[First results of Ph-negative acute lymphoblastic leukemia therapy of adults according to the protocol of Research Group of Russian Hematological Centers ALL-2009].

AIM: To review results of 2-year experience in execution of the protocol on the treatment of adult acute Ph-negative lymphoblastic leukemia ALL-2009. MATERIAL AND METHODS: Of 111 patients registered in the study from November 2008 to December 2010 the analysis covered 96 patients from 23 hematological centers in 18 towns of the RF. RESULTS: Treatment according to the Protocol ALL-2009 resulted in achievement of a complete remission in 91.2% patients with low early lethality of 5.5%. Postremission lethality fell to 3.7% versus previous studies (22%). Overall 2-year survival and recurrence-free survival reached 77.6 and 78.4%, respectively. Detection of any chromosomic aberrations significantly affected recurrence-free survival: 74 vs 100% in patients with normal karyotype. CONCLUSION: Protocol All-2009 demonstrates high efficacy in moderate toxicity and good reproducibility in any hematologic center.

[Diagnosis and treatment of aquired aplastic anemia].

AIM: To analyse the results of diagnosis and treatment of patients with aquired aplastic anemia (AA) in one center. MATERIAL AND METHODS: All AA patients, diagnosed and treated in one clinic in 1998-2005, were included in the trial. In severe and very severe AA (SAA/VSAA) the patients (n = 19) received combined immunosuppressive therapy (IST) with antithymocytic globulin (ATG) and cyclosporin A (CsA), in non-severe AA (NSAA) the patients (n = 9) were given monotherapy with CsA. Allogenic transplantation of bone marrow (alloTBM) was made in 4 young patients with SAA/VSAA. RESULTS: The diagnosis of AA was established in 33 patients (19 males and 14 females): NSAA in 9, SAA in 19, VSAA in 5, idiopathic--in 26, posthepatic--in 5, associated with pregnancy--in 2 patients. Age median was 20 years (13-53). The clone of paroxysmal nocturnal hemoglobinuria (PNH) was identified in 7 of 33 patients (21%), antigen HLA-DRB1 *15 in 6 of 11 patients (55%). In median of 26-month follow-up 31 patients (94%) were alive. In IST, complete or partial remissions were obtained in 88% patients. Median of the interval to achievement of transfusion independence made up 2.5 months. All the patients after alloTBM are in complete remission, chronic extensive transplant against host reaction was observed in one case. CONCLUSION: Introduction of updated protocols provides long-term survival of more than 80% AA patients. To optimize treatment outcomes, it is necessary to include newly diagnosed AA patients into ongoing multicenter studies.

[Quantitative and functional characteristics of T-lymphocytes and monocytes in lymphosarcoma patients at various stages of the neoplastic process]. / Kolichestvennaia i funktsional'naia kharakteristika T-limfotsitov i monotsitov u bol'nykh limfosarkomoi na raznykh stadiiakh opukholevogo protsessa.

IKO monoclonal antibodies were used to study peripheral blood mononuclear types in 92 patients with various histomorphological types of diffuse lymphosarcoma at various stages of tumorous process. Absolute counts of CD7 and CD5 cells (T cells) were found reducing as was CD4 cell (T helpers) level as the disease progressed. CD8 cell (T suppressors) count reliably increased only in the phase of lymphoblastic lymphosarcoma leukemic degeneration. A group of patients with stage IV lymphoblastic lymphosarcoma was detected with drastically increased counts of mononuclears carrying mature T cell markers. Clinical course of the disease in these patients was characterized by the highest malignancy degree and metastatic involvement of the central nervous system. Examination of peripheral blood monocyte/macrophage ratio in the same patient population (n = 26) revealed reduced Fc receptor expression, EA phagocytosis, and increased levels of circulating immune complexes, these shifts augmenting with the tumor progress. The results may be valuable for prediction of lymphosarcoma course and for immunocorrection.