Bush Encroachment of Forest-steppe Landscapes in the Mongolian Part of the Lake Baikal Basin

The character of competitive relationships between woody and shrub vegetation in the southern (Mongolian) part of the Lake Baikal basin was studied via model polygons. Depending on the environmental conditions, native forests are being replaced by different types of shrubs. The main factors contributing to these changesare the aridization of the climate and human activity. It is shown that the current state of shrub communities and their progressive dynamics along the southern border of boreal forests in Mongolia allow us to consider them stable cenoses, which prevent a natural renewal of coniferous (pine, larch) forests in this region. However, some shrub species may be considered indicators of ecotopes’ suitability for natural or artificial reforestation because their ecological requirements are similar to those of forest trees. Keywords: Lake Baikal basin, ecotone area, destruction of forests, bush encroachmen

Diagnostics and treatment challenges of Ph-like acute lymphoblastic leukemia: a description of 3 clinical cases

B-cell acute lymphoblastic leukemia (B-ALL) is a diverse group of malignant blood disorders both with regard to the biological properties of the tumor and to therapeutic approaches. Immunophenotyping, molecular genetic techniques, whole-genome sequencing characterize B-ALL as a very diverse group for sensitivity to chemotherapy and prognosis. We present three clinical cases of patients with B-ALL and expected good response to standard therapy, in whom standard protocol treatment failured: refractoriness, persistence of minimal residual disease (MRD), and progression (MRD increase). The remission in these patients was achieved after chemotherapy change to immunological targeted therapy. Nowadays a unified therapeutic approach to all primary patients of the B-ALL is considered generally outdated. Great efforts are carrying out to develop molecular genetic classifications. The molecular dissection of subtypes of B-ALL goes on, and new protocols for selective treatment with targeting are clearly outlined for each subtype of B-ALL

Results of program acute myeloid leukemia therapy use in National Medical Research Center for Hematology of the Ministry of Health of Russian Federation

Objective. To analyze treatment results of 172 patients with acute myeloid leukemia (AML) aged 18-60 years in National Medical Research Center for Hematology of MHRF. Materials and methods. Inductive and consolidation program for 139 (80%) patients was based on a standardized protocol: 4 courses “7+3” with different anthracycline use (2 courses of daunorubicin, idarubicin, mitoxantrone) and continuous use of cytarabine on the second inductive course. In 20% of patients cytarabine courses at the dose of 1 g/m2 2 times a day for 1-3 days combined with idarubicin and mitoxantrone were used as two consolidation courses. Allogenic bone marrow transplantation was performed in the first complete remission (CR) period in 40% of patients. Results. The frequency of CR achievement in all patients was 78.6%, refractory forms were observed in 13.9% of patients, early mortality - in 7.5% of patients. Seven-year overall survival (OS) rate was 40.7%, relapse free survival (RFS) - 43.2%. When estimating effectiveness depending on cytogenetic risk group it was demonstrated that 5-year OS and RFS in patients with translocation (8; 21) cannot be considered as satisfying, it accounted for 50 and 34%, respectively. At the same time in patients with 16th chromosome inversion (inv16) these characteristics accounted for 68.6 and 63.5%. Acquired results forced reconsidering of the consolidation program in AML patients of this subgroup. The median time to allogenic blood stem cells transplantation (allo-BSCT) in patients with first CR was 6.5 months that was taken as a reference point in landmark analysis of patients in whom allo-BSCT was not performed. Landmark analysis showed that in AML patients of favorable prognosis group allo-BSCT does not significantly reduce the probability of relapse (0 and 36%) and does not influence RFS (33 and 64%). In patients of border-line and poor prognosis allo-BSCT significantly reduces relapse probability (26 and 66%; 20 and 100%) and significantly increases a 7-year RFS (68.7 and 30%; 45.6 and 0%). Allo-BSCT also results in significant RFS increase and reduces the probability of relapse (25 and 78%) in patients in whom CR was achieved only after the second induction course. At the same time allo-BSCT does not influence patients who achieved CR after the first treatment course: 55 and 50%. Conclusion. Multivariate analysis showed that cytogenetic risk group (HR=2.3), time of CR achievement (HR=2.9), and allo-BSCT transplantation (HR=0.16) are independent factors for disease relapse prognosis after achieving CR

EFFICACY AND SAFETY OF VASOACTIVE BETA-BLOCKERS IN ACUTE PHARMACOLOGICAL TEST IN HYPERTENSIVE PATIENTS OF DIFFERENT AGES

Aim. To evaluate a short-term efficacy and safety of nebivolol and carvedilol in hypertensive patients of different ages in acute pharmacological test (APT).Material and methods. 119 patients with arterial hypertension (HT) 2-3 degrees aged 33-89 y.o. were involved into the study. Patients were split into 2 groups according to age: young and middle-aged patients (30-59 y.o.); elderly and senile patients (≥60 y.o.). All patients were randomized for carvedilol (12.5 mg once daily) or nebivolol (5 mg once daily) therapy after wash-out period (3-10 days). Ambulatory blood pressure monitoring (ABPM) was performed one day before and one day after first drug taking and ABPM indices were compared.Results. APT with carvedilol and nebivolol in patients of young and middle age showed significant antihypertensive effect on systolic (-6.9 and -6.0 mm Hg, resp.), diastolic (- 4.6 and -4.7 mm Hg, resp.) and pulse (-1.7 and -1.4 mm Hg, resp.) blood pressure (BP). In patients of elderly and senile age the first daily dose of nebivolol did not have influence on systolic and pulse BP (-2.73 and +0.50 mm Hg, resp., p&gt;0.05), unlike carvedilol (-5.27 and -1.43 mm Hg, resp. p&lt;0.05). Carvedilol and nebivolol increased of hypotension time index for diastolic BP in younger (7,6 and 7,7%, resp.) and elder (11 and 8,2% resp.) patients.Conclusion. Carvedilol in initial dose reduces systolic and pulse BP more significantly than nebivolol does in hypertensive elderly and senile patients. Increase of hypotension time index for diastolic BP revealed for both drugs can limit their use in patients with initially low diastolic BP.</p

EFFICACY AND SAFETY OF VASOACTIVE BETA-BLOCKERS IN ACUTE PHARMACOLOGICAL TEST IN HYPERTENSIVE PATIENTS OF DIFFERENT AGES

Aim. To evaluate a short-term efficacy and safety of nebivolol and carvedilol in hypertensive patients of different ages in acute pharmacological test (APT).Material and methods. 119 patients with arterial hypertension (HT) 2-3 degrees aged 33-89 y.o. were involved into the study. Patients were split into 2 groups according to age: young and middle-aged patients (30-59 y.o.); elderly and senile patients (≥60 y.o.). All patients were randomized for carvedilol (12.5 mg once daily) or nebivolol (5 mg once daily) therapy after wash-out period (3-10 days). Ambulatory blood pressure monitoring (ABPM) was performed one day before and one day after first drug taking and ABPM indices were compared.Results. APT with carvedilol and nebivolol in patients of young and middle age showed significant antihypertensive effect on systolic (-6.9 and -6.0 mm Hg, resp.), diastolic (- 4.6 and -4.7 mm Hg, resp.) and pulse (-1.7 and -1.4 mm Hg, resp.) blood pressure (BP). In patients of elderly and senile age the first daily dose of nebivolol did not have influence on systolic and pulse BP (-2.73 and +0.50 mm Hg, resp., p&gt;0.05), unlike carvedilol (-5.27 and -1.43 mm Hg, resp. p&lt;0.05). Carvedilol and nebivolol increased of hypotension time index for diastolic BP in younger (7,6 and 7,7%, resp.) and elder (11 and 8,2% resp.) patients.Conclusion. Carvedilol in initial dose reduces systolic and pulse BP more significantly than nebivolol does in hypertensive elderly and senile patients. Increase of hypotension time index for diastolic BP revealed for both drugs can limit their use in patients with initially low diastolic BP