CYP2C19*2 gene variant (G681A, rs4244285) as a prognostic marker for the clinical course of multiple myeloma.

BACKGROUND: Multiple myeloma (MM) is the most common type of paraproteinemic hemoblastosis, which is characterized by an aggressive course, high mortality and a large number of complications. The G681A variant (*2, rs4244285) of the CYP2C19 gene leads to the formation of an inactive enzyme and, as a consequence, may affect the development and course of MM. The aim of this research was to analyze the effect of the G681A variant of the CYP2C19 gene on the risk of the development of MM and its course. MATERIALS AND METHODS: The study enrolled 158 patients with MM, who underwent standard clinical and laboratory studies: cytological, general clinical, biochemical, as well as molecular cytogenetic and molecular genetic. Cytogenetic analysis of chromosome abnormalities was performed using interphase fluorescence in situ hybridization. Genotyping by the G681A variant of the CYP2C19 gene was performed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: No association was found between the G681A variant of the CYP2C19 gene and the risk of developing MM. The association between the presence of the G allele and GG genotypes with significant changes in clinical and biochemical parameters (plasma cell count, α2-globulin, calcium content) in MM patients has been established. In the presence of the G allele of the CYP2C19 gene, the development of chromosomal rearrangements del(13q14.2) or del(13q34) with significantly increased levels of albumin occurs more frequently. CONCLUSIONS: The G681A variant of the CYP2C19 gene does not affect the risk of developing MM, but it is associated with significant changes in the clinical and biochemical parameters that determine the severity of the disease and its prognosis. Further research is important to develop new target strategies and maintenance therapy for carriers of different variants of the CYP2C19 gene (G681A).

[Experience of using thalidomide in the treatment of patients with multiple myeloma].

The results of treatment of patients with multiple myeloma with thalidomide and complications of this treatment are presented. Monotherapy with thalidomide and its combinations with corticosteroids and cytostatics is an effective as first line treatment and as a treatment of patients with refractory disease. The most common side effect is toxic neuropathy. Other complications are less common and are easily controlled with medications.

[Reactions and complications caused by thrombocyte concentrate transfusions]. / Reaktsiï ta uskladennia, zumovleni zastosuvanniam kontsentratu trombotsytiv.

The review contains current data on complications developing in the wake of employing thrombocytes concentrate in clinical settings. Complication patterns are submitted, causes thereof are analyzed. Technical aspects are discussed of optimum measures to be implemented in transfusions of the thrombocytes concentrate.