[Results of the treatment of childhood acute lymphoblastic leukemia according to the Berlin-Moscow-91 protocol in 1991-2000]. / Rezul'taty lecheniia ostrogo limfoblastnogo leikoza u detei po protokolu Moskva-Berlin-91 v 1991-2000 gg.

The report deals with the results of application of an original protocol--the Berlin-Moscow-91 (BM-91)--for the treatment of acute lymphoblastic leukemia (ALL) in children. The researchers' major concern was to improve survival and cut down side-effects incidence as well as to prevent and successfully manage occult neuroleukemia as a potential source of relapse. Patients aged 5 months-15 years received the BM-91 and ALL BFM-90m treatment first at one clinic and later at several centers. Out of 852 children with primary diagnosis of ALL admitted to Russian hematological hospitals (March 2, 1991-November 3, 2000), 687 were included into the study; 329 received the MB-91 protocol. Nine-year recurrence-free survival was 73% while overall survival--80%. Toxic side-effects after L-asparaginase were reported in 27 (7.9%). It is concluded that good results in childhood ALL treatment can be achieved without resorting to high-dosage chemotherapy and radiation in most cases.

[Treatment of acute lymphoblastic leukemia in children according to the ALL-BFM-90m protocol in the Russian Federation and the Republic of Belarus]. / Lechenie ostrogo limfoblastnogo leikoza u detei po protokolu OLL-BFM-90m v Rossiiskoi Federatsii i Respublike Belarus'.

Prognosis for children treated according to the BFM-90m protocol (Berlin-Frankfurt-Munster Group) for acute lymphoblastic leukemia (ALL) improved significantly as compared with previous modalities. Methotrexate was used in the dose of 1,000 mg/m2, 36 h. The paper presents the 10-year results for this modification. Patients aged 0-15 years were treated at hematological hospitals of Moscow, other Russian towns and in Minsk, Belarus, (July 5, 1990-November 11, 2000). BFM-90m treatment was given to 682 children out of 1,326 with primary diagnosis of ALL; a comparative trial of the MB-91 protocol hed been carried out at the same clinics since 1991. During 10 years, recurrence-free survival was 72% while overall survival--77%. Toxicity of side-effects was tolerable. The BFM-90m treatment showed significantly better results in both countries.

[Results of screening hematological and cytochemical blood studies of 906 children living in Bryansk Province at places with different intensities of soil contamination with cesium-137 and strontium-90]. / Rezul'taty skriningovykh gematologicheskikh i tsitokhimicheskikh issledovanii krovi 906 detei, prozhivaiushchikh v Brianskoi oblasti v mestakh s raznoi plotnost'iu zagriazneniia pochvy tseziem-137 i strontsiem-90.

Populations of children living in the Bryansk territory (radionuclide contamination 0.2-63.9 Cu/km2) are characterized by heterogeneous blood counts, though relevant mean values are close to control. Mean cytochemical indices indicated a significant reduction in activity of point nonspecific esterase (NSEP), a marker of mature T-cells, in children from all the contaminated districts. Shifts in cytochemical blood lymphocytogram by NSEP test evidencing rejuvenascence of T-lymphocyte pool were recorded in 12-33% of children from different villages. A 10% decrease in NSEP suggested poor adaptation and feasibility of immunodeficiency. In one-third of children with low NSEP the number of lymphocytes with large-granular PAS reaction may reflect uneffective B-lymphopoiesis in these children. In two villages significantly contaminated with 137Cs and 90Sr half of the children had blood hemoglobin above 150 milligrams. Children from three villages exhibited a sharp rise in the number of lymphocytes with intensive-granular PAS reaction. These changes may be related to thyroid abnormalities. The number of children at risk of health deterioration grows with growing environmental contamination with 137Cs.