Optimization of chronic lymphocytic leukemia treatment using game theory

The current strategy of chronic lymphocytic leukemia (CLL) treatment is based on genetic risk factors such as del(17p), TP53 mutations and/or unmutated variant of IGHV genes. Guidelines recommend the usage of targeted drugs, e.g. ibrutinib, in the first line for patients with unfavorable risk factors due to dismal results of other treatment options. Unfortunately,  in real-life treatment decisions are often made without full knowledge of genetic risk factors in the treated patient. Our aim was to find the optimal therapeutic strategy for such patients, that is, those providing the best 5-year progression-free survival (PFS). Using a relatively simple game theory-based approach we here show, that currently, the used strategy is more advantageous (success rate 71%) compared to administration of immunochemotherapy to all patients (success rate with fludarabine + cyclophosphamide + rituximab — 45%, bendamustine + rituximab — 32%). However, the optimal strategy for CLL treatment in the conditions of unknown genetic risks is the administration of ibrutinib to all patients (success rate 73%). Our simple method can be used for optimization of treatment strategy of any oncologic disease and can be integrated into relevant clinical decision support systems

ASSESSMENT OF SHIELDING PROPERTIES OF NATURAL MINERALS AND PRODUCTION WASTE FOR USE IN RADIATION PROTECTION

The paper presents the results of calculating the shielding properties of a number of natural minerals and industrial wastes to assess the possibility of their use as radiation protection against gamma radiation.В работе представлены результаты расчета экранирующих свойств ряда природных минералов и отходов производства для оценки возможности их использования в качестве радиационной защиты от гамма-излучения

ON THE POSSIBILITY OF THE USAGE OF CONCRETE WITH THE ADDITION OF BARITE FOR GAMMA RADIATION PROTECTION

The paper presents the studies’ results of the gamma-ray absorbing properties of concrete with different barite content in its composition in energy range from 1 Kev to 2 MeV. The mass attenuation coefficients of gamma radiation were calculated using the NIST XCOM database. The calculation results were compared with the experimental data of several authors.В работе представлены результаты исследований поглощающих свойств бетона с различным содержанием барита в его составе в диапазоне энергии гамма-излучения от 1 кэВ до 2 МэВ. Массовые коэффициенты ослабления гамма-излучения были рассчитаны с помощью базы данных NIST XCOM. Проведено сравнение результатов расчета с экспериментальными данными, полученными рядом авторов

Investigation of Radiation-Protective Properties of Glasses with the Addition of Niobium Oxide

The radiation protection capabilities of the WO3-La2O3-B2O3-Nb2O5 glass system were calculated. Presents the results of calculating the protective properties of a glass system against gamma radiation using the Geant4 calculation code for the energy range 0,015-3 MeV

EVALUATION OF THE SHIELDING CAPACITY OF THE Na2O-B2O3-Bi2O3-MoO3 GLASS SYSTEM USING THE GEANT4 CODE AND THE XCOM DATABASE

The radiation protection capabilities of the Na2O-B2O3-Bi2O3-MoO3 glass system were calculated. The simulated values of mass intensity ratios (μm) were compared with theoreti-cally calculated values for these glass samples

DOSE COSTS OF PERSONNEL AT THE STAGES OF THE LIFE CYCLE OF FAST NEUTRON REACTORS

В работе выполнен анализ дозовых затрат персонала на этапах жизненного цикла АЭС с реакторами на быстрых нейтронах с натриевым теплоносителем.The paper analyzes the dose costs of personnel at the stages of the life cycle of nuclear power plants with sodium-cooled fast neutron reactors

COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus

Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency

EFFECTIVENESS OF VENETOСLAX IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (LITERATURE REVIEW)

Currently we are facing a revolution in therapy of chronic lymphocytic leukemia, related to the development of novel target drugs, which have markedly improved treatment results in all groups of patients. While inhibitors of Bruton’s tyrosine kinase (ibrutinib, acalabrutinib etc.) and phosphatidylinositol-3 kinase isoforms (idelalisib, umbralisib etc.) are currently in the spotlight, much less attention is paid to antiapoptotic protein inhibitors such as venetoclax. In this review we summarize the results of venetoclax clinical studies in CLL as monotherapy and in combinations. The drug is distinguished by a high rate of complete responses and minimal residual disease eradication in high risk CLL patients, as well as a favorable toxicity profile. This makes it an ideal component of non-genotoxic regimens, aimed at the cure of the disease