development of disease that permitted to conclude about (VEGF165, PDGF-AB) in dynamics of development of disease that permitted to conclude about their important role in mechanisms of oncogene transformation and stimulation of proliferation activity of neoplastic cells at various stages of pathology. At the same time, disturbance of anti-proliferation signals under B-cell chronic lymphatic leukemia was characterized by singleat-once decreasing of controlling cell cycle of several mechanisms of regulation of changing G1-phase to S-phase conditioned by low level of inhibitors of cyclin-dependent kinases (p53 and p73) and inadequate expression of regulator of cellular cycle of protein pRb.

[The diagnostic and prognostic value of increase of blood pro-inflammatory and anti-inflammatory cytokines in chronic lymphatic leukemia].

The article presents the results of study of cytokine profile of blood of patients with B-cell lymphatic leukemia. It is established that at diferent stages of disease the regular characteristic of changes in cytokine status is the increase of concentration of interleukin 4 (IL=4) and tumor necrosis factor This fact can be considered as one of leading pathogenic factors leading to disturbances of intercellular interaction in lymphoid tissue and to development of systemic metabolic and functional disorders. The parallelism between progressing increase of concentration of interleukin 4 and a-tumor necrosis factor character of qualitative and quantitative alterations of cell structure of peripheral blood, severity of clinical manifestations of disease are established. The indicators of concentration of interleukin 4 and a-tumor necrosis factor in blood are the objective diagnostic and prognostic criteria ofpathology development. They can complement the classification attributes of staging of the course of chronic lymphatic leukemia.