scholarly journals THU0649-HPR ASSESSMENT OF THE EFFECTIVENESS OF THE EDUCATIONAL PROGRAM FOR PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 569.2-569
Author(s):  
M. Salokhiddinov ◽  
F. Umarov
Keyword(s):  
Rheumatoid Arthritis ◽  
Social Support ◽  
Educational Program ◽  
Well Being ◽  
Main Group ◽  
Psychological Status ◽  
Response To Treatment ◽  
Control Group ◽  
Functional Capabilities ◽  
Number Of Patients

Background:Effective therapy of rheumatoid arthritis (RA) is impossible without the active and competent participation of the patient in this process, which requires educational programs based on the real needs of the patientObjectives:The purpose of the study was to develop an educational program for patients with RA and evaluate its effectivenessMethods:The study included 65 patients with RA. 35 patients of the main group were trained in the educational program. Of these, 30 patients made up the control group. The educational program consisted of 4 daily classes of 90 minutes. Initially and after 6 months, the indices DAS28, HAQ, RAPID3 were determined using the MDHAQ questionnaireResults:After 6 months after training in the main group, the DAS28 index decreased by 1.28 ± 0.28 points (p <0.05), HAQ - by 0.65 ± 0.39 (55.2%) (p <0.01), RAPID3 - by 4.87 ± 0.82 (45.6%) (p <0.01), anxiety level - by 0.78 ± 0.28 (52.1%) (p < 0.05), depression - by 0.76 ± 0.54 (43.4%) (p <0.05), fatigue - by 2.96 ± 1.21 points (42.3%) (p <0, 05), sleep improved by 0.85 ± 0.34 (52.3%) (p <0.05). 6 months after participating in the educational program, a good response to treatment according to DAS28 according to EULAR criteria was significantly more often recorded (54.5% versus 29.0% in the control group (p <0.05), and the number of patients noted improvement well-being increased by 9 times (p <0.01). The dynamics in the control group was less pronounced, which determined statistically significant differences between groups for most indicators (p <0.05)Conclusion:The educational program improves functional capabilities, psychological status, helps control the activity of the disease and improves the quality of life of patients with RAReferences:[1]Chen SY Wang. The Relationship between Physical Function, Knowledge of Disease, Social Support and Self care behavior in Patients with Rheumatoid Arthritis. Journal of Nursing Research. 2007;15:183–191.[2]Taal E, Rasker JJ, Seydel ER, Wiegman O. Health Status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis. Patient Education & Counseling. 1993;20:63–76.Acknowledgments:I would like to thank to all my Prof Ahmedov and department of Rheumatology for their sincere supportDisclosure of Interests:None declared

P-450 Effects of rheumatoid arthritis and methotrexate therapy on ovarian reserve in infertile women

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Vlasova ◽  
S Perminova
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Ovarian Reserve ◽  
Small Sample Size ◽  
Genetic Material ◽  
Main Group ◽  
Small Sample ◽  
Control Group ◽  
Proliferating Cells ◽  
Number Of Patients

Abstract Study question Do patients with infertility and rheumatoid arthritis (RA) treated with methotrexate (MTX) have ovarian reserve alterations? Summary answer Women with infertility and RA treated with MTX were found to have statistically significant decrease of ovarian reserve. What is known already Rheumatoid arthritis (RA) is one of the most prominent inflammatory diseases affecting women of child-bearing age [Brouwer J. et al, 2014]. RA and its treatment may interfere with the female reproductive physiology. The vast majority of patients with RA are treated with methotrexate (MTX) which is a folate antagonist that inhibits DNA synthesis. MTX, which is the anchor drug in RA, targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve [Min Tun Kyaw et al, 2020]. Study design, size, duration A prospective case-control study that enrolled 72 female patients with infertility was conducted in the 2-year time period of September 2018 to October 2020. Participants/materials, setting, methods The main group comprised 32 patients with infertility and RA; the control group consisted of 40 women with infertility only. Patients with RA were stratified into subgroups based on whether or not they received MTX. To investigate ovarian reserve measurement of serum anti-Müllerian hormone (AMH) was used. The level of AMH was evaluated concerning RA duration and activity, as well as the age at initiation of MTX therapy, dosage, and treatment duration. Main results and the role of chance The mean age of the study population was 36±3 years. The duration of RA was 4 [3;11] years. The low disease activity based on DAS28-ESR (disease activity score based on 28 joints using the erythrocyte sedimentation rate) prevailed(56.2%). In the main group 19(59.4%) women received MTX therapy. The MTX dosage was 15 [15;20]mg /wk, the duration of MTX therapy by the day of inclusion in the study was 18.7[1;15]months. The AMH level was significantly lower in the main group (2.1 n /ml vs 2.73ng /ml, p = 0.043). The number of patients with decreased ovarian reserve (AMH level&lt;1.0ng/ml) significantly prevailed in the group of patients with RA (25% vs 5%, p = 0.015). When assessing the AMH level in patients with RA who received MTX (n = 19) and patients in the control group, there was a tendency towards a decrease in the indicator in the first subgroup, but no statistically difference was found (p = 0.074). Correlation analysis of the dependence of AMH level on the patient age showed the most significant decrease in AMH in the patients with RA receiving MTX compared to the patients with RA who did not, and compared to all patients with RA regardless of the therapy received (rs=-0.563)(p &lt; 0.05). Limitations, reasons for caution The lack of statistically significant data in certain cases may be due to the small sample size. Wider implications of the findings RA and MTX administration are associated with a significant decrease in AMH levels. The age of initiation of the therapy is negatively correlated with the AMH level. In this regard, patients with already compromised reproductive function who are planning to receive MTX should be advised to preserve the genetic material. Trial registration number 567890

P–450 Effects of rheumatoid arthritis and methotrexate therapy on ovarian reserve in infertile women

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Vlasova ◽  
S Perminova
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Ovarian Reserve ◽  
Small Sample Size ◽  
Genetic Material ◽  
Main Group ◽  
Small Sample ◽  
Control Group ◽  
Proliferating Cells ◽  
Number Of Patients

Abstract Study question Do patients with infertility and rheumatoid arthritis (RA) treated with methotrexate (MTX) have ovarian reserve alterations? Summary answer Women with infertility and RA treated with MTX were found to have statistically significant decrease of ovarian reserve. What is known already Rheumatoid arthritis (RA) is one of the most prominent inflammatory diseases affecting women of child-bearing age [Brouwer J. et al, 2014]. RA and its treatment may interfere with the female reproductive physiology. The vast majority of patients with RA are treated with methotrexate (MTX) which is a folate antagonist that inhibits DNA synthesis. MTX, which is the anchor drug in RA, targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve [Min Tun Kyaw et al, 2020]. Study design, size, duration A prospective case-control study that enrolled 72 female patients with infertility was conducted in the 2-year time period of September 2018 to October 2020. Participants/materials, setting, methods The main group comprised 32 patients with infertility and RA; the control group consisted of 40 women with infertility only. Patients with RA were stratified into subgroups based on whether or not they received MTX. To investigate ovarian reserve measurement of serum anti-Müllerian hormone (AMH) was used. The level of AMH was evaluated concerning RA duration and activity, as well as the age at initiation of MTX therapy, dosage, and treatment duration. Main results and the role of chance The mean age of the study population was 36±3 years. The duration of RA was 4 [3; 11] years. The low disease activity based on DAS28-ESR (disease activity score based on 28 joints using the erythrocyte sedimentation rate) prevailed(56.2%). In the main group 19(59.4%) women received MTX therapy. The MTX dosage was 15 [15;20]mg /wk, the duration of MTX therapy by the day of inclusion in the study was 18.7[1; 15]months. The AMH level was significantly lower in the main group (2.1 n /ml vs 2.73ng /ml, p = 0.043). The number of patients with decreased ovarian reserve (AMH level&lt;1.0ng/ml) significantly prevailed in the group of patients with RA (25% vs 5%, p = 0.015). When assessing the AMH level in patients with RA who received MTX (n = 19) and patients in the control group, there was a tendency towards a decrease in the indicator in the first subgroup, but no statistically difference was found (p = 0.074). Correlation analysis of the dependence of AMH level on the patient age showed the most significant decrease in AMH in the patients with RA receiving MTX compared to the patients with RA who did not, and compared to all patients with RA regardless of the therapy received (rs=–0.563)(p &lt; 0.05). Limitations, reasons for caution The lack of statistically significant data in certain cases may be due to the small sample size. Wider implications of the findings: RA and MTX administration are associated with a significant decrease in AMH levels. The age of initiation of the therapy is negatively correlated with the AMH level. In this regard, patients with already compromised reproductive function who are planning to receive MTX should be advised to preserve the genetic material. Trial registration number 567890

scholarly journals AB0177 ANXIETY-DEPRESSIVE SPECTRUM IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDILITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1114.2-1114
Author(s):  
M. Letaeva ◽  
M. Koroleva ◽  
J. Averkieva ◽  
O. Malyshenko ◽  
T. Raskina
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Well Being ◽  
Depressive Syndrome ◽  
Depression Screening ◽  
Anxiety And Depression ◽  
Control Group ◽  
Subjective Well Being ◽  
Anxiety Depression

Objectives:to assess the frequency of occurrence of the anxiety-depressive spectrum in patients with rheumatoid arthritis and ankylosing spondylitis.Methods:A survey was conducted of 44 patients aged from 21 to 57 years (average age - 42.3 ± 6.7 years), who were treated at GAUZ KO OKGVV. All patients had a verified diagnosis of RA and AS according to the ACR criteria and received treatment with basic drugs. The control group consisted of 40 people comparable in age and sex, without concomitant pathology of RA and AS.The depression screening card, the subjective well-being scale, and the hospital anxiety and depression scale (HADS) were used to assess and detect anxiety-depressive syndrome. The assessment of the condition is carried out over the last 2 weeks, which corresponds to the temporary diagnostic criterion for depression.The Depression Screening Scale is a 35-item self-questionnaire that assesses 7 categories of signs: sleep and appetite disorders, anxiety, emotional instability, cognitive impairment, loss of self, guilt, and suicidal tendencies. A total score of 65 and above indicates a high likelihood of depression.The Subjective Well-Being Scale is a psychodiagnostic screening tool for measuring the emotional component of subjective well-being or emotional comfort.Hospital Anxiety and Depression Scale Zigmond A.S., Snaith R.P. was developed for the primary detection of depression and anxiety in a general medical practice. The HADS scale consists of 14 statements with 4 possible answers and includes two parts: anxiety and depression. The sum of points of 8 or more is regarded as “subclinically expressed anxiety / depression”, 11 or more points - “clinically expressed anxiety / depression”.Results:According to the results of the depression screening questionnaire, 34 (77.3%) patients with RA and AS showed signs of depression, while in the control group only 6 (15%) patients tested positive for the presence of depressive disorders. According to the data obtained when assessing the scale of well-being in the main group, 26 (59.1%) patients showed signs of emotional discomfort (the indicator was 80% or more), in the control group - in 6 (15%). Using the hospital scale of anxiety and depression HADS, anxiety-depressive syndrome was detected in 36 (81.8%) patients with RA and AS: 16 (44.4%) patients had anxiety, 20 (55.6%) - depression, of them, subclinically expressed anxiety and depression were observed in 10 (27.7%) and 12 (33.3%) people, respectively. Anxiety-depressive syndrome in the control group, according to the HADS questionnaire, was detected only in 8 (20%) patients, of whom 4 (10%) patients had subclinical anxiety and 4 (10%) had signs of depression. No clinically pronounced anxiety and depression were registered in the control group.Conclusion:In most patients with rheumatoid arthritis and ankylosing spondylitis, anxiety-depressive disorders have been identified, which can directly affect both the course of the disease itself and the development of various complications. Timely diagnosis of mental disorders and close cooperation of rheumatologists, psychiatrists and psychologists in the selection of adequate therapy can improve the course and prognosis of the disease.Disclosure of Interests:None declared

scholarly journals Rasgos de personalidad y recursos psicológicos como predictores del bienestar emocional en adolescentes con y sin formación en escuelas de tauromaquia

2018 ◽  
Vol 23 (1) ◽  
pp. 1
Author(s):  
Pilar Sanjuan ◽  
David Guillen ◽  
Ana María Pérez-García
Keyword(s):  
Social Support ◽  
Problem Solving ◽  
Personality Traits ◽  
Self Efficacy ◽  
Well Being ◽  
Openness To Experience ◽  
Control Group ◽  
Psychological Resources ◽  
Avoidance Coping ◽  
School Group

 Abstract: Personality traits and psychological resources as predictors of emotional well-being in adolescents with and without training in bullfighting schools. The main objective of this study was to analyse how being in training in bullfighting schools can affect the emotional well-being (EW), the personality and the psychological resources of adolescents. The sample consisted of 196 boys, 95 from bullfighting school group (BSG) and 101 from a control group (CG). The BSG, in relation to CG, scored significantly more on conscientiousness, agreeableness and openness to experience, as well as on self-efficacy, problem-solving (PSC) and social support coping (SSC), and EW. The EW was predicted by feeling self-efficacy and not using avoidance coping, and in the CG by being extraverted, showing conscientiousness, being low in neuroticism, feeling self-efficacy and using PSC and SSC. It discusses the psychological adaptive profile of adolescents in the BSG and the need to promote well-being in adolescence through the promotion of self-efficacy and active coping.Resumen: El objetivo principal de este estudio fue analizar cómo la formación en escuelas de tauromaquia puede afectar al bienestar emocional (BE), la personalidad y los recursos psicológicos de los adolescentes. Participaron 196 chicos, 95 del grupo de escuelas taurinas (GET) y 101 del grupo control (GC). El GET, en relación con el GC, puntuaba significativamente más en tesón, afabilidad y apertura, así como en autoeficacia, afrontamiento de solución de problemas (ASP) y basado en los demás (AD), y BE. El BE se predecía en el GET por sentirse eficaz y no usar el afrontamiento de evitación, y en el GC por ser extravertido, mostrar tesón, ser bajo en neuroticismo, sentirse eficaz y emplear el ASP y AD. Se discute sobre el perfil psicológico adaptativo que presentan los adolescentes del GET y la necesidad de promover el bienestar en la adolescencia mediante el fomento de la autoeficacia y el afrontamiento activo.

scholarly journals Impact of rehabilitation measures on cognitive dysfunction in older patients after surgical treatment of nuclear cataract

2020 ◽  
Vol 22 (12) ◽  
pp. 89-92
Author(s):  
Evgenia V. Popova ◽  
◽  
Evgenia V. Popova ◽  
Evgenia V. Popova ◽  
◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Abilities ◽  
Older Patients ◽  
Cognitive Status ◽  
Main Group ◽  
Control Group ◽  
Nuclear Cataract ◽  
Number Of Patients ◽  
Moderate Cognitive Impairment ◽  
Rehabilitation Measures

Background. The high prevalence of nuclear cataracts in older age groups is accompanied by a simultaneous decrease in cognitive abilities as a result of this ophthalmic disease, and other General somatic polymorbid pathology. Aim. To study the cognitive abilities of elderly and senile patients with nuclear cataracts during medical rehabilitation. Materials and methods. In clinical conditions, 68 elderly and senile patients with nuclear cataract underwent femtolaser-assisted cataract phacoemulsification with intraocular lens implantation, and in the postoperative period, medical and non-drug rehabilitation was performed (the main group). The control group con-sisted of 65 patients with nuclear cataract of the same age who also underwent the above-mentioned surgery without rehabilitation measures. The MMSE scale was used to assess cognitive impairment. Results. 9 months after surgical treatment, the cognitive status of patients in the main group improved from 17.4±0.2 to 20.7±0.3 points (p>0.05). Moderate initial cognitive dysfunction in patients of the main group changed to mild after 9 months, while in the control group it remained the same. At the same time, the proportion of patients with moderate cognitive impairment decreased significantly in the main group from 61.71±5.9% before rehabilitation to 13.2±4.1% after it was completed, and the number of patients with no cognitive deficit increased (p<0.001). In the control group, the number of patients with moderate cognitive impairment decreased from 60.0±6.0 to 46.2±6.2% (p>0.05). Conclusion. The implementation of rehabilitation measures in the postoperative period helps to improve the cognitive status of older patients with nuclear ca-taracts.

Investigating the Validity of the Minimal Disease Activity State for Patients with Rheumatoid Arthritis Treated with Abatacept

2009 ◽  
Vol 36 (2) ◽  
pp. 260-265 ◽  
Author(s):  
GEORGE A. WELLS ◽  
MAARTEN BOERS ◽  
TRACY LI ◽  
PETER S. TUGWELL
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Health Assessment ◽  
Control Group ◽  
Minimal Disease Activity ◽  
The Core ◽  
Core Set ◽  
Number Of Patients ◽  
Minimal Disease ◽  
Activity State

Objective.To validate the definitions of minimal disease activity (MDA) in patients with rheumatoid arthritis (RA) and to compare abatacept to control with respect to patients attaining a state of MDA.Methods.Two randomized controlled trials comparing abatacept to control in patients with RA were considered: ATTAIN and AIM. Core set measures, Disease Activity Score 28-joint count (DAS28), and, for AIM, radiographic scores were available. The core set and DAS-based definitions for MDA were calculated and the number of patients in the treatment groups meeting the definitions was compared to determine sensitivity of the criteria to treatment differences and patient severity. The number of times achieving MDA was compared to the change in Health Assessment Questionnaire (HAQ), and for the AIM study compared to change in radiographic scores.Results.For both definitions of MDA, the change in radiographic scores showed a continual decrease in progression the more often a patient was in MDA. The change in HAQ, for both studies, showed a similar consistent improvement — the longer a patient was in MDA, then the better the HAQ score. Significantly more patients in the abatacept group met the core set and DAS-based definition of MDA than in the control group.Conclusion.The presence and persistence of MDA was associated with slowing of radiographic progression and improvement in the HAQ, providing support for discriminative and predictive validity of the measure. The MDA results were consistent with other efficacy analyses indicating a treatment advantage for abatacept.

Understanding the Role and Uses of Alternative Therapies for Management of Rheumatoid Arthritis

2021 ◽  
Vol 17 ◽  
Author(s):  
Archana Tripathy ◽  
Nitish Swain ◽  
Bhawna Gupta
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Animal Model ◽  
Well Being ◽  
Alternative Therapies ◽  
High Quality ◽  
Success Stories ◽  
Clinical Investigations ◽  
Number Of Patients ◽  
Mental Well Being

: With growing popularity of complementary and alternative medicine (CAM) among the individuals with chronic pain and muscular problems, a number of patients with rheumatoid arthritis (RA) show their interest in CAM interventions for disease improvement. Various reports published on CAM are based on animal model of RA however there is often lack of high quality clinical investigations for explaining the success stories of CAM therapies in patients with RA. CAMs having potential to be used for therapy in patients with RA have been identified, however lack of awareness and scepticism of their efficacy has made the patients reluctant to choose these drug less therapies. In this review, we have summarized the existing evidences which suggest promising efficacy of different alternative therapies in managing RA and providing both physical and mental well being to RA patients.

Treatment Methods for Different Variations Syndrome Mirizzi

2021 ◽  
Vol 04 (04) ◽  
Author(s):  
Omarov N.B., Aimagambetov M. Zh. ◽  
◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Main Group ◽  
Mirizzi Syndrome ◽  
Long Term Results ◽  
Control Group ◽  
Type Iii ◽  
Type Iv ◽  
Number Of Patients

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts. The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed: 1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1); 2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1). The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology. These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).

Transgender Youth and Social Support: A Survey Study on the Effects of Good Relationships on Well-being and Mental Health

Young ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 199-216
Author(s):  
Katarina Alanko ◽  
Heidi Lund
Keyword(s):  
Social Support ◽  
Relationship Quality ◽  
Online Survey ◽  
Well Being ◽  
Survey Study ◽  
Control Group ◽  
Gender Conflict ◽  
Transgender Youth ◽  
Mental Well Being

Positive gender-supportive relationships have been found to promote well-being of transgender youth. The present study investigates how the quality of relationships to parents, friends and partners affects the mental well-being of transgender youth. An online survey was used for data collection. The sample consisted of 1,613 Finnish youth between 15 and 25 years of age. Youths who were identified as a transgender ( n = 370) were compared to cisgender (= no gender conflict, n = 1,243, mostly sexual minority youth) on measures of relationship quality and positive well-being. Transgender youth reported poorer well-being and relationships to parents than the control group did. Relationship quality predicted well-being of all participants, and there were no significant interactions between gender identity and relationship quality. Social support is important for transgender youth and has an impact on the well-being of youth regardless of gender identification.

Paraprotein levels in assessing effectiveness of polychemotherapy plus selective plasma exchange for multiple myeloma patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e19511-e19511
Author(s):  
Irina B. Lysenko ◽  
Nailya Guskova ◽  
Oleg Ivanovich Kit ◽  
Natalya Dmitrievna Ushakova ◽  
Nadezhda Golomeeva ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Exchange ◽  
Treatment Effect ◽  
Reduction Rate ◽  
Main Group ◽  
Response To Treatment ◽  
Light Chains ◽  
Control Group ◽  
Blood Levels

e19511 Background: Our purpose was to analyze levels and types of paraprotein in polychemotherapy combined with selective plasma exchange in patients with multiple myeloma. Methods: Blood levels of paraprotein (PP) were studied by capillary electrophoresis (Helena Bioscience V8), and content of plasma cells was determined in the bone marrow of 16 patients (main group) with multiple myeloma (MM) during polychemotherapy (PCT) plus selective plasma exchange (SPE). 14 patients receiving standard PCT were the controls. Results: MM patients in both groups were characterized with the presence of PP in the blood serum with the M-peak in the gamma-globulin zone. Only heavy IgG chains were found, bound to lambda (λ) light chains in 48% and to cappa (κ) light chains in 57.15%. The initial PP level in MM-IgGλ was 91.01±0.79 g/L and was 2.4 times higher than in MM-IgGκ (38.3±0.34 g/L). Significant differences in were found in PP reduction rate and intensity depending on the treatment. PP in the main group reduced by 42.4% after course1, by 41.4% after course 2, by 52.2% after course 3 and by 24% after course 4; in the control group – by 17.2%, 19.3%, 27.9% and 47.3%, respectively. PP levels decreased by 87.4% and 74.6% by the end of the treatment, respectively. The data were confirmed by a decrease in plasma cell content in the bone marrow of patients: up to 1.2% in the main group and 6.2% in the controls. Response to treatment in the main group was registered at the early stages of therapy, and at the late stages in the control group. Treatment effect was associated with the type of secreted PP. In MM-IgGκ, PP levels in the main group decreased by 59.7% after course 1, by 40.6% more after course 2 and by 51.9% after course 3; in MM-IgGλ – by 25.1%, 42.1% and 52.5%, respectively. Treatment effect was noted earlier and PP reduction was more intensive in MM-IgGκ than in MM-IgGλ. PP levels decreased by the end of the treatment by 85.4% in MM-IgGκ and by 73% in MM-IgGλ. Similar changes were observed in the control group. Conclusions: Increased rates and intensiveness of paraprotein reduction reflect effectiveness of polychemotherapy plus selective plasma exchange for multiple myeloma. Patients with MM-IgGκ are more sensitive to the therapy.

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