[Velcade in multiple myeloma].

AIM: To study efficacy of velcade therapy in patients with progressive or refractory multiple myeloma (MM). MATERIAL AND METHODS: From April 2005 to November 2006 velcade was used in therapy of 18 patients (11 females and 7 males) with progressive or refractory to prior standard therapy MM course. The patients' age median was 55 years (36 to 76 years). Velcade was injected intravenously on the course days 1, 4, 8 and 11 with interval 10 days between the courses. A total of 77 courses were made (median 4.5). RESULTS: Overall efficacy was assessed according to EBMT criteria in 16 (68%) patients. Partial remission (PR) was achieved in 9 patients, complete remission (CR)--in 1, minimal response (MR)--in 1 patient. Five patients failed the treatment. In 5 of 11 patients with confirmed efficacy of velcade the drug was used in induction of remission before high-dose chemotherapy (HDC) and autotransplantation of hemopoietic stem cells (HSC), in 3--as monotherapy, in 1--in combination with high-dose dexamethasone, in--with high dose dexamethasone and doxorubicin. Four patients achieved PR, one--MR. HSC were obtained before velcade therapy in one patient, in 4--after its conduction. After HDC there were one CR and 4 PR. Recovery of hemopoiesis after HDC took the same time as after standard induction therapy. In 6 of 11 patients HDC was not performed. Velcade therapy is continued in 2 patients, in 1 case with CR the treatment was stopped. In 3 cases PR for 2 to 6 months was followed by the disease progression. CONCLUSION: Velcade as a new effective antitumor drug can be used for treatment of progressive and refractory forms of MM.

[Infectious complications in patients with Hodgkin's lymphoma of unfavourable prognosis].

Analysis of the infectious complications in 48 primary patients with Hodgkin's lymphoma of infavourable prognosis recorded within 1998-2006 is presented. Respiratory tract infections, mucositis and Herpes infection were stated in 43, 24 and 22% of the patients respectively. Bacterial infections predominated (61% of the patients), then followed viral and fungal infections (26 and 43% of the patients respectively). Associations of bacterial and fungal infections were most frequent (50% of the patients). Associations of bacterial and viral infections were less frequent (30%) and fungal and viral infection associations were revealed in 20% of the patients. The structure of the bacterial, viral and fungal infections and the dynamics of the pathogen spectra are presented. The results of the analysis showed that the infections were frequent complications in such patients and could be due not only to obligate but also to opportunistic pathogens, that requires design of the diagnostic algorithm for prediction of the complication process and outcome, thus improving the remote results of the treatment.