[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.

[Prognosis factors in imatinib mesilate therapy in patients with a chronic phase of Ph-positive chronic myeloid leukemia: data from a multicenter non-randomized trial in Russia].

AIM: To reveal prognostically significant factors affecting efficacy of glivek therapy in untreated (duration of the disease < or = 6 months) and pretreated (duration of the disease > 6 months) patients with chronic myeloid leukemia (CML) in a chronic phase. MATERIAL AND METHODS: A total of 338 patients (64 untreated and 274 pretreated) with a chronic-phase CML on glivek therapy entered the trial. RESULTS: Five-year survival on glivek was high (89, 98 and 88% in untreated and pretreated patients, respectively). Incidence of transformation in the acceleration phase and blast crisis was low both in untreated and pretreated patients (1.6 and 11%, respectively) and correlated with the rate of a complete cytogenetic response (CCR). Untreated patients had no factors affecting treatment efficacy negatively, CCR probability was 96%. Blastemia, thrombocytosis and splenomegaly reduced CCR probability significantly in pretreated patients. Slow reduction of the tumor mass, late achievement of a complete hematological response and a cytogenetic response decreased probability of CCR. CONCLUSION: Glivek is a drug of choice for patients with chronic-phase CML. High probability of CCR both in untreated and pretreated patients lowers the risk of the disease transformation into the phase of acceleration/blast crisis and raises overall survival in both groups.

[Low doses of alpha-interferon preparations in the treatment of patients with chronic myeloleukemia]. / Malye dozy preparatov al'fa-interferona v lechenii bol'nykh khronicheskim mieloleikozom.

AIM: To compare the effects of low-dose alpha-interferons with those of cytostatics (hydroxyurea or myelosan) on survival of patients and duration of chronic phase of chronic myeloid leukemia (CML). MATERIAL AND METHODS: 107 CML patients were divided into two groups. 28 patients (15 males and 13 females) aged 17-59 entered group treated with alpha-interferon drugs. 79 control patients (35 males and 44 females) aged 15-79 received standard chemotherapy (hydroxyurea or myelosan). RESULTS: 3-year survival in the study group and controls was 94 and 67.5%, respectively. 5-year survival--70.8 and 28.9%, respectively. The survival medians for the groups were 66 and 48 months, respectively. 36 months after CML diagnosis, chronic phase of the disease still continued in 90.2% of the study group patients and in 53.4% of patients on chemotherapy. 54 months after the diagnosis the chronic phase was registered in 56.5 and 24% of patients, respectively. The medians made up 54 and 39 months, respectively. CONCLUSION: Treatment of CML with low-dose alpha-interferons increases duration of the CML chronic phase and survival of CML patients.

[Alpha-interferons in the treatment of patients with chronic myeloid leukemia]. / Al'fa-interferony v lechenii bol'nykh khronicheskim mieloleikozom.

Chronic disease duration and survival have been investigated in three groups of patients suffering chronic myeloid leukemia (CML). The first group included 13 patients on alpha-interferons 6-9 mln MU/24 h (mean dose--48 mln MU/week). 31 patients received 2 mln MU/m2/24 h; mean weekly dose--15 x 10(6) MU. Standard chemotherapy was given to another 79 patients (group III). Actual survival and chronic disease duration were computed after Kaplan-Meyer: 4-year survival in group I--88%; group II--85.6% and group III--54%. Five-year survival in patients who had received standard or lower doses of alpha-interferon was 78.7%; chemotherapy alone--28.9%. Median survival in alpha-interferon-treated patients was 66 months; chemotherapy--48 months. After standard alpha-interferon, chronic disease three years after CML diagnosis was in 87% of those treated with standard alpha-interferon, 89% of those receiving lower doses of the drug and 53.4% of chemotherapy-treated patients. After 4 years, chronic disease was registered in 75.5% (alpha-interferon)--74.8% in group I and 72.9% in group II, and in 34.4% of patients treated with myelosan or hydroxyurea. Median chronic stage duration after interferon was 51 months and 39 months in group III, hence, both standard and lower doses of alpha-interferon prolong chronic disease and improve survival in CML patients.

[The efficacy of treatment with native lymphoblast alpha-interferon (Wellferon) in patients with chronic myeloleukemia]. / Effektivnost' lecheniia nativnym limfoblastoidnym alfa-interferonom (vellferonom) bol'nykh khronicheskim mieloleikozom.

Data are submitted on treatment with vellferon of patients with chronic myeloid leukemia (CML) in the chronic phase of the illness. The data obtained suggest that vellferon has a pronounced therapeutic effect in CML patients. The drug has a positive effect on both the clinical- and hematological status and cytogenetic changes in bone marrow cells. After 3-month treatment of patients with vellferon the sizes of the liver and spleen returned to normal as did the peripheral blood leucocyte and platelet counts. Two patients revealed a minimum cytogenetic response to therapy, one patient achieved a complete cytogenetic remission, and only 1 patient failed to demonstrate a cytogenetic response. A six-month therapy was associated with a complete clinical-and-hematological remission in 4 (80%) patients, with its duration ranging between 4 to 5 months, all patients maintaining a minimum cytogenetic response to vellferon treatment. Thus, treatment with vellferon permits obtaining not only a clinical and hematological but also a cytogenetical response to therapy in a major proportion of CML patients.