The Problem of Timeliness of Young Children Vaccination and Ways to Solve It

Relevance Aims. Despite of widespread achievements and maintenance of appropriate levels of coverage of preventive vaccinations (>95%) the problem of delayed immunizations and vaccination on time is still existed in the Russian Federation over the last years. Materials and methods.  A selective analysis of the vaccination on time against diphtheria, tetanus, pertussis and hepatitis B, of children aged under 2 years in Russia, Moscow, from 2014 to 2018 was conducted. To assess the timeliness of vaccination, two independent sample studies were conducted: the vaccination history of 6003 whooping cough patients in Moscow was analyzed and vaccination was evaluated in 641 children, who were born 2016–2018  in Kirov, depending on the implementation of combination vaccines.  Results.  The current  95% coverage  of preventive  age-recommended vaccination  of decreed  age against  pertussis, diphtheria, tetanus, polio, hepatitis B is achieved only by 2–3 years of age. Conducted analysis showed, that the implementation of combination vaccines contributed  to increase in the proportion  of timely vaccinated children up to 1 year of age as well as propotion of children who started primary immunization series at recommended age of 3 months. Also as a result the vaccination coverage against Hib infection and proportion of timely vaccinated against pneumococcal infection was increased. Conclusions.The implementation of modern multicomponent combination vaccines allows to increase vaccination coverage in population and to control effectively infectious diseases and also to reduce number of injections and visits to clinics

Flow cytometric minimal residual disease monitoring in children with acute lymphoblastic leukemia treated by regimens with reduced intensity

191 consecutive unselected children with acute lymphoblastic leukemia aged from 1 to 16 years were enrolled in the study. Bone marrow samples were obtained at the time of initial diagnostics as well as at days 15 (n = 188), 36 (n = 191), and 85 (n = 187) of remission induction. Minimal residual disease (MRD) was assessed by 6–10-color flow cytometry. Flow cytometry data at day 15 allowed distinguishing three patients groups with significantly different outcome (p ˂ 0.0001): 35.64 % patients with MRD < 0.1 % represented 5-year event-free survival (EFS) of 100 %; 48.40 % cases with 0.1 % ≤ MRD< 10 % had EFS 84.6 ± 4.2 %; 15.96 % patients with very high MRD (≥ 10 %) belonged to group with poor outcome (EFS 56.7 ± 9.0 %). At the end of remission induction (day 36) 36 children (18.85 %) with MRD higher than 0.1 % had significantly worse outcome compared to remaining ones (EFS 49.4 ± 9.0 and 93.5 ± 2.1 % respectively; p ˂ 0.0001). From a clinical standpoint it is relevant to evaluate both low-risk and high-risk criteria. Multivariate analysis showed that day 15 MRD data is better for low-risk patients definition while end-induction MRD is the strongest unfavorable prognostic factor