[The clinical significance of bone involvement in patients with primary lymphogranulomatosis]. / Klinicheskoe znachenie porazheniia kostei u pervichnykh bol'nykh limfogranulematozom.

A retrospective analysis of 2450 case histories of primary Hodgkin's disease established bone lesions incidence at 3.8%. They occurred in cases of general symptoms (6%) rather than otherwise (1.6%). Bone involvement came about chiefly via the blood flow pathway (59%), with several bones being involved in most cases. Dissemination through contact was less frequent 39%), the breast bone or vertebrae being involved relatively more often. Both radiation and polychemotherapy caused local healing effect which would lead to full recovery of bone structure in some cases. Therefore, combined (polychemotherapy + radiation) treatment should be recommended in cases of single lesions whereas treatment for multiple lesions may be limited to medication.

[Pleural lesions in patients with Hodgkin's disease with pulmonary involvement]. / Porazhenie plevry u bol'nykh limfogranulematozom s vovlecheniem v protsess legkikh.

A retrospective study of 334 primary patients with Hodgkin's disease with the affected mediastinal lymph nodes and pulmonary tissue (stages IIE, IV) was carried out. Pleural affection was detected in 280 (88.8%) patients. Limited pleural affection resulting from contact dissemination from the enlarged lymph nodes was shown to make no effect on prognosis. Generalized involvement of the pleura was shown to deteriorate considerably a course of disease in patients with contact (localized) pulmonary involvement and to have no prognostic importance in disseminated involvement.

[The combined (polychemical and radiation) and drug treatment of lymphogranulomatosis patients with generalized lung involvement (stage IV)]. / Kombinirovannoe (polikhimio- i luchevoe) i lekarstvennoe lechenie bol'nykh limfogranulematozom s generalizovannym porazheniem legkikh (IV stadii).

The paper is concerned with analysis of the peculiarities of a course of disease and effectiveness of different therapeutic programs in 121 primary patients suffering from Hodgkin's disease with generalized lung lesion (true stage IV). The 5-year total and recurrence-free survival of patients after polychemoradiotherapy was 59.5 and 45.6%, respectively. Prognosis of disease in patient with generalized lung lesion is determined mainly by the development of a specific process in pulmonary tissue and, to a lesser degree, by spreading of disease via the lymphatic collectors. The authors have shown the appropriateness of combined therapy of this group of patients. Therapy includes cycles of polychemotherapy for achieving remission and radiotherapy including total irradiation of the affected lung for its consolidation.

[Malignant neoformations of the hematopoietic and lymphoid tissues in the personnel of the 1st plant of atomic industry]. / Zlokachestvennye novoobrazovaniia krovetvornoi i limfaticheskoi tkanei u personala pervogo predpriiatiia atomnoi promyshlennosti.

Rates of mortality from hemopoietic and lymphoid malignancies for 1948-1987 were studied in male staff of industrial atomic reactors and radiochemical industry for irradiated uranium processing versus dose of external gamma radiation. An increase in mortality due to radiation--induced acute leukemia was registered in the radiochemical industry staff 5-10 years following the start of exposure and was associated with high dose of external radiation. The risk of acute leukemia for this period was 1.65 x 10(-3) x Sv-1 cases during 5 years whereas within the other 30-35 years of follow-up the risk of death from hemolymphoblastosis or acute leukemia was less than 1 x 10(-3) x Sv(-1) during 5 years.

[Course of lymphogranulomatosis with primary location below the diaphragm]. / Osobennosti techeniia limfogranulematoza pri pervichnoi lokalizatsii porazheniia nizhe diafragmy.

Some peculiarities in a course of stage I-II Hodgkin's disease with a primary site below the diaphragm are analyzed. This site is more common in men and in a mixed cell histological variant of lymphogranuloma. The frequency of recurrence is higher in this group than in patients with a primary site above the diaphragm. Recurrences affect more frequently the lymphatic areas above the diaphragm. The data obtained suggest the necessity of irradiation of the lymphatic collectors on both sides of the diaphragm in a primary site below the diaphragm, particularly in patients with "mixed cell" and "lymphoid depletion" histological variants of lymphogranuloma.

[The bone marrow in Hodgkin's disease following radiotherapy and splenectomy]. / Kostnyi mozg pri limfogranulematoze posle luchevoi terapii i splenéktomii.

A study was made of the bone marrow status in unirradiated zones of 33 patients with stage I-II Hodgkin's disease in complete 9-12 year remission after therapeutic irradiation of the lymphatic collectors of the upper part of the trunk in combination with irradiation of the spleen (16 patients) or splenectomy (17 patients). The total count of myelokaryocytes, myelogram, a relative and absolute content of lymphoid cells, immature granulocytes and elements of the erythroid series were defined in the punctates of the upper portion of the ilium. T- and B-lymphocyte count, the number of granulocytomacrophage (CFU-C) and stromal (CFU-F) precursor cells were defined using morphocytochemical and immunological methods. At that time an increase in the relative and absolute content of C- and B-lymphocytes was noted. The T-cell count and the total number of myelokaryocytes, on the one hand, and the content of immature granulocytes and erythronormoblasts, on the other hand, showed correlation of various degree which was particularly noticeable in the group of unoperated patients. The total number of myelokaryocytes in 1 microliter of the bone marrow of the patients after splenectomy, on an average, significantly exceeded that in the group of patients with the irradiated spleen. These changes were considered to be a result of the rearrangement of T-differentiating lymphocytes with their raised accumulation in the bone marrow after irradiation of a considerable volume of the lymphoid tissue and spleen or after splenectomy.

[Ultrasound diagnosis of the involvement of retroperitoneal and abdominal lymph nodes in Hodgkin's disease]. / Ul'trazvukovaia diagnostika porazheniia zabriushinnykh i abdominal'nykh limfaticheskikh uzlov pri limfogranulematoze.

Ultrasonography and lymphography have been carried out in 238 patients with Hodgkin's disease to define the stage, recurrences and evaluate the efficiency of treatment. In 35 cases the results have been verified by morphologic study of lymph nodes removed during laparotomies. The results of ultrasonic study demonstrate involvement of lymph nodes of the spleen hilum, liver and other abdominal nodes found in 14 out of 115 untreated patients. The involvement of the nodes below the diaphragm has been found in 39 patients out of 123, subjected to different treatments. The significance of the technique in evaluating treatment efficiency, diagnosing recurrences and progression of the process has been shown.

[Function of the bone marrow stroma in patients with lymphogranulomatosis undergoing radiation therapy]. / Sostoianie stromy kostnogo mozga bol'nykh limfogranulematozom, podvergavshikhsia louchevoi terapii.

Monolayer cultivation of the radiated bone marrow was performed in 39 lymphogranulomatosis patients with a long-term remission attained after radiotherapy according to the radical program. In 41 patients, the non-radiated bone marrow was also subjected to monolayer cultivation. Counts were made of the total number of myelokaryocytes and myelogram. Analysis of the punctates from the radiated areas has shown that the growth of fibroblast colonies occurred where complete or partial recovery of the cellularity was detected and the total focal dose per bone marrow was less than 35 Gy. With the use of large doses the growth of the colonies was detected in none of the cases. In the radiated areas, the patients commonly manifested bone marrow aplasia. Investigation of the punctates from intact areas pointed to the growth of the colonies in the majority of cases whereas the myelogram count to the increased percentage of the reticular cells, lymphoid and erythroid elements.

[Role of splenectomy in impairing lymphocyte elimination in patients with lymphogranulomatosis]. / Rol' splenéktomi v narushenii éliminatsii limfotsitov u bol'nykh immunogranuletmatozom.

The study group included 113 patients in a continuing 1 to 10 year-long complete clinical-hematological remission from Hodgkin's disease. 43 of them had prior splenectomy. The latter revealed a higher level of lymphocytes (chiefly 0-cells) and a diminished response of mononuclear blood cells to PHA as compared to the other patients and healthy controls. Also, they had more lymphocytes which became capable of E-rosette formation following a short-term incubation at 37 degrees C (lymphocyte reactivation by means of surface modification). The negative correlation between the reactivated T-cells level and mononuclear cell response to PHA suggested a functional blocking of T-cells involving damage to membranes. The absence of reactivated T-lymphocytes in nonsplenectomized patients was regarded as circumstantial evidence for the role played by the spleen in withdrawing faulty lymphocytes from peripheral blood.

[Ultrasonic diagnosis of splenic and hepatic lesions in lymphogranulomatosis]. / Ul'trazvukovaia diagnostika porazhenii selezenki i pecheni pri limfogranulematoze.

Ultrasound investigation was conducted in 21 patients with Hodgkin's disease to determine the involvement of the spleen and liver in the process. The results obtained were verified histologically in 19 cases at laporotomy and in 2 cases at autopsy. Focal spleen lesion (focal sizes from 0.3-2 cm) was correctly recognized in 7 out of 9 patients, liver lesion in 3 out 4 patients. No false-positive results were obtained in cases in which spleen and liver lesions were not determined histologically. The value of ultrasound investigation for dynamic observation in liver lesion was emphasized. The method was recommended for a wide clinical use and assessment of therapeutic results of disseminated Hodgkin's disease.

[Course of pregnancy and condition of infants born to patients treated for lymphogranulomatosis]. / Techenie beremennosti i sostoianie rodivshikhsia detei u bol'nykh, lechennykh po povodu limfogranulematoza.

The paper is concerned with some data on the pregnancy and delivery of 78 patients with Hodgkin's disease as well as on the condition of 89 infants born to them following radiation and combined treatment. It was established that pregnancy and delivery in most of the women were normal, the infants' psychomotor development (at the age of 1 to 14) was in accordance with age.

[Changes in the lungs in patients with lymphogranulomatosis, Stages I-II, following combination therapy]. / Izmeneniia v legkikh u bol'nykh limfogranulematozom I-II stadii posle kombinirovannogo lecheniia.

Early and late pulmonary changes in 140 patients with Hodgkin's disease, Stages I-II, following combined treatment (polychemo- and radiotherapy) are analysed. Radiation pulmonitis and local paramediastinal fibrosis occur less frequently and they are less noticeable in combined therapy as compared to similar changes developing after radiation therapy only. It can be due to the fact that a course of polychemotherapy at its first stage results in a considerable decrease of the mediastinal lymph nodes (up to their complete regression) thus making it possible to shape irradiation fields of smaller sizes and to decrease the volume of pulmonary tissue to be irradiated.

[Radiosensitivity of stromal mechanocytes in human bone marrow and spleen]. / Radiochuvstvitel'nost' stromal'nykh mekhanotsitov kostnogo mozga i selezenki cheloveka.

The monolayer cultivation of the bone marrow and spleen from patients with Hodgkin's disease was done. The content of stromal precursor cells (CFU-F) varies significantly in the human spleen (1.2-26.4 per each 10(6) incubated in the culture of nucleated cells) and is approximately one order lower than in the bone marrow (2.1-53.8 per 10(5) myelokaryocytes). During exposure to 60Co gamma-rays the values of a mean lethal cell dose (D0) for splenic CFU-F proved to be higher (2.03 +/- 0.17 Gy) than those for CFU-F from the bone marrow (1.49 +/- 0.12 Gy).