6 research outputs found
Иммуно-биохимические показатели в ранней диагностике хронической ишемии головного мозга
The paper presents results of clinical and laboratory investigation of 106 patients with chronic brain ischemia (CBI) I—II stages, included detection levels of circulating desquamated endothelial cells, endothelin-1, autoantibodies to encephalitogenic protein, neuron-specific enolase and protein S100. Reliable changes of immune status as well as signs of endothelium dysfunction progressed with stage of CBI. Direct correlation between intensity of endothelium dysfunction and activity of neurodegererative process in brain was revealed.Представлены результаты клинического и лабораторного исследования 106 больных с хронической ишемией головного мозга (ХИМ) I—II стадии, которое включало определение количества циркулирующих десквамированных эндотелиоцитов, эндотелина-1, титра аутоантител к мозгоспецифическим белкам: энцефалитогенному протеину, нейроспецифической енолазе и белку S100. Выявленные изменения иммунного статуса, а также признаки эндотелиальной дисфункции прогрессировали со стадией ХИМ. Найдена прямая корреляция между степенью дисфункции эндотелия и активностью нейродегенеративного процесса в головном мозге
CHRONIC MYELOID LEUKEMIA: EPIDEMIOLOGY AND FIFTEENTH YEARS OF THERAPY IN THE NOVOSIBIRSK REGION
The incidence of chronic myeloid leukemia from 2004 to 2018 amounted to 0.63 per 100 000 people per year. The prevalence of chronic myeloid leukemia over the past 15 years has increased from 1.88 to 7.02 case per 100 000 people. We have analyzed the therapy outcomes of chronic myeloid leukemia of patients, received imatinib treatment for more than 12 month (165 patients). Complete hematologic response is attained in 88.5 % cases (146 patients), complete cytogenetic response (CCR) (ph+<0 %) – in 72.1 % cases (119 patients), major molecular response (MMR) – in 50.3 % cases (83 patients). The primary resistance to imatinib is observed in 21.8 % cases (36 patients), secondary – in 6.1 % cases (10 patients – 7 patients have lost the complete hematologic response and CCR and 3 patients have lost the CCR and MMR). The thirteen patients of those, who have primary or secondary resistance to imatinib have been treated with second-generation tyrosine kinase inhibitors (nilotinib, dasatinib) and in 93,3 % cases (14 patients) CCR have been obtained, 10 patients (66.7 %) have attained the CCR and 9 patients (60 %) have achieved MMR. Among all those patients treated with I and II generations tyrosine kinase inhibitors, we have carried out the overall survival (OS) analysis and obtained following results: the median of OS have not been achieved, 5-year OS rate is estimated as 90 %, 10-year OS rate – more than 77 %, calculated 15-year OS – more than 60 %
ЭПИДЕМИОЛОГИЯ И КЛИНИКО-ДЕМОГРАФИЧЕСКАЯ ХАРАКТЕРИСТИКА ДИФФУЗНОЙ В-КРУПНОКЛЕТОЧНОЙ ЛИМФОМЫ НА ТЕРРИТОРИИ Г. НОВОСИБИРСКА
Background. The annual reporting forms for malignant neoplasms do not provide for the division of lymphomas into variants. In international publications and statistical reference books of the Russian Federation, variants of non-Hodgkin’s lymphomas (NHL) are also not separated. For these reasons, a detailed assessment of the epidemiology of NHL in Russia is difficult, and data for individual variants of the disease are not provided.Purpose: to present the clinical and epidemiological characteristics of Diffuse Large B-cell Lymphoma (DL BCL ) in Novosibirsk according to the data of the City Hematology Center (CHC).Material and Methods. A retrospective analysis of primary medical documentation (case histories, outpatient charts, and immunohistochemical study reports) of 271 patients with DL BCL was performed in the period from January 1, 2013 to December 31, 2018.Results. The calculated registered primary morbidity and mortality from DL BCL in Novosibirsk for the analyzed years fluctuated slightly. The average incidence and mortality rates were 2.85 and 1.98 per 100,000 population, respectively. When analyzing the dynamics of the prevalence of DL BCL in Novosibirsk, a positive trend of annual increase in the indicator was revealed: 1.87 times over the past 6 years. In men, the tumor developed 2.6 years earlier than in women. In General, the risk of getting DL BCL after 50 years was 3 times higher than at the age of 30 years. Among patients diagnosed with primary lymphoma who underwent treatment at the Hematology department of CHC, half of the patients had DL BCL .Evaluation of the clinical characteristics showed a pronounced severity of the analyzed cohort.Conclusion. The updated quantitative and qualitative indicators of clinical and epidemiological characteristics of DL BCL in Novosibirsk for 2013–18 were obtained. These indicators can be used for further monitoring, development and implementation of measures for the prevention, diagnosis and treatment of this form of hemoblastosis. Введение. В формах годовой отчетности по злокачественным новообразованиям не предусмотрено разделение лимфом на варианты. В международных изданиях и статистических справочниках Российской Федерации варианты неходжкинских лимфом (НХЛ) также не разделяются. По этим причинам детальная оценка эпидемиологии НХЛ в России затруднена, данные для отдельных вариантов заболевания не описаны. Цель исследования – представить клинико-эпидемиологическую характеристику диффузной В-крупноклеточной лимфомы (ДВККЛ) в г. Новосибирске по данным Городского гематологического центра (ГГЦ). Материал и методы. Проводился ретроспективный анализ первичной медицинской документации (историй болезни, амбулаторных карт и заключений иммуногистохимического исследования) 271 больного ДВККЛ, наблюдавшегося в ГГЦ в период с 1 января 2013 г. по 31 декабря 2018 г. Результаты. Рассчитанная регистрируемая первичная заболеваемость и смертность от ДВККЛ в г. Новосибирске по анализируемым годам незначительно колебались. Средний показатель для заболеваемости составил 2,85 случая на 100 000 населения, смертности – 1,98 случая на 100 000 населения. При анализе динамики распространенности ДВККЛ в г. Новосибирске был выявлен положительный тренд ежегодного увеличения показателя: в 1,87 раза за последние 6 лет. У мужчин опухоль развивалась на 2,6 года раньше, чем у женщин. В целом риск заболеть ДВККЛ после 50 лет был в 3 раза выше, чем в возрасте до 30 лет. Среди больных с первично диагностированными лимфомами, проходивших лечение в гематологическом отделении ГГЦ, половина всех случаев госпитализаций в отделение и проведенных курсов терапии приходилась на больных ДВККЛ. Оценка клинической характеристики показала выраженную тяжесть анализируемой когорты. Заключение. В проведенном исследовании получены актуализированные количественные и качественные показатели клинико-эпидемиологической характеристики ДВККЛ в г. Новосибирске за 2013–18 гг. по данным ГГЦ, которые могут применяться для дальнейшего мониторинга, разработки и внедрения мероприятий по профилактике, диагностике и лечению данной формы гемобластоза
FORMATION OF IRON EXCESS IN PATIENTS WITH INTERMEDIATE- AND LOWER-RISK MYELODYSPLASTIC SYNDROME
Immunal and biochemical indexes in early diagnostics of chronic brain ischemia
The paper presents results of clinical and laboratory investigation of 106 patients with chronic brain ischemia (CBI) I—II stages, included detection levels of circulating desquamated endothelial cells, endothelin-1, autoantibodies to encephalitogenic protein, neuron-specific enolase and protein S100. Reliable changes of immune status as well as signs of endothelium dysfunction progressed with stage of CBI. Direct correlation between intensity of endothelium dysfunction and activity of neurodegererative process in brain was revealed
ADULT-ONSET STILL’S DISEASE: ASPECTS OF THE HEMATOLOGY CLINIC
The analysis of literature data on modern approaches in the diagnosis and treatment of adult-onset Still’s disease has been performed. A clinical case of Still’s disease associated with lymphadenopathy syndrome was demonstrated. It is noted that the diagnosis of adult Still’s disease requires a doctor to exclude a complex of a tumor, rheumatological and infectious pathology. It is important for a hematologist not to miss a blood tumor and to prevent a diagnostic error. The authors showed the criteria for exclusion of myeloblastic hematosarcoma and malignant lymphoma in a patient with Still’s disease. The importance of taking into account the clinical data is noted: the absence of progressive sarcomal growth of lymph nodes, the lack of generalization and dissemination of myeloblastic substrate in the body, the reduction of fever with steroids and nonsteroidal anti-inflammatory drugs. The role of monitoring clinical and biochemical blood parameters has been proved such as: blood ferritin level, C-reactive protein, hemogram parameters. The relative value of positron emission computed tomography data, which can be falsely interpreted, is shown. Correct diagnosis, rejection of an incorrect diagnosis of hematological tumor will prevent the administration of myeloablative polychemotherapy, which is dangerous for an adult patient with Still’s disease. The article outlines the differential diagnosis algorithm, presents the criteria for diagnosis and approaches to therapy. A feature of the clinical case was the detection of antibodies against yersenia. A meeting with an infectious agent could be a trigger for the development of a multisystem form of Still’s disease in a patient