[Unidirectionality of elemental state disorders in workers contacting arsenic compounds and in oncologic patients].

The authors determined concentrations of 24 elements in hair of workers contacting arsenic high concentrations in workplace air, of individuals suffering from malignancies variable in localization, and of general population residing in places with environmentally high level of arsenic. Individuals with high hair content of arsenic and certain elemental dysbalance (sharp decrease of elements ratio Si/Hg, Zn/Hg, Se/Hg, P/Hg, Ni/Hg and Nb/Hg, if compared to control group) were assigned to high risk group for malignancies development.

[Metalloligand homeostasis: molecular basis of iatrogenic and technogenic trace element deficiency].

It is well known that a toxic effect of some medicines is the result of their in vivo interactions with trace elements leading to disturbance of trace element balance in the living body. The Mossbauer spectrometry technique has been used for toxicochemical evaluation of iron-bearing medicines. This method can be used in forensic toxicology. We studied composition of trace elements in the hair of children living in Macedonia: in polluted territory (the town of Veles, the study group) versus in unpolluted one (Ivankovci village, the control group). AES-ICP and ICP-MS techniques were used. We discovered that the hair of children living in the polluted territory contain significantly elevated concentrations of Pb (in 43% cases), Hg, Ni (14%), Cd (21%), Cu (16%), Sn, As, Na, Se and subnormal concentrations of Mg (in 51% cases), Mn, Cr and Li.

[The empirical antibiotic therapy of patients with acute leukemias: the results of a multicenter study]. / Empiricheskaia antibioticheskaia terapiia u bol'nykh ostrymy leikozami: itogi mnogotsentrovogo issledovaniia.

AIM: To evaluate efficacy of ampicilline/sulbactame and fluconasole in the regimen of empirical antibiotic therapy in patients with acute leukemia. MATERIALS AND METHODS: The trial covered 14 hematological departments of Russia and 1 of Ukraine. Acute myeloid leukemia patients were included. 92 cases of fever in 56 patients with analysis of efficacy in 66 cases were considered. At the first stage of empirical antibiotic therapy, cefoperason (4 g/day) and gentamycin (240 mg/day) were administered. If no response was reached, ampicilline/sulbactam (7.5 g/day) was added. This was the second stage. If no response occurred for 5 days the three drugs were joined by fluconasol (400 mg followed by 200 mg). RESULTS: Fever of unclear genesis was cured in 82% (28 of 34), clinical infection--in 80% (20 of 25), microbiologically confirmed infection--in 4 of 7 cases. A complete response to the empirical antibiotic therapy was registered in 52 of 66 cases (79%). 7(10.5%) patients died of infectious complications. 7(10.5%) received other antibiotics.

[An evaluation of the prognostic significance of antigen CD95(Fas/APO-1) expression on the cells of patients with a myelodysplastic syndrome, acute myeloid leukemia and chronic myeloleukemia]. / Otsenka prognosticheskoi znachimosti ékspressii antigena CD95(Fas/APO-1) na kletkakh bol'nykh s mielodisplasticheskim sindromom, ostrym mieloidnym leikozom i khronicheskim mieloleikozom.

AIM: The expression of CD95(Fas/APO-1) antigen was studied on bone marrow cells of 19 MDS patients, peripheral blood blast cells of 15 acute myeloid leukemia (AML) patients, blast cells and granulocytes of 68 patients with chronic myeloid leukemia (CML)--24 in chronic, 9 in accelerated phase and 35 in blastic crisis (BC)--by indirect surface immunofluorescence assay using flow cytometry (FACScan, Becton Dickinson, USA). RESULTS: CD95(Fas/APO-1) antigen was revealed on bone marrow cells of 8 out of 19 (36.8%) MDS patients; the percentage of antigen-positive cells was 38.1 +/- 19.2%; on 45.5 +/- 22.8% of cells in 6(45%) of 15 AML patients. Fas/APO-1 antigen was totally absent in CML chronic stage; its expression was found in 34% (12 of 35) of our patients with CML BC on peripheral blood blasts and in 56% (5 of 9) on peripheral blast cells of CML patients in acceleration phase. CONCLUSION: The data on overall survival of CD95-positive MDS patients suggest that the presence of Fas antigen is a favorable prognostic sign for patients with MDS. The patients from CD95-negative group represent a risk group both for survival and AML transformation. In CML BC group the survival does not depend upon Fas-antigen expression.

[A comparative clinico-morphological analysis of acute myelo- and myelomonoblastic leukemias in children and adults]. / Sravnitel'nyi kliniko-morfologicheskii analiz ostrogo mielo- i mielomonoblastnogo leikozov u detei i vzroslykh.

Previous morphocytochemical, immunological and cytogenetic analyses of blast cells in 174 children and 188 adults admitted to Cancer Research Center have shown that compared to adults in children leukemic precursors belong to earlier stage of differentiation similar to polypotent cell. The analysis covered 2 FAB-variants of ANLL comparable by the number of patients and intensity of the given chemotherapy (M2 and M4 ANLL FAB variants). The study included 65 children (50 with M2 and 15 with M4 FAB variants) and 43 adults (26 with M2 and 17 with M4 FAB variants) given therapy of standard intensity in the regimen 3+7 and 2+5. The children more frequently demonstrated involvement of the liver, spleen and peripheral lymph nodes. The percentage of complete remissions in both groups was not significantly different. 2- and 3-year recurrence-free survival was similar in two age groups with M2 FAB variants of ANLL. However, in M4 variant in adults this survival made up 18% against 0% in children. The differences may arise from lower peroxidase activity in children than in adults. It is suggested that M4 FAB variant in adults may indicate better prognosis than in children. Therefore, therapy in children with M4 FAB ANLL variant should be intensified.

[Use of a new antimacrophage monoclonal antibody D11 in diagnosis of hemoblastosis]. / Primenenie novogo antimakrofagal'nogo monoklonal'nogo antitela D11 v diagnostike gemoblastozov.

Expression of new Mab D11 on blood and bone marrow cells was investigated in 85 hemoblastosis patients. In normals, antigen D11 is expressed on some monocytes and all tissue macrophages. D11 was noted on lymphoblasts of 5 out of 10 cases with B-cell ALL and of 1 case in B-lymphoid blast crisis of chronic myeloid leukemia. In T-ALL, ANLL, non-Hodgkin's lymphomas in leukemization stage, hairy cell leukemia and chronic lymphoid leukemia the cells were nonresponsive to Mab D11. Unlike D11 which have round nuclei, lymphoblasts D11+ have folded nuclei and more pronounced cytoplasmic basophilia. There were both B and myeloid antigens on D11+ blasts. ALL D11+ patients had extramedullary foci, more suppressed granulocytic and thrombocytic components of hemopoiesis, shorter remissions than those with ALL D11-.

[Use of long-acting L-asparaginase (PEG-asparaginase) in acute lymphoblastic leukemia]. / Primenenie L-asparaginazy prolongirovannogo deistviia (PEG-asparaginazy) pri ostrom limfoblastnom leikoze.

Twenty-five patients with acute lymphoblastic leukemia [15 adults and 10 children] received standard treatment in which regular L-asparaginase was replaced for L-asparaginase of prolonged action [PEG-asparaginase]. The drug was administered once in two weeks in a dose 2500 IU/m2 for remission induction and consolidation or as a component of maintenance therapy. It was found that the response to primary PEG-asparaginase treatment or its use in the disease relapses produced the same response as regular L-asparaginase, being superior in convenience and feasibility of outpatient use. Side effects in the form of hypoproteinemia, hepatic toxicity and toxic pancreatitis [in children, 9 and 1 adults, respectively] were moderate and disappeared after 10-20-day discontinuation of the drug.

[The comparative evaluation of the efficacy of different therapeutic plans in acute nonlymphocytic leukemias]. / Sravnitel'naia otsenka éffektivnosti razlichnykh skhem terapii ostrykh nelimfoblastnykh leikozov.

78 previously untreated patients with acute non-lymphoblastic leukemia (ANLL) were assigned to cytosar-anthracyclines therapeutic programs: 29 (group I) received daunorubicin and AraC, 18 (group II) aclacinomycin A and AraC, 12 (group III) the scheme 3 + 7 with 12 mg/m2 novantron instead of daunorubicin, 19 (group IV) the scheme 3 + 7 with 12 mg/m2 idarubicin and cytosar. Groups I-III comprised both prognostically favorable and unfavorable ANLL variants, group 4 patients had for the most part unfavorable prognosis (MO-M3). A mean age of the patients was 41-42. Complete remissions were observed in 17 (58.6%), 9 (50%), 10 (83.3%), 11 (57.9%) patients of groups I, II, III and IV, respectively. An initial course of the treatment produced complete remissions in 65%, 33%, 80% and 90.9% of them, respectively. A mean duration of cytostatic leukothrombocytopenia was the longest in groups III and IV (16-22 days). Nonhematological toxicity occurred in the form of enteropathy and hepatitis. During the remission induction and consolidation 76% of the deaths were caused by infection and hemorrhagic diathesis. The median remission lasted 17.5, 13.5 and 5 months in groups I, II and III, respectively, and was not reached in group IV because of continuing remission in 50% of the patients by the end of the follow-up period (14 months). A 2-year survival rate was observed in 25% (group I), 11% (group II), 30% (group III) and 40% (group IV).

[The results of using differentiated programs of therapy in acute lymphoblastic leukemia in adults]. / Rezul'taty primeneniia differentsirovannykh programm terapii ostrogo limfoblastnogo leikoza vzroslykh.

Results of the treatment of 30 adult patients with acute lymphoblastic leukemia are analyzed. Before the treatment was commenced, the patients were distributed into groups with a favourable, intermediate and unfavourable prognosis depending on the signs previously defined by the authors. In the phase of induction and consolidation of a remission, the treatment intensity in these groups varied. The rate of complete remissions (CR) reached 70% in the whole group; provided Ph-positive ALLs were excluded from the analysis, it was 75%, the median duration of the CR amounted to 21 months, the projected 4-year relapse-free survival was 41%. In the group of historic control (31 patients treated in accordance with the unified program), these indicators were 58 and 69%, 18 months, and 21%, respectively. All the differences appeared statistically insignificant. In spite of the total treatment intensification, the rate of lethal outcomes did not rise during remission induction.

[The combination of chronic lympholeukemia with other malignant neoplasms]. / Sochetanie khronicheskogo limfoleikoza s drugimi zlokachestvennymi novoobrazovaniiami.

Altogether 23 patients examined for secondary tumors at the All-Union Cancer Research Center of the USSR AMS underwent a clinical analysis. The overwhelming majority of the patients (17) were subjected to surgical intervention. Of these, none of the patients developed any postoperative complications or showed progress of chronic lympholeukemia (CLL). No relationship was noted between cytostatic treatment of CLL and origin of second tumors. No correlation was revealed either between the duration of CLL treatment and the incidence of second tumors origin. The authors provide a brief review of the literature on the given problem. Give a summary of the statistics of the CLL incidence in other malignant neoplasms.