[Prognostic value of a number of blood laboratory parameters in the use of erythropoiesis-stimulating agents in anemic patients with lymphoproliferative diseases].

AIM: To clarify the prognostic value of the baseline blood levels of endogenous erythropoietin (EE) and tumor necrosis factor-a (TNF-a) involved in the key components of the pathogenesis of anemia in lymphoproliferative diseases (LPD), the counts of reticulocytes and platelets (hematopoietic preservation indicators) in the use of erythropoiesis-stimulating agents (ESAs) to correct anemia syndrome (AS) in patients with LPD. SUBJECTS AND METHODS: The results of AS treatment with ESAs were analyzed in 48 patients with LPD. A study group comprised patients with chronic lymphocytic leukemia (n=1 3), indolent lymphomas (n=14), and multiple myeloma (n=21). Their hemograms (hemoglobin concentration, red blood cells, packed cell volume, reticulocytes, and platelets) and blood EE and TNF-alpha levels were examined before using ESAs. The hemogram was monitored during treatment. ESAs (eralfon (epoietin alpha) in 21 patients and epres in 27) were subcutaneously injected in a dose of 150 IU/kg thrice weekly (for not more than 16 weeks). A control group included 21 anemic patients with multiple myeloma who did not receive ESAs. Increasing hemoglobin concentrations up to 120 g/l was regarded as a positive response to ESA treatment. RESULTS: By and large, the efficacy of epoietin alpha was 62.5% (61.9% for eralfon and 63.0% for epres), which was significantly higher than that in the control group (23.4%; p<0.05). A number of blood laboratory parameters were found to be of value in predicting the efficacy of ESAs. The patients with the decreased baseline concentrations o EE ( <130 mlU/ml) and TNF- alfa (,15 pg/ml) were ascertained to show a positive response more frequently (80 and 92.9%, respectively; p<0.05) than those with thepredicting the efficacy of ESAs. The patients with the decreased baseline concentrations of EE (<130 mlU/ml) and TNF-a (<15 elevated concentrations of the enzymes in question. In addition, a positive response was more often recorded in patients with reticulocyte counts of more than 1% (77.4%; p<0.05) and platelets of 100-10(9)/1 (70%; p=0.05). CONCLUSION: Estimating the baseline blood levels of EE and TNF-a and the counts of reticulocytes and platelets prior to the use of ESAs enables prediction of the efficiency of erythropoiesis-stimulating therapy in anemic patients with LPD.

[Effect of emulsions of carbon perfluoride compounds on the blood plasma complement system and functional state of the rabbit brain]. / Vliianie émul'sii perftoruglerodnykh soedinenii na sistemu komplementa plazmy krovi i funktsional'noe sostoianie mozga krolikov.

Experiments were conducted in vitro on rabbits to study the effect of emulsions based on composition of carbon perfluorides (decalin perfluoride/methyl cyclohexyl piperidine perfluoride) and proxanol (P-268) on the blood complement system. It is shown that despite preservation of the composition some emulsions activate complement others fail to do this. Intravenous infusion of complement-activating emulsion in a test-dose leads to early neutropenic reaction in the peripheral blood of rabbits and intensified power of low frequency rhythms in the electrocorticogram.

[Activation of the complement system of plasma and the changes in various parameters of homeostasis in rats after intravenous administration of emulsion of organoperfluorine compounds]. / Aktivatsiia sistemy komplementa plazmy krovi i izmenenie nokotorykh parametrov gomeostaza posle vnutrivennogo vvedeniia krysam émul'sii perftororganicheskikh soedinenii.

Anticomplementary activity of emulsion based on the organoperfluorine compounds (PFC) perfluorodecalin and perfluorotripropylamine (7:3) has been shown in vitro. A temporary reduction of the neutrophil number up to 25% of the initial level was recorded 5 min after intravenous plethoric administration of 1.0 ml of this emulsion to rats. A drop in the arterial pressure and blood minute volume was observed in half of the animals, 30 and 60 min later impairment of the body oxygen regimen resulting in tissue hypoxia was recorded in all the rats. It has been suggested that the disorders observed in the animals are caused by the action of varying mediators produced due to the intravascular activation of the complement by PFC.

Side reaction caused by the perfluorocarbon emulsions in intravenous infusion to experimental animals.

The perfluorocarbon (PFC) emulsions are infusion gas-transporting media and are usually called the artificial blood. However anaphylactoid reaction were observed during intravenous infusion of PFC emulsions. The cause of side reactions is the activation of the complement system. An indirect sign of the intravascular activation of the complement is the neutropenic effect in the peripheric blood. Taking into consideration the phenomen, the method of evaluation of anaphylactoid reaction caused by PFC emulsions has been elaborated using the neutropenic index. We evaluated the biocompatibility of 26 PFC emulsions of different composition in intravenous infusion to rabbits using this index. Emulsions evoked reactions of different extent. Some emulsions did not cause the neutropenic effect at all. Results of this work allow to reach conclusion, that influence of PFC emulsions on the complement system is explained not only by emulsifying agent proxanol: the stability of emulsions in the vascular bed and in the period of storage in frozen state is of great importance as well.