Biomedical subjects
Publications and source records attributed to S A Balakirev.
The paper outlines the outcomes of treatment for complications associated with chemo- and radiation therapy in children with malignant neoplasms by using low-intensity laser radiation. The use of this therapy may reduce the duration of treatment of these complications by 1.5-2 times. The use of low-intensity laser radiation in the treatment of other complications that are common in pediatric oncological care is briefly described.
Application of low-intensity laser radiotherapy (LILR) allowed to cut down time needed for management of radiation injury and chemotherapy complications in pediatric patients 1.5-2-fold. It was shown that exposure to LIILR caused mononuclear (MN) levels of donors' blood to rise which in turn led to release, in higher concentrations, of IL-1 and FNO cytokins, major factors of immune response development.
The report deals with the development of procedures, evaluation of laser application and prevention of complications involved in intensive chemoradiation therapy of neoplasms of hemopoietic and lymphoid tissue in childhood. The clinical data on 548 patients, aged 2 months-15 years, with leukemia and solid tumor were evaluated. Laser application for treatment of different complications of chemoradiation therapy of pediatric leukemia proved a valuable innovation. It had a pronounced antiinflammatory and analgetic effect, promoted tissue regeneration processes and cut down the duration of complication treatment drastically.
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Altogether 77 children aged up to 3 years with acute lymphoblastic leukemia (ALL) were examined for the immunological phenotype of blast cells. L1, L1/L2, L2/L1, L2 variants of ALL and the undifferentiated one were established in accordance with criteria of the FAB classification. T1, zero and Ia immunosubvariants were recorded most frequently. Mature cell T2 and pre-B variants (3 and 2 cases, respectively) were rare; B-cellular acute lymphoblastic leukemia was lacking; the "common" subvariant was revealed in 28 patients. The patients' age produced the highest effect on the prognosis: the significantly least disease standing and remissions were noted in a group of children under 2 years as compared to those aged 2 to 3 years. As for immunological markers, expression of Thy1-antigen exerted an unfavourable effect on the prognosis and duration of the first remission.
Tolerability and efficacy of high-dose methotrexate was studied in 70 pediatric patients with lymphoblastic tumors (acute lymphoblastic leukemia and non-Hodgkin's lymphoma). Methotrexate was given by 24-hour infusion of 500-1000 mg/m2 (total dose-700-3000 mg) after remission had been achieved. An antidote--calcium folinate--was administered 24 hours postinfusion. Major adverse side-effects involved were stomatitis, hepatotoxicity and fever. Survival in the study group was higher than in controls.
Clincocytological features of leukemia were investigated in 58 infants of the first year of life. Among these infants the sucklings present the most unfavourable group with respect to the disease prognosis. Specific clinical symptoms were most manifest in patients with congenital acute leukemia (21), and congenital chronic myeloid leukemia (20 patients). Cytogenetic investigation has revealed anomalic karyotypes (some of them are similar) in most of infants with congenital acute leukemia. In three patients with congenital chronic myeloid leukemia a typical Philadelphia chromosome has been detected, that is a rather rare case.
It has been found that kinetic parameters of proliferation in a dominating clone of bone marrow blast cells with Ia-positive and Ia-negative phenotype, as well as with expression of myeloid differentiating antigens (ICO-GM1 and ICO-G2), or in the absence of these antigens, do not significantly differ in children with subvariants MO-M4 of acute nonlymphoblastic leukemia, sensitive and resistant to the therapy. A higher rate of the bone marrow blast cell population growth and a lower effectiveness of the combined chemotherapy have been recorded in children with T-cell and pre-B-cell acute lymphoblastic leukemia as compared to acute lymphoblastic leukemia with the phenotype of blast cells that have only Ia-like or "common" antigens.
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Rearrangement of the short arm of chromosome 6 with a breakpoint at 6p23 was found in five patients with myeloid leukemia. Three of them had different morphological variants of AML (M2, M3, M4) and two blastic crisis of Ph1 negative and Ph1 positive CML. Identical translocation, t(6;9)(p23;q34), was revealed in two patients. One of them had AML (M2), the other blastic crisis of Ph1 negative CML. The blast cells of the last patient were morphologically similar to those in the M2 variant of AML. Translocation (6;9)(p23;q34) was also detected in two AML patients of Rowley and Potter (1976). The role of the breakpoint at 6p23 in myeloid malignancies needs further investigation.
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