cytostatic therapy
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2021 ◽  
Vol 6 (6) ◽  
pp. 141-147
Author(s):  
G. S. Maslak ◽  
◽  
G. P. Chernenko ◽  
V. M. Baibakov ◽  
A. D. Viselko ◽  
...  

The purpose of the study was to study the nature of changes in the exposure of surface glycans of peripheral blood lymphocytes in patients with B-cell chronic lymphocytic leukemia under conditions of antitumor therapy. Materials and methods. We studied the features of exposure of surface glycotopes of peripheral blood lymphocytes in patients with B-cell chronic lymphocytic leukemia under conditions of antitumor therapy using a set of seven lectins labeled with FITC and monoclonal antibodies to Tn-antigen- FITC for the detection of Tn antigen and CD43 exposure on blood lymphocytes. Cytostatic therapy included cyclophosphamide, vincristine (oncovin), prednisolone. Data were recorded on a Beckman Coulter EPICS flow cytometer. The results were processed using FCS3 Express. Results and discussion. The number of lymphocytes of healthy donors with a positive reaction to ConA, PHA-L, SNA, MAA-II and α1-acid glycoprotein amounted to 16.0±3.0%, 23.0±2.3%, 15.0±1.5%, 25.0±1.8% and 15.0±1.3%, respectively. The number of LABA-, UEA I-positive lymphocytes was 0.90±0.03% and 2.9±0.2%, respectively, and there was no binding to antibodies to Tn- and CD43-antigens. In the blood of patients with chronic lymphocytic leukemia, the level of ConA-, SNA- and MAA-II-positive lymphocytes increased relative to control by 2.2, 3.7 and 2.6 times, respectively. The number of LABA- and UEA I-positive lymphocytes in patients with chronic lymphocytic leukemia increased by 11 (p <0.01) and 23 (p <0.001) times and amounted to 10.5±0.5% and 67.5±5.5% respectively. The number of lymphocytes with CD43 antigen on their surface increased by 72 times, and the Tn antigen increased by 80 times. Cytostatic therapy reduced the level of LABA- and UEA I-positive lymphocytes by almost half, and MAA II-positive cells and lymphocytes interacting with antibodies to CD43 and Tn antigen by a third. The level of PHA-L-positive lymphocytes in the blood of chronic lymphocytic leukemia patients after undergoing alkylating therapy increased by 18.0±2.0% and almost did not differ from those obtained in the control group. Conclusion. 1. In chronic lymphocytic leukemia patients, the structure of glycoconjugates in peripheral blood lymphocytes changes, manifested in increased exposure of L-fucose, α-mannose and N-acetylneuraminic acid, which is confirmed by a significant increase in relation to the control of the number of ConA-, SNA-, MAA-II-, LABA I-positive cells. 2. Patients with chronic lymphocytic leukemia showed a significant increase in the number of lymphocytes, in which the markers of carcinogenesis CD43 and Tn antigens were found. 3. Cytostatic therapy significantly reduced the level of LABA-, UEA I- and MAA II-positive cells, as well as partially Tn- and CD43-antigen-positive lymphocytes, which indicates its positive effect on the treatment of chronic lymphocytic leukemia


2021 ◽  
pp. 44-54
Author(s):  
O.I. Dorosh ◽  
◽  
Yu.O. Letz ◽  
I.P. Melko ◽  
I.P. Tsymbalyuk-Voloshin ◽  
...  

The predisposition of patients with acute leukemia (АL) to various infectious complications is a well-known fact. The reason is a decrease in immunity due to the underlying disease and due to the use of immunosuppressive cytostatic and radiotherapy. Tuberculosis infections (TIs) are serious and life-threatening complications in patients with malignant hematological disorders and recipients after hematopoietic stem cell transplantation. Verification of tuberculosis (TB) is often delayed among patients with hematooncological diseases due to low suspicion and due to the search for other infectious complications. Those with the involvement of the respiratory system are the most common complications in immunologically compromised patients. In acute leukemia, the TB process may have been underestimated, due to negative tests for mycobacterium tuberculosis (MBT), and patients with neoplasia are often prescribed antibacterial agents such as amikacin and ftorchinolones, which are also effective against TI. We describe a 10-year-old boy who was diagnosed with pulmonary tuberculosis, a disseminated form complicated by hydrothorax, during induction chemotherapy for acute promyelocytic leukemia (APL). For diagnostic purposes, repeated punctures of the pleural cavity with drainage of pathological effusion and diagnostic and remedial bronchoscopy were performed, bacterial pneumonia and systemic mycosis were suspected. The diagnosis of TB was verified on the basis of positive PCR test for TB, molecular genetic study of sputum, bronchial lavage for the presence of genome of MBT without resistance to rifampicin, sputum microscopy, while sputum culture and pleural fluid were negative for MBT. TB treatment was coEadministered with AML-BFM 2004 intensive cytostatic therapy without dose reduction of cytostatics. The child was prescribed intensive tuberculostatic therapy with 4 drugs (rifampicin + isoniazid + pyrazinamide + inbutol) for 3 months and subsequent maintenance antituberculous chemotherapy with two drugs for 4 months (rifampicin + isonimazide). With this analysis, we advocate the need for early suspicion of TB in patients receiving treatment for AL. The results of our study suggest that antitumor chemotherapy is not an obstacle to effective TB-treatment. The described patient is in remission of AML and TB for 21 months. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: acute promyelocytic leukemia, tuberculosis, cytostatic therapy, children.


2021 ◽  
Vol 67 (4) ◽  
pp. 86-96
Author(s):  
H.A. Hirna ◽  
◽  
D.V. Maltsev ◽  
L.V. Natrus ◽  
M.M. Rozhko ◽  
...  

The state of antitumor immunity of patients with oral cavity and oropharyngeal cancer during treatment (radiation and chemoradiation therapy), which additionally included α/β-defensin immunotherapy, was studied. In all three study groups, where preparation α/β-defensins was used, there was a more pronounced dose-dependent decrease in the relative number of lymphocytes in the blood than among those receiving cytostatic therapy in mono mode. Patients of group I received radiation therapy and immunotherapy, group II - chemoradiation and immunotherapy, group III - radiation therapy with immunotherapy in increased doses, VI - radiation, V - chemoradiation. Thus, in group І the decrease in the absolute number of lymphocytes was by 0.6×109/l, in group II - by 0.82×109/l, and in group III - by 0.93×109/l; by 8.51% there was a decrease in the relative number of lymphocytes in group I, by 15.52% in group II and in group III - by 14.32%. A significant decrease in the absolute number of CD3+ T cells in the blood was registered with a combination of radiation- and immunotherapy: in group I from 1141×106/l to 682×106/l and in group III - from 871×106/l to 309×106/l. At the same time, there was an increase in the relative number of natural killers in the blood of patients undergoing radiation therapy in combination with immunotherapy, also with a dose-dependent effect, the growth in group I is from 16 to 17% and group III - from 13.4 to 19.5%. Among patients undergoing cytostatic therapy, there were significant differences in the absolute number of NKT cells in the combination of radiation and immunotherapy, groups I and III, by reducing the number of these lymphocytes in the blood from 86 to 57 and from 62 to 31, respectively. α/β-defensins have been shown to have a dose-dependent adjuvant effect on cytostatic treatment – radiation, and chemoradiation of patients with cancer of the oral cavity and oropharynx. Simultaneously with the use of the drug α/β-defensins associated additional immunomodulatory effect in the form of the restructuring of the subpopulation of lymphocytes due to an increase in the relative number of natural killers in the blood.


2021 ◽  
Vol 11 (3) ◽  
pp. 14-16
Author(s):  
Alexander Siprov ◽  
Mariya Solovyova ◽  
Pavel Skopin ◽  
Larisa Mosina ◽  
Yulia Skopina ◽  
...  

— In this study, we’ve evaluated the myelotoxic effect of treating Walker-256 carcinoma with cytostatics, followed by correction of thrombocytopenia with liposomal and liposome-free mexidol. The study included 60 rats, which, depending on the type of treatment, were divided into 5 groups. We recorded the greatest increase in the number of platelets on the background of liposomal mexidol both on the 3rd and 7th day after the start of chemotherapy. At the end of the monitoring, the myeloprotective effect was 30% higher in the liposomal mexidol compared to its non-liposomal form. Conclusion: Activation of thrombocytopoiesis on the background of cytostatic therapy helps to reduce the complications related to the use of chemotherapy.


Author(s):  
Vynnytska O. A.

The aim of this study was to evaluate the prognostic value of the relationship between genetic abnormalities and clinical and laboratory parameters of peripheral blood and bone marrow in children with acute lymphoblastic leukemia (ALL).Material and methods. 105 children diagnosed with ALL were examined (average age 6 years). To detect chromosomal translocations AF4/MLL t(4; 11) (q23; p23), BCR/ABL t (9; 22) (q34; q11), E2A/PBX1 t (1; 19) (q23; p13) and TEL/AML t(12; 21) (q13; q22) the method of polymerase chain reaction with reverse transcription (RT-PCR) was applicated. PCR was performed with specific primers for the appropriate chromosomal aberrations. Detection of PCR products was performed by electrophoresis in 2% agarose gel. Determination of minimal residual disease (MRD) was performed by multiparameter flow cytofluorimetry using monoclonal antibodies.Results. Among patients, the incidence of ALL is most pronounced in children aged 3 to 6 years - 37 people (35.2%) and aged 6 to 9 years - 26 people (24.8%). The highest accidence was found among patients with chromosomal translocation TEL / AML - 22 (21%) of patients with a median age 5 years. In second place, the frequency of mutations is the translocation of E2A / PBX1. BCR / ABL translocation was less common - 1.9% of patients, but the expression of this gene indicates a bad course of the disease, as patients after cytostatic therapy under the ALLIC BFM 2009 program had a recurrence. Recurrence has also been observed in patients with TEL/AML chromosomal translocation.Determination of MRD showed its increased level in patients with chromosomal aberrations BCR / ABL and TEL/AML throughout the treatment phase. In addition, patients in these groups were diagnosed with initial leukocytosis followed by leukopenia after a course of chemotherapy. Patients of all groups showed a decrease in hemoglobin.Conclusion. The biggest changes in clinical and laboratory parameters were found between patients with chromosomal translocations BCR/ABL and TEL/AML, as evidenced by the development of relapses in patients of these groups. The low level of association between karyotype disorders, with the formation of AF4/MLL and E2A/PBX1, and clinical and laboratory parameters in patients with GLL may indicate that the isolated clonal disorders are independent prognostic factors for the course of the disease.


2021 ◽  
Vol 6 (1) ◽  
pp. 56-64
Author(s):  
O. A. Vynnytska ◽  
◽  
O. I. Dorosh ◽  
L. Ya. Dubey ◽  
N. V. Dubey

Immunophenotyping of leukemia cells was studied in this work; minimal residual disease was monitored among children with acute lymphoblastic leukemia under conditions of relapse and complete remission after the application of ALLIC-BFM 2009 cytostatic therapy. The study showed that after application of ALLIC-BFM 2009 therapy, 88% of children had complete remission, and 12% had relapses. Among patients with relapses, the number of blast cells in the bone marrow was at a high level (more than 6%). Monitoring of patients during therapy established an increase in the minimal residual disease level of more than 1% after treatment in patients with recurrent disease. Immunophenotyping of blast cells among patients with relapse showed the expression of linear independent antigens HLA (93%), Auti-TdT (91%), CD10 (78%), CD38 (91%) and CD34 (57%) and B-linear antigens: CD19, CD22, CD58, CD79a, the highest expression was found for the CD19 antigen. A low level of expression of CD45 (28%) was recorded with relapses of acute lymphoblastic leukemia and high (89%) level was with complete remission of the disease. We did not detect expression of antigens characteristic of T-cell acute lymphoblastic leukemia in bone marrow of patients with acute lymphoblastic leukemia, both with relapses and with remission. At the same time, the expression of myeloid antigens (CD33 and CD13) was noted among acute lymphoblastic leukemia patients. Among patients, the incidence of acute lymphoblastic leukemia was the most pronounced in children aged from 3 to 6 years – 37 patients (35.2%) and aged from 6 to 9 years – 26 (24.8%) patients. The highest accidence was found among patients with chromosomal translocation TEL / AML – 22 (21%) patients with a median age 5 years. In second place, the frequency of mutations is the translocation of E2A / PBX1. BCR / ABL translocation was less common. It was noted in 1.9% of patients, but the expression of this gene indicated a bad course of the disease, as patients after cytostatic therapy under the ALLIC BFM 2009 program had a recurrence. Recurrence was also observed in patients with TEL/AML chromosomal translocation. Determination of minimal residual disease showed its increased level in patients with chromosomal aberrations BCR / ABL and TEL/AML throughout the treatment phase. In addition, patients in these groups were diagnosed with initial leukocytosis followed by leukopenia after a course of chemotherapy. Patients of all groups showed a decrease in hemoglobin. The biggest changes in clinical and laboratory parameters were found between patients with chromosomal translocations BCR/ABL and TEL/AML, as evidenced by the development of relapses in patients of these groups. The low level of association between karyotype disorders, with the formation of AF4/MLL and E2A/PBX1, and clinical and laboratory parameters in patients with acute lymphoblastic leukemia may indicate that the isolated clonal disorders are independent prognostic factors for the course of the disease


2020 ◽  
pp. 32-33
Author(s):  
Yu.L. Yevstakhevych ◽  
M.M. Semerak ◽  
I.Y. Yevstakhevych ◽  
V.L. Novak ◽  
R.M. Lototskyi ◽  
...  

Objective. To present the immediate results of the splenectomy and preferable variants of transfusion therapy performance in patients with malignant non-Hodgkin’s lymphoma (MNHL). Materials and methods. 109 splenectomies were performed in patients with MNHL at the Department of General and Hematological Surgery of the institute from 1987 to 2020. The surgery was conducted by upper middle laparotomy under general anesthesia with intubation and, in particular cases, under spinal anesthesia. Results and discussion. The indications for splenectomy in patients with MNHL were as follows: massive splenomegaly, abdominal syndrome, associated hemocytopenia, inefficacy of cytostatic therapy, absence of diagnosis. All patients underwent vaccination against capsular bacteria for prevention of post-splenectomy infection in 10-14 days prior to the surgery. In case of anemia, which has been observed in 55 % of patients, the RBC concentrate was applied. All the patients, who received corticosteroid hormones prior to splenectomy, were administered prednisolone and hydrocortisone in the amount of 3 mg/kg of body mass at similar doses in an hour before the surgery for prevention of adrenal insufficiency during the surgery. The patients, who did not receive those medications, were also intramuscularly administered prednisolone at a dose of 0.5 mg/kg of body mass in an hour before the surgery for the same aim. The patients with PLT value <150.0×109/L were administered 1-2 doses of PLT concentrate immediately before the laparotomy. M-gradient was found in blood serum of 3 patients prior to the surgery. They underwent courses of therapeutic plasmapheresis due to the risk of intraoperative hemorrhage. 2 patients with hyperleukocytosis (WBC >80.0×109/L) underwent two courses of leukapheresis. The patients with concomitant regional portal hypertension and in case of manipulations close to the pancreatic tail were administered somatostatin drugs in the course of the splenectomy. The splenectomy proved to be effective in 100 (92 %) of patients with MNHL: the great tumor mass was removed, the abdominal syndrome and concomitant hemocytopenia were neutralized, the signs of hypersplenism ceased, the hemolysis ceased, the cytostatic therapy became less necessary or unnecessary, the final diagnosis was established. The most serious postsurgical complications were acute adrenal failure (n=3), postsurgical intra-abdominal hemorrhage (n=2), pancreonecrosis (n=6). The postsurgical lethality was 2.7 %. Conclusions. The splenectomy proved to be effective in 92 % of patients with MNHL. The infusion therapy is individual for each patient and may include transfusion surgeries if indicated. The main objective of the infusion therapy in patients with MNHL is prevention and elimination of intra- and postsurgical complications.


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