[The synopsis of clinical cytometry: acute megakaryoblastic leukemia.]

The acute megakaryoblastic leukemia is a rather rare form of pathology even in practice of specialized oncological hematological departments. The data of cytometry analysis of 2363 patients monitored from 2007 to 2014 carried out in The Dmitrii Rogachev Federal research clinical center of children hematology, oncology and immunology and The academician I.P. Pavlov First St. Petersburg state medical university was used to diagnose acute megakaryoblastic leukemia. The corresponding diagnosis was established in 24 patients of various age categories, including 16 children (11 boys and 5 girls) and 8 adults (ratio male/female 1:1). The trisomy on chromosome 21 was revealed only in 4 children out of 13 of early age (younger than 3 years). The article describes characteristics of samples taking preparation and interpretation of data of multicolor with regard to experience of national and foreign colleges.

[Immunological features of children with primary peritonitis].

An immunological research of the patients and control group with primary peritonitis was made. The main indices of immune response were in the range of age rates. However, the immune signs of foci of chronic inflammation were revealed in patients after operation. The consequences of disease (an abdominal cavity effusion) were eliminated during surgical interventions, but not the cause of the inflammation. Children with the primary peritonitis should be examined for detection of infection foci.

[The application of method of flow cytometry in diagnostics of hereditary spherocytosis (eosin-5 maleimid binding test)].

The technique of binding eosin-5 maleimid fluorescent dye with lysine-430 of first extracellular protein bulge of band 3 of erythrocytes' membranes makes it possible to detect the defects of cytoskeleton of erythrocytes as a biological foundation of pathogenesis of hereditary spherocytosis. The samples of peripheral blood from 125 adult persons and 18 children with established absence of hematologic disorders were analyzed The samples of peripheral blood from 19 patients with verified hereditary spherocytosis were analyzed too. The method of flow cytometry was applied to register the average intensity of fluorescence of eosin-5 maleimid. The decrease of average intensity of fluorescence of eosin-5 maleimid of erythrocytes of patients with hereditary spherocytosis as compared with data from comparison groups was established in all cases.

[The significance of investigation of the endothelium function in diagnosis and assessment of effectiveness of treatment of infective endocarditis].

The complex state of the endothelium function was studied in 25 patients with infective endocarditis in the preoperative and early terms after surgery. A reliable elevation of all indices of endothelium dysfunction independent of the localization of the formed heart disease was detected. Against the background of operative treatment reliable changes demonstrating an improved functional state of the endothelium were noted in the early postoperative period.

[Bone marrow immunophenotyping for the diagnosis of multiple myeloma: practical aspects].

Multiple myeloma is a malignant proliferative disease of plasma cells. Flow cytometric immunophenotyping makes it possible to identify a malignant clone of myeloma cells in the shortest possible time, to determine its phenotype, and differentiate transformed and preserved plasma cells. The article presents an immunophenotyping strategy using three-color monoclonal antibodies (CD35, CD14, CD38, CD138, and CD19) and an algorithm of verification of transformed plasma cells. Particular emphasis is placed on both the practical aspects of performing this assay and on the clinical application of the obtained results.

Participation of IIb-IIIa glycoprotein in spontaneous platelet aggregation.

In some patients with stable and unstable angina pectoris and in some donors without clinical manifestations of cardiovascular diseases and other pathologies, spontaneous platelet aggregation was completely suppressed by glycoprotein IIb-IIIa antagonists blocking the interaction of this glycoprotein with fibrinogen. Antibodies inhibiting binding of glycoprotein Ib with von Willebrand factor had no effect on the level and rate of spontaneous platelet aggregation. In the donor group, the level of spontaneous aggregation was almost 1.5-fold higher in persons with a certain genetic polymorphism (Leu-->Pro substitution in position 33 of glycoprotein IIIa). The level of spontaneous aggregation correlated with the amount of glycoprotein IIb-IIIa on the platelet surface (r = 0.41).

[Effectiveness of using autologous mono-nuclears of the bone marrow in treatment of patients with ischemic heart disease].

The authors have analyzed their experiences with treatment of 50 patients with ischemic heart disease using transplantation of autologous mono-nuclears of the bone marrow. It was shown that this operation resulted in an improvement of indices of the heart functions and myocardium metabolism. Transplantation of stem cells as mononuclear fraction of the bone marrow is indicated in treatment of different groups of patients: in recurrent diseases after previous operations on the coronary arteries; in patients with distal lesions of the coronary bed; transplantation of autologous stem cells of the bone marrow is expedient simultaneously with coronary artery bypass grafting or coronary angioplasty (stenting).

[Mobilization of peripheral blood cells for auto- and allogenic transplantations of hemopoietic cells]. / Poluchenie stvolovykh kletok perifericheskoi krovi dlia auto- i allogennykh transplantatsii gemopoéticheskikh kletok.

AIM: To study mobilisation of peripheral blood stem cells (PBSC) via single and split subcutaneous injection of granulocytic colony-stimulating factor (G-CSF) and isolation of PBSC concentrates for their transplantation with leukapheresis (LA) and large volume leukapheresis (LVL) in patients with solid tumors and hematological diseases as well as in the group of relative donors. MATERIAL AND METHODS: LA procedures were made on cell blood fractionator COBE Spectra. In groups 1 and 2 LVL was made with apparatus perfusion of circulating blood of the patient or donor (15-33 l) vs 7-12 l in LA by standard technique in group 3. To reduce the volume of sodium citrate solution used in LVL, to prevent citrate intoxication and hypervolemia, a sharp rise of anticoagulant/blood ration was applied. RESULTS: PBSC-mobilisation with split doses of G-CSF and large volume leukapheresis in 23 patients and 11 relative donors vs mobilisation in 26 patients with single-daily dose of G-CSF and leukapheresis of 3 TBV has revealed that split administration of G-CSF increased the number of leukocytes and CD34+ cells more considerably. CONCLUSION: LVL provides PBSC dose sufficient for transplantation during one procedure in the majority of donors and relative donors. This makes the method more comfortable and cost-effective.

[Diagnostic value of evaluation of desquamated endothelial cells in blood]. / Diagnosticheskaia tsennost' opredeleniia deskvamirovannykh éndotelial'nykh kletok v krovi.

Circulating endotheliocytes as indicator of endothelial dysfunction were evaluated in the blood by Hladovec's method (1978) in patients with coronary disease, coronary stroke, insulin-dependent diabetes mellitus, and gestosis. The content of circulating (desquamated) endotheliocytes was increased in all patients, which reflected endothelial damage. The most pronounced changes were detected in patients with gestosis. Endotheliocyte content correlated with the concentration of Willebrandt's factor in the blood, which recommends using endotheliocyte count as a marker of endothelial damage.

[The DNA content in the cell nuclei of trophoblastic tumors]. / Soderzhanie DNK v iadrakh kletok opukholei trofoblasta.

The DNA content in cytotrophoblast (CTB) and syncytiotrophoblast (STB) cell nuclei was assayed in tissue sections of 7 hydatidiform moles (HM) and 27 choriocarcinomas (CH). The procedure involved Feulgen's reaction and scanning cytophotometry. The analysis of summarized histograms showed the DNA distribution in CTB cell nuclei, on the one hand, and that in STB, on the other, to differ significantly in both the tumors. The HM studied cases were referred to as two subtypes on the basis of such parameters as modal class value, its ploidy and degree of nuclear poly- and heteroploidy of CTB and STB. These characteristics were used to identify three patterns of CH. A pronounced modal class (2c--4c) was typical of type 1. A wider range of modal class (2c--10c or 4c--8c) was observed in type 2. Type 3 of tumor was characterized by a pronounced polyploidy with the absence of the modal class. The analysis of individual CTB and histograms showed no significant differences between HM and CH with respect to the DNA content. An increase in the share of highly polyploid cells was associated with a shorter survival of patients.

[Value of the morphological characteristics of choriocarcinoma in the prognosis of the disease]. / Znachenie osobennostei morfologii khoriokartsinomy dlia prognoza zabolevaniia.

Morphologic studies of 59 choriocarcinomas identified 56 histologic patterns which are of prognostic value. According to information index of Koulback, 17 of them were the most valuable (cytologic pattern of tumor, degree of polymorphism of cyto- and syncytiotrophoblast, mitotic activity of cytotrophoblast, type of tumor growth, degree of blood vessel invasion, etc.). Individual prognosis can be established on the basis of said characteristics, using the Neuman-Pearson procedure. The reliability of individual prognosis made in the study reached 93%.

[Characteristics of the production of chorionic gonadotropin by the cells of trophoblastic tumors (immunohistochemical research)]. / Osobennosti produktsii khorionicheskogo gonadotropina kletkami trofoblasticheskikh opukholei (immunogistokhimicheskoe issledovanie).

An immunohistochemical investigation of chorionic gonadotropin (CGT) in normal placental, hydatidiform mole and choriocarcinoma tissues was undertaken. Cyto- and syncytiotrophoblast both were shown to produce the hormone in normal and tumor trophoblast; the rate of synthesis increased in proportion to the degree of cell elements differentiation, except for very large elements of syncytiotrophoblast with numerous pycnotic nuclei which were found to contain either only traces of response to CGT or none at all. The percentage of syncytiotrophoblast--produced hormone progressively increased in the succession of the placenta--hydatidiform mole--choriocarcinoma. No significant difference in the levels of immunohistochemically--identified hormone was found in the hydatidiform mole and choriocarcinoma.

[Mitotic regime of benign and malignant tumors of the trophoblast]. / Mitoticheskii rezhim dobrokachestvennykh i zlokachestvennykh opukholei trofoblasta.

Mitotic regimen was studied in 52 choriocarcinomas and 45 hydatidiform moles. A clear-cut correlation between the rate of proliferation and degree of hyperplasia of the trophoblast was established for hydatidiform mole. Choriocarcinoma revealed higher values for mitotic index, incidence of pathologic mitoses and the profile of abnormal cell division patterns. Higher mitotic index and incidence of pathologic mitoses in cases of choriocarcinoma were associated with less favorable clinical course of the disease. The presence of villi ruled out the diagnosis of choriocarcinoma.