[The combination of chronic myeloid leukemia and multiple myeloma in one patient].

The article describes the clinical observation of a patient with simultaneous course of lymphoid and myeloid neoplasms. The patient developed two diseases--chronic myeloid leukemia (CML) and multiple myeloma (MM), which were confirmed by corroborated hemogram, myelogram, immunophenotyping of bone marrow cells, biopsy, immunohistochemical, cytogenetic, biochemical and radiological studies. Target therapy of CML with tyrosine kinase inhibitors (imatinib at the standard dose of 400 mg per day) has provided a complete cytogenetic remission at 6 months and major molecular response at 18 months of treatment. Administration of 2 courses of programmed treatment "BD" > (bortezomib + dexamethasone) resulted in a very good partial response, which was maintained through a year and a half. However, against the background of programmed treatment there were developed complications as polyneuropathy of grade 2, which was treated with thioctacide, milgamy, and anemia of grade 2, successfully treated with epoetin beta. Subsequently, the patient was administered continuously with imatinib 400 mg that kept the major molecular response. Relapsed MM was revealed in 20 months and confirmed by a full clinical and hematological examination. The absence of organ dysfunction allowed choosing a supervisory tactics for the patient.

[Bone marrow structure and HIV infection]. / Struktura kostnogo mozga pri VICh-infektsii.

Bone marrow hematopoietic tissue and stromal elements were characterized histologically on iliac bone trepanobioptats from 8 HIV infected patients. Signs of dyserythropoiesis, dysgranulocytopoiesis, dysmegakaryocytosis, focal accumulations of plasmocytes lymphoid and histiocytic cells were demonstrated. Changes of hematopoietic tissue were accompanied by reorganization of stromal microenvironment. Growth of intramedullar reticuline cells quantity and decline in number of endosteal stromal cells were found.

[Morphofunctional characteristics of stromal structures of bone marrow in aplastic anemia patients]. / Morfofunktsional'naia kharakteristika stromal'nykh struktur kostnogo mozga u bol'nykh aplasticheskoi anemiei.

Stromal structures of the bone marrow in 22 patients with aplastic anemia (AA) were studied histophotometrically. A significant increase of the fat tissue volume and a decrease of hematopoietic tissue volume were observed. Bone tissue volume was significantly increased in 81.8% of patients, the number of endosteal cells was increased in all the patients and that of reticular cells in one third of them. The conclusion is made that hematopoietic microenvironment of the bone is not a determining factor in the majority of AA patients. Excessive bone formation might be one of the mechanisms of aplasia development.

[Structure of the bone marrow stroma and hematopoiesis following chemotherapy in patients with acute myeloblastic leukemia]. / Struktura stromy kostnogo mozga i gemopoéz posle khimioterapii bol'nykh ostrym mieloblastnym leikozom.

Histometric methods were used to examine interrelations between hemopoiesis and bone marrow stroma in the trepanned iliac bones from 17 healthy subjects, 30 patients with acute myeloblastic leukemia and 6 patients at different times after chemotherapy. In health, young granulocytes were located endosteally, less frequently along the periphery of the vessels and around reticular cells. Erythro-normoblasts were mostly demonstrable perivascularly or near reticular cells and macrophages. During acute myeloblastic leukemia the interrelations under consideration were deranged. The significance of the endosteum in the regeneration of the stroma and hemopoiesis after cytostatic aplasia is demonstrated.

[Morphologic features of bone marrow in myelodysplastic states]. / Morphologicheskie osobennosti stromy kostnogo mozga pri mielodisplasticheskikh sostoianniiakh.

The results of histological and ultrastructural studies of bone marrow hemopoietic microenvironment carried out in 27 patients with different myelodisplasias are presented. The following morphological peculiarities of bone marrow stromal tissue have been identified: abnormal localisation of immature hemopoietic cells, reticuline fibrosis, disorganized erythroid islands, and intranuclear virus-like pathologic inclusions in all stromal cells. The structure of nucleoli in endosteal and perivascular cells was changed. It was shown that morphofunctional changes in hemopoietic environment may lead to hemopoietic disorders.

[Structural and functional changes of bone marrow stroma in chronic lymphocytic leukemia]. / Strukturnaia i funktsional'naia perestroika stromy kostnogo mozga pri khronicheskom limfotsitarnom lekoze.

Marrow stroma was investigated in 20 patients with chronic lymphocytic leukemia (CLL). Such morphological and functional features as adipose tissue reduction, sinusoid pattern obliteration and increased number of reticular cells were identified as typical of marrow stroma in such patients. Foci of fibrosis, nuclear bodies in stromal cell nuclei and heightened proliferation of stromal precursors in organ cultures were recorded in the subendostal and perivascular areas in 60% of patients with diffuse lesions of bone marrow. Bone marrow stroma was shown to suffer morphological and functional changes which were particularly pronounced in diffuse lesions of the bone marrow. Such changes may be traced both to the malignant clone of lymphoid cells and stromal lesions.

[Morphologic and functional features of hemopoietic microenvironment in acute lymphoblastic leukemia]. / Morfofunktsional'nye osobennosti krovetvornogo mikrookruzheniia pri ostrykh limfoblastnykh leikozakh.

Data of the histological, ultrastructural and culture cell investigations of bone marrow microenvironment in 20 patients with acute lymphoblastic leukemia (ALL) are presented. Morphological and functional peculiarities of the patients' bone marrow stroma different from that in healthy subjects were identified. They included distorted histotopographic patterns of stroma-hemopoietic cell-to-cell interaction, obliteration of sinusoid counts, resorption on the sites of internal bone support structures, a changed stromal cells ratio, formation of reticular cell clusters in the subendosteal and perivascular bone marrow areas, fibroid centers, the presence of nuclear bodies in stromal cell nuclei and an intensified proliferation of stromal cell precursors in organ tissue cultures. Morphological and functional changes in bone marrow microenvironment were detected in ALL patients, which could have been caused both by malignant cell clones and stromal defects.

[Nature of stromal elements of the human bone marrow capable of releasing humoral stimulators of precursor cells of granulomonocytopoiesis]. / Priroda stremal'nykh élementov kostnogo mozga cheloveka, obladaiushchikh sposobnost'iu vydeliat' gumoral'nye stimuliatory kletok-predshestvennits granulomonotsitopoéza.

Whole bone marrow fragments of trepanobiopsies of the upper flaring portion of the ilium were cultivated over 1 to 8 weeks in a liquid phase of the agar drop-liquid medium system. Fifty-two hematological patients and controls were examined in order to study the character of regeneration of different stromal cells and their role in the production of stimulants of precursor cells of granulomonocytopoiesis. It was shown that during cultivation of bone marrow fragments precursors of the stromal cells form a monolayer at the dish bottom, forming a capsule around the fragments and proliferating inside the medullary lacunae. Endosteum is the main source of the regeneration of the stromal elements. The studies did not reveal any relationship between the colony-stimulating activity of the trepanobiopsies and the area occupied in them by sinuses, fibrous and osseous tissue. A positive correlation was established between the CSA and the number of fatty cells. The magnitude of the area of the stromal cell monolayer did not influence colony formation. Based on the data obtained the authors suggest that fatty acids are the main producers of the CSA within the system under consideration.

[Clinical biological features of mixed myeloid diseases]. / Kliniko-biologicheskie osobennosti smeshannykh mieloidnykh zabolevanii.

AIM: To characterize patients with mixed myeloid neoplasias with proliferation of neutrophils, platelets and eosinophils. MATERIAL AND METHODS: Examination and treatment results were analysed for patients with atypical myeloid leukemia (n = 4), myelodysplastic syndrome (MDS, n = 1) and thrombocytosis, MDS and eosinophilia (n = 1). The examination included morphological, histological, cytogenetic and molecular tests. RESULTS: One patient with atypical chronic myeloid leukemia was prior diagnosed to have primarily MDS with a typical aberration of chromosome 5. Two other patients had an initial morphological picture of resistant anemia with blast excess, signs of myeloproliferation and extramedullary hemopoiesis. One and two months after the first examination they received transfusions of erythrocytic mass. Just then they were found to have splenomegaly and leukocytosis due to proliferating and maturating forms of neutrophils. The course of the disease in patients with MDS, thrombocytosis and normal karyotype and in patients with MDS, eosinophilia and combined chromosomal breaks including translocation (3;12)(q21;p13) was characterized by resistance to standard programs of polychemotherapy and transformation into acute myeloblastic leukemia. CONCLUSION: In some cases atypical CML is a stage of a natural course of MDS. Some MDS variants with eosinophilia and thrombocytosis should be referred to the group of mixed myeloid neoplasias.

[Treatment of chronic lymphocytic leukemia in relation to clinico- morphological characteristics of the disease]. / Lechenie khronicheskogo limfoleikoza v zavisimosti ot kliniko- morfologicheskikh osobennostei zabolevaniia.

Marrow histomorphometry was performed in 73 untreated chronic lymphoid leukemia (CLL) sufferers. Follow-up results are available for 36 of them: 25 treated and 11 untreated with chemotherapy. The method of marrow histomorphometry allows recognition of three CLL forms: diffuse, diffuse-focal and focal; helps to determine indications to chemotherapy, assess its efficacy, prognosticate the disease course; is more reliable than clinical and laboratory findings.

[Enhanced osteogenesis in severe aplastic anemia]. / Usilenie osteoobrazovaniia pri tiazeloi aplasticheskoi anemii.

Histologic specimens of the bone marrow were obtained from healthy subjects and aplastic anemia (AA) ones. Comparison of the histomorphometry was indicative of an increase in spongy bone tissue and in the number of osteoid cells in AA. This indirectly suggested enhanced proliferative activity of osteogenic precursors and osteosynthesis in AA. Interrelationship is probable between osteogenesis and hemopoiesis.

[Ultrastructural organization of the hematopoietic microenvironment of human bone marrow]. / Ul'trastrukturnaia organizatsiia krovetvornogo mikrookruzheniia kostnogo mozga cheloveka.

The results have been presented of electron-microscopic and ultracytochemical investigations of sinusoidal vessels, fat, reticular and endosteal cells of the bone marrow from the iliac bone fragments of 30 normal subjects. Close morphological and functional relationships have been established between the structures of the hemopoietic microenvironment and hemopoietic cells, and the role of certain stromal elements in the maintenance of the hemopoietic function has been specified.

[Sonographic and histomorphologic parallels in various histologic variants of chronic myeloid leukemia]. / Sonograficheskie i gistomorfologicheskie paralleli pri razlichnykh gistologicheskikh variantakh khronicheskogo mieloleikoza.

Histomorphometric findings at the study of marrow puncture specimens were compared to sonographic picture of the liver and spleen in 20 myeloid leukemia chronic. Histomorphometric and sonographic changes observed showed parallel pathological processes in the hemopoietic micro-surroundings and in the liver, spleen. Sonography proved able to considerably broaden diagnostic armory of the physician, to prognosticate leukemia outcomes, thus suggesting a differential approach to the disease treatment.

[New ultrastructural characteristics of the bone marrow stromal cells in patients with aplastic anemia]. / Novye ul'trastrukturnye osobennosti stromal'nykh kletok kostnogo mozga bol'nykh s aplasticheskoi anemiei.

Unlike hemopoietic cell, stromal cells of aplastic anemia patients' bone marrow undergo pathological shifts. This has been proved by ultrastructural investigations which showed intranuclear inclusions structurally similar to virus bodies. The latter are divided into three types this allowing follow-up of the inclusions to mature forms seen in the stromal cells cytoplasm. The findings suggest primary viral affection of stromal cellular elements of aplastic anemia patients' bone marrow. The attention is also drawn to ultrastructural shifts recorded in adipose cells in aplastic anemia.

[A comparative analysis of the effect of alpha 2-interferon (reaferon) therapy on the morphofunctional state of the bone marrow in patients with chronic myeloleukemia]. / Sravnitel'yi analiz vliianiia terapii al'fa 2-interferonom (reaferonom) na morfofunktsional'noe sostoianie kostnogo mozga u bol'nykh khroniceskim mieloleikozom.

Marrow trepan biopsy was performed in 11 patients upon diagnosis of chronic myeloid leukemia and in clinicohematological remission of the disease. The patients were treated with alpha 2-interferon (reaferon) versus conventional myelosan (6 and 5 patients, respectively). The biopsies were studied histomorphometrically. In reaferon group the number of megakaryocytes and endosteal stromal cells diminished. This may be due to an indirect action of reaferon on hemopoietic tissue via endosteal cells of the marrow stroma. Reaferon is recommended for myeloid leukemia chronic with a granulocytic-megakaryocytic histological variant of the disease.

[Morphologic structural characteristics of the hematopoietic microenvironment in patients with multiple myeloma]. / Morfologicheskaia kharakteristika struktur krovetvornogo mikrookryzheniia u bol'nykh mnozhestvennoi mielomoi.

The authors' investigations found plasmocytic infiltration of bone marrow and marked resorption of bone tissue in patients with multiple myeloma (MM). Instead of the expected reduction in bone marrow volume the latter slightly increased. MM patients have significantly higher quantity of endosteal stromal cells, accumulations of osteoblastic cellular elements considered as initial osteogenesis. A close correlation was revealed between bone tissue volume, number of erythroid elements in bone marrow and red cell count in peripheral blood. Volume of fatty tissues in MM patients is low. MM patients demonstrate pronounced morphofuctional disturbances in hemopoietic microenvironment of bone marrow.

[Various morphofunctional characteristics of hematopoietic tissue in preleukemic conditions]. / Nekotorye morfofunktsional'nye osobennosti gemopoéticheskoi tkani pri predleikoznykh sostoianiiakh.

Cultural, ultrastructural, cytochemical and histological investigations of bone marrow tissue were conducted in 26 patients with varying types of preleukemia states. A number of early structural, morphological and functional signs of hemopoietic disorders of different character and manifestation degree have been revealed. Particularly, a relationship has been established between the pathologic changes appearing in the bone marrow stroma and disorders in the morphological and functional state of the hemopoietic cells.

[Erythrocyte preservative based on a solution of modified deionized gelatin with adenine and sodium phosphate]. / Konservant dlia éritrotsitov na osnove rastvora modifitsirovannogo deioinizirovannogo zhelatina s adeninom i natriia fosfatom.

The paper reports storage properties of a new erythro-preservative made of the solution of modified deionized gelatin with addition of adenine and disodium phosphate. 42-day storage of red cell suspension in the above preservative was assessed in comparison to Modejele preservative according to the following characteristics: free hemoglobin, the count of osmotically unstable red cells, red cell ATP concentration, red cell deformability index, zeta-potential, extracellular potassium and sodium concentrations, amount of microclots, acid-base condition of the suspensions, blood rheology. Control and test parameters showed the greatest difference by ATP concentrations: on storage day 42 ATP in the controls made up 58.9%, in the test series 77.8% against the baseline. Red cell deformability under storage in the new preservative also tended to a decrease. The rest test parameters did not differ much in the control and test series. Acute mouse, chronic rat, rabbit and dog experiments proved low toxicity of the preservative. The repeated introduction of the preparation brought about a slight shift to hypercoagulation.