Impact of Cultivating Environment on the Terms of Persistence and Certain Properties of Cholera Vibrios

Objective of the study is to investigate the impact of cultivating temperature and medium on the terms of persistence, ctx gene retention, and enzymatic activity of V. cholerae O1 with various toxigenicity.Materials and methods. Utilized were the strains of V. cholerae El Tor: P-5879, P-19613, and also the strain P-19787.Results and conclusions. In the process of studying cholera vibrios El Tor with different genetic characteristics it was determined that the longest terms of persistence (19 days) on mineral substrates at 5 ºC were observed for toxigenic strains, while for non-toxigenic ones it made less than 17 days. At the same time cholera vibrios can persist continuously and even reproduce on mineral substrates under the conditions of subnormal lowered temperatures (not less than 10 °C). Toxigenic strains of Vibrio cholerae, irrespectively of cultivating medium and temperature, retained ctx gene in their genome and maintained enzymatic activity throughout the experiment. Such long-term persistence of cholera vibrios at low temperatures on mineral substrates may be regarded as possibility of preservation of V. cholerae toxigenic strains in case of import by the infected persons or vibrio-carriers

DEVELOPMENT OF SPATIAL ANALYSIS TECHNIQUES FOR IDENTIFICATION OF "RISK AREAS" IN CASE OF EXTERNAL THREATS REALIZATION AS REGARDS SANITARY AND EPIDEMIOLOGICAL WELLFARE

Objective of the study was to develop the methodology for identification of administratively independent areas under potential risk of “external” epidemiological threat realization, by the example of cholera.Materials and methods. Analysis was conducted using free software package with open source code (QGIS 2.8 and GRASS GIS 7.0) on the basis of the data received from Rosgranitsa and the Federal State Statistics Service. The construction of risk cartogram was performed on the base of Euclidean distance and estimation of nuclear density.Results and conclusions. In accordance with the obtained results, the GIS containing information about the checkpoints on the Russian border, settlements, roads and railway lines was worked out. The method of identification of risk areas due to importation of infectious diseases based on the cholera model has been developed, and the total area of such territories was less than 1 % of the total area of the country. It was found that in some cases the risk area is located at a certain distance from the checkpoint, but the existence of checkpoint does not lead to the formation of risk areas. The developed GIS is available on the geo-information portal of FGHI Rostov-on-Don Research Anti-Plague Institute of Rospotrebnadzor

СРАВНЕНИЕ ЭФФЕКТИВНОСТИ ХИМИОТЕРАПИИ И АЛЛОГЕННОЙ ТРАНСПЛАНТАЦИИ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОК ПРИ ОСТРОМ МИЕЛОБЛАСТНОМ ЛЕЙКОЗЕ В ПЕРВОЙ РЕМИССИИ У ВЗРОСЛЫХ

The aim of the study was to compare the efficacy of allogeneic hematopoietic stem cell transplantation (alloHSCT) and chemotherapy (CT) of acute myeloid leukemia (AML) in first remission (CR1), to identify factors influencing the results. We compare the efficacy alloHSCT in CR1 (n = 70) and CT (n = 52). Patients were stratified by age, the level of leucocytes, the origin of AML, cytogenetic risk group and response to induction CT. Five-years overall and disease-free survival (OS and DFS) were higher in the group alloHSCT (67 and 65 % vs 46 and 30 % (p = 0.02 and p = 0.001)). Benefits of DFS after alloHSCT was in standard and high-risk cytogenetic groups (78 % versus 29 % (p = 0.001), and 34 % vs 17 % (p = 0.007)). The risk of relapse (RR) was 24 % in patients after alloHSCT vs. 57 % for CT (p = 0.003). Comparing the RR after alloHSCT and CT depending on the cytogenetic risk groups: standard (HR0.2(CI95 %0.07 - 0.56) p = 0.002), and high (HR0.27(CI95 %0.08-0.86) p = 0.03). Additional factors affect the RR were the origin of AML (de novo) (HR0.47 (CI95 %0.3-0.74) p = 0.001), the hyperleukocytosis (HR1.91 (CI95 %1.09 - 3.32) p = 0.02), and no remission after the first course CT (HR3.32(CI95 %1.57-7.0) p = 0.002). The efficacy of alloHSCT compared with CT is higher both in standard and high-risk cytogenetic group.Цель - сравнить эффективность аллогенной трансплантации гемопоэтических стволовых клеток (аллоТГСК) и химиотерапии (ХТ) при остром миелобластном лейкозе (ОМЛ) в первой ремиссии и выявить факторы, влияющие на результаты лечения. Сравнивалась эффективность в первой ремиссии ОМЛ алло ТГСК (n = 70) и ХТ (n = 52). Пациенты были разделены по возрасту, уровню лейкоцитов, происхождению ОМЛ, цитогенетическим группам риска и ответу на индукционную ХТ. Пятилетняя общая и бессобытийная выживаемость (ОВ и БСВ) были выше в группе аллоТГСК (67 и 65 % против 46 и 30 % (р = 0,02 и р = 0,001)). При анализе БСВ от цитогенетических групп риска выявлены преимущества аллоТГСК в стандартной и высокой группах риска (78 % против 29 % (р = 0,001) и 34 % против 17 % (р = 0,007)). Совокупный риск рецидива (РР) составил 24 % у пациентов после аллоТГСК против 57 % при ХТ (р = 0,003). При сравнении РР после аллоТГСК и ХТ от цитогенетических групп риска: стандартная (HR,0,2(CI95 %0,07-0,56) p = 0,002) и высокая (HR,0,27(CI95 %0,08-0,86) p = 0,03). Дополнительными факторами, оказывающими влияние на РР, были: происхождение ОМЛ (de novo) (HR,0,47(CI95 %0,3-0,74) p = 0,001), гиперлейкоцитоз в дебюте заболевания (HR,1,91(CI95 %1,09-3,32) p = 0,02) и отсутствие ремиссии после одного курса индукции (HR,3,32(CI95 %1,57 - 7,0) p = 0,002). Эффективность алло ТГСК по сравнению с ХТ выше при стандартной и высокой цитогенетических группах риска

THE EFFICACY OF HIGH-DOSE CONSOLIDATION AND AUTOLOGOUS BONE MARROW TRANSPLANTATION IN FIRST REMISSION OF ACUTE MYELOID LEUKEMIA

Introduction. The question of the most adequate treatment strategy of AML in cases when it is impossible to perform allogeneic HSCT because of any reason still remains open.The aim of this study was to assess the long-term survival of patients with AML who received chemotherapy (CT) or autologous HSCT as consolidation in the first remission of the disease. It was included 135 patients aged 18 to 67 years, with a verified diagnosis of AML (except FAB M3) in the study. Of these, 100 patients received only CT, 35 patients received consolidation with autologous bone marrow transplantation. Patients who achieved remission after completion of induction CT courses received one of three treatment options as consolidation: 1) chemotherapy of standard-intensity (sCT), 2) high-dose chemotherapy (HDCT), 3) autologous HSCT (autoHSCT) conducted after 1–2 courses of high-dose CT. Adverse prognostic factors were identified as: age over 40 years, hyperleucocytosis more than 50,0 × 10 9/L and unfavorable cytogenetic and molecular-biological risk group.Materials and methods. Depending on the number of prognostic factors at the onset of disease relapse-free survival (RFS) was 47 % in their absence, 45 % in the presence of 1 factor, in the presence of 2 factors – 14 % (p = 0,000), regardless of the variant of consolidation therapy (sCT, HDCT, autoHSCT). A high level of white blood cells adversely affects OS (38 % vs. 22 %) and increases the frequency of relapse (52 % vs. 69 %) when performing only CT (sCT and HDCT). At initial white blood cells level more than 50,0 × 10 9/L the 5-year OS was 60 % when performing both autoHSCT and HDCT. Performance of autoHSCT at failure to achieve remission after the 1st induction course CT is associated with the best 2-year OS (62 % vs. 35 %, p = 0,05), EFS (50 % vs. 22 %, p = 0,05) and RFS (50 % vs. 37 %, p = 0,05) in comparison with HDCT and sCT. In favorable cytogenetic risk group 5-year RFS was 80 % when performing autoHSCT and 67 % when performing HDCT; the 5-year OS was 80 % regardless of consolidation therapy option.Conclusion. AutoHSCT is the preferred consolidation option in favorable risk group patients, and after failure to achieve remission after the 1st CT course

PROGNOSTIC SIGNIFICANCE OF POSITRON EMISSION TOMOGRAPHY IN AUTOLOGOUS STEM CELL TRANSPLANTATION FOR NON-HODGKIN’S LYMPHOMA

Objective: evaluation and comparison of positron emission tomography (PET) prognostic value with other predictors of effectiveness in patients with non-Hodgkin’s lymphoma (NHL) receiving high-dose chemotherapy with autologous hematopoietic stem cell transplantation (AHSCT).Materials and methods. The retrospective data on 49 consecutive patients with NHL  receiving high-dose chemotherapy with АHSCT was               analyzed. The median age was 36.2 (7–60)  years. Median follow-up is currently 24 (1–82)  months. Prognostic factors analyzed included sex, response to the initial chemotherapy, time to relapse, second-line chemotherapy regimen type, B-symptoms on relapse, serum lactate dehydrogenase and albumin levels, response assessed by computer tomography (CT), number of chemotherapy lines, condition regimen, PET-scan results before (PET1, n = 49) and after (PET2, n = 39) AHSCT.Results. Two-year overall and event-free survivals were 74.4 and 79.1 %, respectively. Patients with CT-confirmed progression prior to AH-SCT had the worse prognosis. Prognostic significance of PET-status  was shown in chemosensitive patients (partial/complete response).The overall survival in PET1-negative and PET1-positive patients were 95.4 vs 71.0 % (р = 0.019), respectively. In PET2-positive and PET2-negative patients the overall and event-free survivals were 59.8 vs 100 % (р = 0.001) and 54.4 vs 94.4 % (р = 0.02), respectively.     In combined analysis of PET1 and PET2 statuses prognostic significance of PET2 prevailed over PET1 results significance. The multivariate analysis confirmed only PET1 significance for survival prediction.   Conclusion. Chemosensitivity of the tumor, assessed by CT, is the most important prognostic factor. In chemosensitive patients achievement PET1 or PET2 negativity means better prognosis. The patients with PET positivity prior and after AHSCT have the worst prognosis