[Role of high-dose BEAM-chemotherapy and autologous hemopoietic stem cell transplantation in the treatment of drug-resistant Hodgkin disease]. / Mesto vysokodoznoi BEAM-terapii i autologichnoi transplantatsii gemopoéticheskikh kletok u bol'nykh khimiorezistentnymi formami bolezni Khodzhkina.

In 1995-1999, 67 patients with relapsed Hodgkin's disease or refractory to chemotherapy (group A--first relapse, B--primary refractory disease, and C--repeated relapse) received cytoreductive (dexaBEAM, DHAP) therapy followed by high-dose BEAM chemotherapy and autologous bone marrow or blood cell transplantation. Early postoperative transplant-related mortality rate was 4.5%. At day 100, complete remission rates were: group A--95.6%; B--74.1%; and C--76.5%. Survival for all patients was: overall--61.9%; event-free--43.9%; disease-free--46%; and relapse-free survival--49.5%. Such factors as primary refractory disease, age over 30 years and response to cytoreductive therapy had significant influence on overall survival prognosis.

[Experience in the use of allogeneic bone marrow transplantation in severe forms of aplastic anemia at the Byelorussian hematological center]. / Opyt primeneniia transplantatsii allogennogo kostnogo mozga pri tiazheloi forme aplasticheskoi anemii v Belorusskom gematologicheskom tsentre.

AIM: Investigation of the response to antilymphocytic globulin (ALG) and transplantation of allogenic bone marrow (TABM) in patients with a severe form of aplastic anemia (AA). MATERIALS AND METHODS: 15 patients were treated for severe AA in 1995-1997. 8 patients of group 1 were given ALG/cyclophosphamide with subsequent TABM from HLA-identical sib donor. To prevent graft versus host reaction the patients took cyclosporin A (CSA) + prednisolone. Those who had no sib donor (7 patients) were treated with ALG/CSA (group 2). RESULTS: A complete remission at 7-30-month follow-up was observed in 6 patients of group 1. One patient died of infectious complications in rejection of the transplant and one patient died of acute graft versus host reaction. None of group 2 patients achieved the remission. One patient died of infectious complications. The others need continuous hemotransfusion therapy. CONCLUSION: In spite of high probability of early complications after TABM, TABM-subjected patients are more likely to achieve a complete remission and recurrence-free survival than those given immunosuppressive therapy alone.

[Hemopoietic stem cell transplantation in lymphogranulomatosis]. / Transplantatsiia stvolovykh gemopoeticheskikh kletok pri limfogranulematoze.

Twenty patients with resistant and relapsed Hodgkin's disease were included into this investigation. The treatment effectiveness and regimen-related toxicity of BEAM-protocol were evaluated. Stem cell transplantation (SCT) was carried out either as bone marrow transplantation (BMT) in 11 patients or peripheral blood stem cell transplantation (PBSCT) in 9 patients. A comparison of the results pointed to a significant decrease in neutropenia duration, fewer blood transfusions needed and shorter stay in hospital in the PBSCT group. Complete remission was observed in 90% of patients of the SCT group, 91%-in BMT and 89%-PBSCT groups. It was found that high-dose chemotherapy followed by SCT is more effective in the treatment of resistant and relapsed Hodgkin's disease and, in certain situations, it is a treatment of choice. As to the toxicity of BEAM-protocol, it does not exceed those of the other chemotherapy modalities used in SCT.

[Toxic complications of high-dose polychemotherapy in the transplantation of bone marrow and of peripheral blood stem cells]. / Toksicheskie oslozhneniia vysokodoznoi polikhimioterapii pri transplantatsii kostnogo mozga i stvolovykh kletok perifericheskoi krovi.

The authors propose their own system of assessment of high-dose polychemotherapy toxicity. The system was applied to toxic complications of high-dose polychemotherapy in 31 patients with hematological malignancies subjected to allogenic, autologous bone marrow transplantation and transplantation of stem cells from peripheral blood within the scope of different protocols of high-dose polychemotherapy in conditioning regimen. A special scale developed in the Belarus Center for Bone Marrow Transplantation basing on the above system provides prediction of survival in early post-transplantation period.

[Superhigh-dosage chemotherapy with the transplantation of autologous hemopoietic precursor cells in patients with a prognostically unfavorable relapse and resistant course of lymphogranulomatosis]. / Sverkhvysokodoznaia khimioterapiia s transplantatsiei autologichnykh kletok predshestvennikov gemopoéza u bol'nykh s prognosticheski neblagopriiatnym retsidivom i rezistentnym techeniem limfogranulematoza.

Eighteen patients with relapsed or refractory Hodgkin's disease (HD) have been treated with high-dose chemotherapy (BEAM regimen) followed by autologous peripheral stem cells and/or bone marrow rescue. There were no treatment-related deaths. Overall response rate was 82%. With a median follow-up of 10 months (3-24 months) overall survival and freedom from progression were 100 and 94% (95% confidence interval 58-97%), respectively. The use of peripheral stem cells in addition to bone marrow resulted in a significant shortening of the time to engraftment (p < 0.01). The BEAM regimen is an effective conditioning schedule which is well tolerated.