[Advances and difficulties of present-day treatment of acute myeloblastic leukemia]. / Uspekhi i slozhnosti sovremennogo lecheniia ostrogo mieloblastnogo leikoza.

The success in acute myeloblastic leukemia (AML) treatment for the last 10 years has been referred to growing intensity of chemotherapy. The efficacy of treatment has been assessed in 56 patients under 60 years of age. Double induction of remission according to the scheme TAD-9 (2-day administration of cytosar) and consolidation by large-dose cytosar (1 g/m2) with rubomycin have increased the frequency of 2-year recurrence-free running from 13 to 35%. Resistance to treatment was absent. Maintenance prolonged total and recurrence-free survival. Mycosis and hepatitis were factors responsible for inadequate intensity of chemotherapy. These need more advanced prevention. The intensive double induction and consolidation did not raise general toxicity and immediate lethality compared to standard regimens which proved inferior to the proposed treatment.

[Use of autologous hematopoietic stem cells from peripheral blood for transplantation in patients with hematologic and solid neoplasms after high-dose chemotherapy]. / Primenenie autologichenykh kletok-predshestvennikov gemopoéza ia perifericheskoi krovi dlia transplantatsii u bol'nykh s gematologicheskimi i solidnymi novoobrazovaniiami posle vysokodoznoi khimioterapii.

Peripheral mononuclears under normal hemopoiesis and after chemotherapy or/and cytokin were isolated on blood cell separator and cryopreserved. The cells from 22 patients with different hematological and solid malignancies were examined. Mononuclears with high content of hemopoiesis precursors may be collected rapidly after stimulation. Fast and persistent recovery of hemopoiesis in transplantation of this material after superhigh-dose chemotherapy of prognostically unfavourable patients is demonstrated. Cytokin (granulocytic and granulocytic-macrophagal growth factors) promoted fast and reliable production of sufficient quantities of peripheral blood hemopoiesis cells precursors.

Hematopoietic recovery after 10-Gy acute total body radiation.

Considerable data suggest that very high doses of acute total body radiation destroy most hematopoietic stem cells and that recovery is possible only after a bone marrow transplant. We review data from a radiation accident victim exposed to about 10-Gy or more acute total body radiation. Total dose and uniformity of distribution were confirmed by physical measurements (paramagnetic resonance), computer simulation, and biologic dosimetry (granulocyte kinetics and cytogenetic abnormalities). Treatment consisted of supportive measures, transfusions, and hematopoietic growth factors (granulocyte-macrophage colony-stimulating factor and interleukin-3). Hematopoietic recovery occurred slowly. Granulocytes were detectable throughout the postexposure period, exceeding 0.5 x 10(9)/L by day 37. There was slower and incomplete recovery of red blood cells and platelets. Increases in blood cell production were paralleled by morphologic changes in bone marrow biopsies. Gastrointestinal toxicity was moderate. Death from a probable radiation pneumonitis infection occurred on day 130. These data indicate the possibility of hematopoietic recovery after approximately 10 Gy or more acute total body radiation without a transplant. They also suggest that lung rather than gastrointestinal toxicity may be dose-limiting under these circumstances.

[The relation of the times of onset of vomiting to the magnitude and power of the dose of ionizing radiation]. / Zavisimost' srokov vozniknoveniia rvoty ot velichiny i moshchnosti dozy ioniziruiushchego izlucheniia.

The paper is concerned with analysis of correlation of the time of appearance of vomit in a person and a mean dose rate of prolonged gamma-radiation in the persons affected at the Chernobyl accident. The data were approximated by power function. For irradiation with a constant dose rate (P) such correlation looks like Tp = 2.48p-0.5, where Tp is the time of the beginning of vomit, hours after the beginning of irradiation. A semiempirical model combining different conditions of irradiation was formed. Prognosis of a severity of lesion with relation to the time of vomit was given for different conditions of irradiation.

[The principles of and some experience with component therapy in acute radiation sickness]. / Printsipy i nekotoryi opyt komponentnoi terapii pri ostroi luchevoi bolezni.

The previous experience gained with the treatment of acute radiation sickness supported during the treatment of the victims to the disaster at the Chernobyl NPP has shown the multimodality treatment to be indispensable for the bone marrow syndrome, particularly in terms of correcting postradiation thrombocytopenia and counteracting bleeding sickness. The use of the whole blood was found to be inadvisable because of the low efficacy, with the risk of transfusion complications being fairly high. Adequate replacement therapy with donor's platelets is capable of a complete modifying of the hemorrhagic syndrome.

[The skin manifestations of the graft vs. host reaction]. / Kozhnye proiavleniia reaktsii transplantat protiv khoziaina.

A patient with the graft-versus-host reaction is described. The description is illustrated with photographs of the patient, with histo- and electron grams.

[Whole-body therapeutic gamma-irradiation using a dose of 3 Gy in acute leukemia--hematologic and clinical aspects of the bone marrow syndrome]. / Total'noe gamma-terapevticheskoe obluchenie v doze 3 Gr pri ostrom leikoze--gematologicheskie i klinicheskie aspekty kostnomozgovogo sindroma.

The authors described the time course of changes in the peripheral blood of 18 patients with acute leukemia exposed to total-body single gamma-therapeutic irradiation in a dose of 3 Gy at the stage of complete remission of leukemia. Proceeding from the number of neutrophils the authors defined 3 types of hematological response to irradiation. They also described cytopenic complications and means and methods of maintenance therapy. An attempt was made to modify radiation myelosuppression and to assess the results of the use of cytosine arabinoside in 4 patients who had received the drug in a single dose of 2 g 5-7 days before irradiation.

[Experiences in transplanting bone marrow, leukocytes and human embryonic liver cells in hemoblastosis patients]. / Opyt transplantatsii kostnogo mozga, leikomassy i kletok émbrional'noi pecheni cheloveka bol'nym gemoblastozami.

The authors describe the experience gained with 19 allogenic and autologous transplantations of the bone marrow, peripheral blood leukocytes, embryonal liver cells of man and syngeneic transplantation of the bone marrow to 15 patients with hemoblastoses and aplastic anemia. Non-medullary toxicity of the pretransplantation conditioning of the patients was moderate and could be successfully corrected. The clinical analysis of the complications and causes of the patients' death demonstrated an evident reduction of organ lesions as a result of the use of the common methods of preventing exo- and endogenous infections and early treatment of the complications. The authors describe an acute secondary disease as the main reason for death during the latest allogenic transplantations of the bone marrow and support the conclusion about the necessity of transplantation only in the cases with a satisfactory prognosis.