[Retrospective evaluation of blood immunologic parameters in the course of remission of acute lymphoblastic leukemia in children]. / Retrospektivnaia otsenka immunologicheskikh pokazatelei krovi u detei v raznye sroki remissii ostrogo limfoblastnogo leikoza.

The authors investigated cellular and humoral immunity in 53 children over 3 years of age suffering from acute lymphoblastic leukemia. The children had remission lasting from 6 to 120 months and were followed up for 7-14 years after the diagnosis was made. The treatment was performed according to programs of polychemotherapy practiced in 1981-1988. In November of 1995 42 children were alive, 15 had the disease for 10 years. Lymphocytopenia (absolute number of T-cells and B-cells fell 3-5 and 2-3-fold, respectively) was reported in all the examinees both in early remission and later (6-12, 24-60, 60 and more months since the disease onset). In early remission there was a significant reduction in the serum IgG, IgA and IgM. In children with ALL lethal outcome serum IgM and absolute number of E-RFCa dropped in early remission more significantly indicating deep drug-induced depression of lymphocytopoiesis. After 5 years of treatment the pool of peripheral T-lymphocytes and T/B lymphocyte proportion changed for the best, though their absolute number was subnormal. Serum IgG, IgA and circulating immune complexes were 1.3-1.5 times higher than normal which may be explained by gastrointestinal pathology and food allergy in the majority of children treated.

[Monoclonal immunophenotyping of acute lymphoblastic leukemia cells in children using rapid immune alkaline phosphatase]. / Monoklonal'noe immunofenotipirovanie kletok ostrogo limfoblastnogo leikoza u detei s pomoshch'iu metoda bystroi immunnoi shchelochnoi fosfatazy.

Monoclonal immunophenotyping of leukemia cells of the bone marrow was carried out by the method of rapid immune alkaline phosphatase (RIAP) in 30 patients with acute lymphoblastic leukemia (ALL) aged 6 months-14 years. The authors used a panel of monoclonal antibodies (MCA) produced by Leu (Belgium) and DAKO (Denmark) directed to antigens of differentiation clusters: Tdt, HLA-DR, CD: 10, 19, 20, 22, 7, 8, 2, 5, 13, 33, 14. The results indicate diversity of compositions of differentiating antigens on leukemia cells of the dominant population and a different degree of leukemic cell pool heterogenicity. RIAP advantages over flow cytometry in immunotyping of ALL cells are shown. Arguments are provided in favor of introduction of broader MCA panel.

[Alloimmune neutropenia in newborns]. / Alloimmunnaia neitropeniia novorozhdennykh.

Investigations were conducted in 4 infants with alloimmune neutropenia caused by leuko-agglutinins (2 cases) and granulo-cytotoxins (2 cases) detected in the mothers' and infants' sera. Anti-granulocytic antibodies reacted with granulocytes of the child and father but did not react with the mother's own cells. A more severe clinical course (repeated pyo-inflammatory diseases, sepsis) was recorded in infants with alloimmune neutropenia caused by granulo-cytotoxins, alloimmune neutropenia was characterized by disorders in neutrophil phagocytic activity (mainly, due to decreased digestive capacity of cells), inhibition of colony-forming capacity of precursor-cells of granulocytopoiesis; a tendency to T-lymphocytopenia was noted during the study of cellular immunity parameters. Prognosis was favourable in all the cases of neutropenia. The maximum term of neutropenia duration was 6 months. The catamnesis has shown that the development of the infants is normal and they fall ill not often.

[Roentgenologic endovascular occlusion of the spleen in the treatment of hereditary spherocytic hemolytic anemia in children]. / Rentgenoéndovaskuliarnaia okkliuziia selezenki v lechenii nasledstvennoi sferotsitarnoi gemoliticheskoi anemii u detei.

Roentgenoendovascular occlusion of the spleen has been suggested for the treatment of children with hereditary spherocytic hemolytic anemia as an alternative to splenectomy. The operation was conducted in 8 children aged from 1 to 11 years. Selective decontamination of the intestine was used for prevention of inflammatory complications. Occlusion of 60% of the splenic parenchyma results in a stable clinico-hematological effect and can be performed as a single stage. Young children could be operated on by this method.

[Evaluation of hematopoietic and stromal cells-precursors in children with neutropenia]. / Otsenka krovetvornykh i stromal'nykh kletok-predshestvennikov pri neitropeniiakh u detei.

The content of hemopoietic and stromal precursor-cells was studied in the bone marrow of 46 children with congenital neutropenia and of 2 children with chronic benign neutropenia. It was found that the number of GM-CFC and F-CFC in the bone marrow of patients with chronic benign neutropenia did not differ from that in the control group of normal children, and the lowering of the neutrophil number in the blood was, probably, associated with their redistribution mechanism or increased destruction in the body. Multiple defects of hemopoietic and stromal tissue were detected in children with a hereditary form of congenital neutropenia when anomalous proliferation of F-CFC and disorders in GM-CFC differentiation led to hypoplasia of granulocytic growth stem and neutropenia.

[Significance of morphological, cytochemical and immunological identification of tumor cells in acute leukemia in children]. / Znachenie morfologicheskoi, tsitokhimicheskoi i immunologicheskoi identifikatsii opukholevykh kletok pri ostrom leikoze u detei.

The authors discuss the reported data and the results of own studies characterizing the current state of the problem of the phenotyping of leukemic cells. Emphasize the necessity of the use of a complex of morphological, cytochemical and immunological research methods for identification of tumor cells in children suffering from acute leukemia.

[Precursor cells of the granulomonocytopoiesis in children with immune neutropenia]. / Kletki-predshestvenniki granulomonotsitopoéza u detei s immunnoi neitropeniei.

The study of precursor cells of granulocytes and macrophages has shown that in children with immune neutropenia the higher division of granulopoiesis-committed precursor cells is not affected, while the defect is localized in the periphery of hemopoiesis, and it is induced by increased destruction of neutrophils.

[Late (after 5-year remission) recurrences of acute leukemia in children (a cooperative study)]. / Pozdnie (posle 5 let remissii) retsidivy ostrogo leikoza u detei (kooperirovannoe issledovanie).

Cooperative investigations were conducted in seven Pediatric Hematologic Clinics (in Moscow, Leningrad, Kiev, Minsk and Tbilisi) to study the nature of late (after five years of remission) relapses of acute leukemia that were diagnosed in 21.6% of cases (in 80 out of 371 children) with long-term remissions. Late relapses in most patients occurred on the 6-7th year of remission. In cases when the treatment was abolished, relapses took place 1-2 years after the abolition. Extramedullary foci of leukemic lesions (CNS, sexual glands, etc.) were detected more frequently (41 children). Bone marrow lesions were recorded in 21 combined relapses were observed in 8 patients. It has been stressed that initial risk factors should be taken into consideration, and current diagnostic tests should be applied to individualize therapy at all the stages of the treatment.