[Deposition of 51Cr-labeled donor platelets in health and myelosuppressive thrombocytopenias].

AIM: To study the deposition of donor platelets (DP) in myelosuppressive thrombocytopenia (TP) in patients with acute leukemia (AL) or lymphosarcoma (LSA), by using a radionuclide label (51Cr) for DP. SUBJECTS AND METHODS: Complex clinical, hematological and radionuclide studies were conducted in 63 patients divided into 3 groups: 1) 7 healthy volunteers (a control group); 2) 37 patients with AL; 3) 19 patients with LSA. RESULTS: Changes were found in the deposition of labeled DPs used to prevent and treat hemorrhagic syndrome in myelosuppressive TP in patients with AL or LSA. In AL, this function was established to be virtually completely suppressed whereas in LSA, some functional activity of mononuclear phagocytes was preserved. Different degrees of suppression of this function were probably related to the nature of these diseases and particularly due to varying degrees of leukemic infiltration of depot organs. A mechanism for increased consumption of transfused DP in profound TP, one of the causes of which is the myelosuppression as a result of programmed polychemotherapy, cannot be ruled out. CONCLUSION: By and large, the radionuclide labeling technique for DP may be useful in specifying a number of uncertain mechanisms for derangements of the thrombocytic component of hemostasis in oncohematologic diseases.

[The survival and sequestration of transfused donor platelets in cytostatic cytopenias].

AIM: To study the survival and sequestration of transfused donor platelets labeled with 51Cr in patients with acute leukemia (AL). SUBJECTS AND METHODS: Seven donor volunteers and 39 patients with different forms with AL at various stages of polychemotherapy (PCT) were examined. Cytostatic therapy was accompanied by 51Cr-labeled platelet concentrate (PC) transfusions. The patients were on appropriate high-dose (HD) PCT. RESULTS: The duration of donor platelet circulation was 8-10 days in healthy individuals. No platelet hypersequestration was recorded in both the spleen and the liver. Donor platelet survival was shorter in all patients with in a state of cytostatic cytopenia. There was an inverse correlation between the degree of circulation shortening and some clinical and hematological parameters (the bone marrow level of blastemia and blastosis, the XIIa-dependent fibrinolysis parameters). Four variants of radioactivity trends above the spleen and liver were identified. The findings suggest that there is platelet hypersequestration in the spleen, liver, and both organs. In some patients, the above both organs are uninvolved in the hypersequestration processes and the possible mechanism for increased consumption of transfused donor platelets, which is associated with recovery of the HD PCT-damaged vascular endothelium is considered. CONCLUSION: Shortening of transfused donor platelet circulation was found in relation to the level of blastosis. The described procedure may be used as one of the additional methods for evaluating the efficacy of donor PC transfusion and for specifying the pathogenesis of thrombocytopenias in AL patients on programmed HD PCT. A procedure is proposed to time the circulation of 51Cr-labeled platelets, by assessing deposit phenomena and estimating the level of their sequestration in the spleen and liver for the prediction of the efficiency of TC transfusions.

[Diagnosis of early manifestations of myocardial dysfunction at early stages of antitumor treatment in patients with lymphogranulomatosis and lymphosarcomas].

AIM: To comparatively assess the capabilities of currently available instrumental studies in the diagnosis of early cardiac performance changes in patients with lymph tumors at different stages of treatment and to study the myocardial histomorphological pattern in relation to the intensity of the therapy performed (as evidenced by sectional studies). MATERIALS AND METHODS: 44 patients, including 26 with various types of lymphogranulomatosis (LGM) and 18 with lymphosarcomas were examined at different stages of antitumor treatment. Radionuclide equilibrium ventriculography (REVG), echocardiography (EchoCG), and electrocardiography (ECG) were used. Postmortem studies of the myocardial histological pattern were conducted in 20 patients (archive data). RESULTS: No significant pathological REVG, EchoCG, and ECG changes were found in 10 patients examined prior to treatment. In a group of 17 patients receiving a total dose of doxorubicine of 240 +/- 30 mg/m2, there was a significant decrease in diastolic duration, a reduction in diastolic volume, end systolic volume, stroke volume, stroke index, filling fraction over 1/3 diastole. In a group of 17 patients receiving a total dose of doxorubicine of 250 +/- 30 mg/m2 and radiotherapy applied to the mediastinum, the above changes were more marked. There were myocardial histomorphological changes whose magnitude progressed as therapy became more intensive. CONCLUSION. The findings have indicated that by using relatively small cumulative dose of anthracyclines, cardiovascular dysfunction can occur at the early stages of programmed treatment for LGM and lymphosarcomas. REVG has the greatest advantage in their detection.

[Gamma-scintigraphy with Ga-67 citrate in differential diagnosis of residual tumors in lymphogranulomatosis and lymphosarcoma].

AIM: To study informative and diagnostic efficacy of quantitative evaluation of the results of gamma-scintigraphy in patients with lymphogranulomatosis and lymphosarcoma with prevalent mediastinal and pulmonary lesions. MATERIAL AND METHODS: 100 patients with verified lymphogranulematosis were studied: 67 with lymphosarcoma and 33 with mediastinal involvement. The mediastinal tumor monitoring was made before therapy, in complete clinicohematological remission, in progression using a complex of radio-, clinicohematological, histomorphological and radionuclide methods. RESULTS: A comparative analysis of the findings of radiation, radionuclide and histomorphological examinations of the removed residual mediastinal tumor in 10 patients showed that scintigraphic evidence was similar to that of histological findings in most of the examinees. CONCLUSION: A high diagnostic efficacy of a complex of radiation and radionuclide methods with Ga-67 citrate based on estimation of accumulation intensity providing comprehensive information about mediastinal tumor is demonstrated. A comparative analysis was made of the results of radiation, radionuclide and histomorphological examinations of the removed residual lesion of the mediastinum in 10 patients. In most cases, scintigraphic findings coincided with the results of histological studies of biopsies of mediastinal residual lesion.

[The diagnosis of a hemorrhagic syndrome in chronic myeloleukemia]. / K diagnostike gemorragicheskogo sindroma pri khronicheskom mieloleikoze.

A study was performed of 40 patients with chronic myeloid leukemia. Clinicohematological, radionuclide (51CR), electron-microscopic methods and examinations of plasma and platelet components of hemostasis were applied to elucidate stage-specific relationships between functional-morphological changes in platelets and early manifestations of hemorrhagic syndrome (HS). The latter was directly related to platelets functional activity and their ultrastructure. With HS progression, platelet functions decline, their degeneration becomes more evident in line with growing blood loss from gastrointestinal tract.

[Latent gastro-intestinal hemorrhages as symptoms of hemorrhagic syndrome in acute leukemia]. / Skrytye zheludochno-kishechnye krovotecheniia kak proiavleniia gemorragicheskogo sindroma pri ostrykh leikozakh.

A clinicoradiologic investigation of latent gastrointestinal hemorrhages was conducted in acute leukemia patients with the use of 51Cr. A total of 26 patients suffering from varying forms of leukemia with no external hemorrhages were investigated. Latent gastrointestinal hemorrhages were detected in 50% of the patients. A definite relationship has been revealed between the hemorrhage degree and the leukemic process stage, in acute periods of the disease the volumes of gastrointestinal hemorrhages significantly exceed the permissible volumes. The authors have shown that the method of quantitative determination of latent gastrointestinal hemorrhages with the use of 51Cr, due to its accuracy and informative value, can be recommended for practical use and scientific investigations.

[Quantitative evaluation of latent gastrointestinal hemorrhage in patients with iron deficiency anemia (preliminary report)]. / Kolichestvennaia otsenka skrytykh zheludochno-kishechnykh krovo- techenii u bol'nykh zhelezodefitsitnymi anemiiami (predvaritel'noe soobshchenie).

Radiologic investigation of concealed gastro-intestinal hemorrhage with 51Cr was conducted for its detection and quantitative estimation in 102 patients with iron-deficiency anemia (IDA), loss of blood from the digestive tract was detected in 52 of them. A definite relationship was noted between the volume of hemorrhage and the disease responsible for the development of IDA. Moderate hemorrhage from 2.5 to 15.0 ml/day was detected in chronic inflammatory diseases of the gastro-intestinal tract (GIT): chronic gastritis, colitis. High volumes of hemorrhage are characteristic of diseases attended by gross changes in the digestive tract: polyps, tumors, diverticula, varicosis in GIT. It has been shown that the radiologic method of quantitative estimation of concealed gastro-intestinal hemorrhage with the use of 51Cr is highly sensitive and accurate, that permitted the authors to recommend this method for both practical and scientific investigations.