[Role of high-dose BEAM-chemotherapy and autologous hemopoietic stem cell transplantation in the treatment of drug-resistant Hodgkin disease]. / Mesto vysokodoznoi BEAM-terapii i autologichnoi transplantatsii gemopoéticheskikh kletok u bol'nykh khimiorezistentnymi formami bolezni Khodzhkina.

In 1995-1999, 67 patients with relapsed Hodgkin's disease or refractory to chemotherapy (group A--first relapse, B--primary refractory disease, and C--repeated relapse) received cytoreductive (dexaBEAM, DHAP) therapy followed by high-dose BEAM chemotherapy and autologous bone marrow or blood cell transplantation. Early postoperative transplant-related mortality rate was 4.5%. At day 100, complete remission rates were: group A--95.6%; B--74.1%; and C--76.5%. Survival for all patients was: overall--61.9%; event-free--43.9%; disease-free--46%; and relapse-free survival--49.5%. Such factors as primary refractory disease, age over 30 years and response to cytoreductive therapy had significant influence on overall survival prognosis.

[Experience in the use of allogeneic bone marrow transplantation in severe forms of aplastic anemia at the Byelorussian hematological center]. / Opyt primeneniia transplantatsii allogennogo kostnogo mozga pri tiazheloi forme aplasticheskoi anemii v Belorusskom gematologicheskom tsentre.

AIM: Investigation of the response to antilymphocytic globulin (ALG) and transplantation of allogenic bone marrow (TABM) in patients with a severe form of aplastic anemia (AA). MATERIALS AND METHODS: 15 patients were treated for severe AA in 1995-1997. 8 patients of group 1 were given ALG/cyclophosphamide with subsequent TABM from HLA-identical sib donor. To prevent graft versus host reaction the patients took cyclosporin A (CSA) + prednisolone. Those who had no sib donor (7 patients) were treated with ALG/CSA (group 2). RESULTS: A complete remission at 7-30-month follow-up was observed in 6 patients of group 1. One patient died of infectious complications in rejection of the transplant and one patient died of acute graft versus host reaction. None of group 2 patients achieved the remission. One patient died of infectious complications. The others need continuous hemotransfusion therapy. CONCLUSION: In spite of high probability of early complications after TABM, TABM-subjected patients are more likely to achieve a complete remission and recurrence-free survival than those given immunosuppressive therapy alone.

[Toxic complications of high-dose polychemotherapy in the transplantation of bone marrow and of peripheral blood stem cells]. / Toksicheskie oslozhneniia vysokodoznoi polikhimioterapii pri transplantatsii kostnogo mozga i stvolovykh kletok perifericheskoi krovi.

The authors propose their own system of assessment of high-dose polychemotherapy toxicity. The system was applied to toxic complications of high-dose polychemotherapy in 31 patients with hematological malignancies subjected to allogenic, autologous bone marrow transplantation and transplantation of stem cells from peripheral blood within the scope of different protocols of high-dose polychemotherapy in conditioning regimen. A special scale developed in the Belarus Center for Bone Marrow Transplantation basing on the above system provides prediction of survival in early post-transplantation period.

[First results of bone marrow transplantation in acute and chronic leukemia at the Byelarus Center for Bone Marrow Transplantation]. / Pervye rezul'taty transplantatsii kostnogo mozga ostrykh i khronicheskikh leikozakh v Belorusskom tsentre transplantatsii kostnogo mozga.

The first 10 bone marrow transplantations (BMT), 6 of the allogenic (allo-BMT) and 4 autologous (auto-BMT) were performed from February to June 1994 in Byelarus Center for Bone Marrow Transplantation. Two of the patients were experiencing the first complete remission of acute lymphoblastic leukemia (ALL), one of them - the first ALL recurrence, three patients with acute myeloblastic leukemia had the first complete remission, four patients had a chronic phase of chronic myeloid leukemia. In auto-BMT bone marrow (BM) was stored in liquid hydrogen after programmed freezer. An average yield of nucleated cells (NC) after taking and separation of allo-BM made up 3.0 x 10(8) cell/kg and 2.7 x 10(8) cell/kg in auto-BMT. After thawing of BM NC yield reached 1.5 x 10(8) cell/kg (0.8-2.3) x 10(8) cell/kg. CFU concentrations persisted at 24.7 x 10(4) (5.0-40.4) x 10(4) cell/kg body weight. The mean duration of leukocyte, neutrophil and platelet rise to the levels of over 1.0 x 10(9)/l, 0.5 x 10(9)/l, 20 x 10(9) cell/l, respectively, and the last time red cells were transfused were 23 (19-33), 23 (19-31), 22 (9-51), 4.5 (0-19), respectively. One ALL (first complete remission) patient died on day 52 after allo BMT of severe hepatic venous-occlusive disease. The other ALL patient (the first relapse) developed another relapse on day 112 after BMT. The rest 8 patients are in satisfactory condition.

[Autospecific antileukemia cytotoxic lymphocytes induced by interleukin-2 and their use for elimination of leukemic cells from human bone marrow in vitro]. / Poluchenie s pomoshch'iu interleikina-2 utospetsifichnykh protivoleikoznykh tsitotksicheskikkh limfotsitov i ikh ispol'zovanie dlia udaleniia leikoznykh kletok iz kostnogo

The possibility of production of cytotoxic antileukemic lymphocytes (CTL) was studied in a mixed culture of lymphocytes and autologous leukemic cells of patients with varying types of acute leukemia. It has been shown that CTL can be induced only in the presence of exogenous preparations of lymphocytic interleukin-2. CTL can be reproduced in vitro in amounts sufficient for the conduction of immunotherapy. Four-hour incubation in vitro of the bone marrow containing leukemic cells with antileukemic CTL permits the bone marrow to be completely free of leukemic cells, and to preserve hemopoietic precursor cells (CFE-GM).

[Effect of cytotoxic lymphocytes obtained by in vitro immunization with syngeneic lymphoma cells on pluripotent hemopoietic cells]. / Vliianie tsitotoksicheskikh limfotsitov, poluchennykh pri immunizatsiiin vitro kletkami singennoi limfomy, na polipotentnye krovetvornye kletki.

The possibility of the presence of leukemia-associated antigens on pluripotent hemopoietic cells was studied with the aid of immune lymphocytes, cytotoxic against mouse syngeneic lymphoma cells. Cytotoxic lymphocytes were obtained during immunization in vitro of C57BL/6 mouse splenocytes by syngeneic T lymphoma EL-4 cells in the presence of interleukin-2. Specific cytotoxic activity of immune lymphocytes as regards EL-4 cells was not blocked by addition of normal bone marrow cells. Incubation of the bone marrow with immune killers did not lead to a decrease in the number of colony-forming units in the spleen. It was shown that using cytotoxic lymphocytes the total killing of lymphoma cells might be achieved in a mixture of bone marrow and lymphoma cells, whereas pluripotent precursor cells might be retained.

[Elimination of syngeneic lymphoma cells from a mouse bone marrow suspension using immune cytotoxic lymphocytes sensitized in vitro]. / Eliminatsiia singennykh kletok limfoma iz suspenzii kostnogo mozga myshei s pomoshch'iu immunnykh tsitotoksicheskikh limfotsitov, sensibilizirovannykh in vitro.

Murine splenocytes were cultivated with syngenic EL-4 lymphoma cells in the presence of interleukin-2 to obtain cytotoxic antileukemic lymphocytes. It was shown that the use of cytotoxic lymphocytes helped killing completely syngenic lymphoma cells in the mixture of bone marrow and EL-4 cells, spleen colony-forming hemopoietic predecessor cells being retained.