[The results of 2 and 1/2 years of work of the Russian Multicenter Trial on the Treatment of Acute Myeloid Leukemias in Adults].
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Biomedical subjects
Publications and source records attributed to V G Savchenko.
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Compatibility in mixed lymphocyte culture (MLC) test was determined for 60 hemoblastosis patients with their 71 HLA-identical sibs to transplant allogenic syngeneic bone marrow. A protocol for the MLC radioisotope micromethod with culturing in plates is described for the pair donor-recipient in the direct and reverse variants covering about 20 variants of mixed cultures. This secures the results' reliability. Plotting of the MLC compatibility results for each pair has been proposed. Incompatibility by MLC was revealed in 5 out of 71 pairs (7%). Bone marrow transplantation was performed in 30 patients from their HLA-identical/MLC-compatible sibs. The secondary disease due to incompatibility missed in the MLC reaction occurred in 5 cases (16.7%), transplant rejection in 2 cases (6.7%), which is less in number than literature data. It was established that determination of compatibility by MLC may serve a reliable criterion of assessing a genotypic pair HLA identity and should be conducted before each allogenic and syngeneic transplantation of bone marrow. The protocols of the method performance and compatibility parameters evaluation warrant high significance of the compatibility definition confirmed by clinical responses with minimal probability of secondary disease.
Hemopoietic effects in bone marrow long-term cultures (BMLTC) of healthy subjects and patients with acute myeloid leukemia (AML) in remission were studied due to fibronectin (FN) and glycoprotein of extracellular matrix of stromal microenvironment. Twelve AML patients and 6 healthy donors of allogenic transplant were examined. Blood formation in the BMLTC was assessed by weekly production of cells in nonadhesive BMLTC fraction and the content of granulocytic-macrophagal colony-forming cells in it. The response of hemopoietic stroma on FN sublayer was evaluated by weekly measurements of BMLTC adhesive layer cellularity. FN is demonstrated to stimulate the growth of BMLTC adhesive cell sublayer, the cellularity increase being the same in the above groups. FN sublayer had no influence on cellularity of the nonadhesive fraction and on the number of granulocytic-macrophagal colony-forming cells in healthy subjects, whereas it increased these values in AML patients in remission. This rise, however, was not significant. BMLTC is capable of defining a favorable effect of FN sublayer on hemopoiesis in AML patients in remission. This effect may arise from higher quality of the sublayer and survival of cells-precursors at initial stages of the cultivation.
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The clinical efficacy of aclarubicin, an anthracycline antibiotic, was studied in 48 patients with leukemia. The antibiotic was used in the following combinations with cytarabine: "7 + 7", "5 + 5" and "7 & 3". A complete remission was stated in 14 (42.4 per cent) out of 33 patients with acute nonlymphoid leukemia, 6 (43 per cent) out of the 14 patients having relapses. The combined therapy was effective in 4 out of 5 pre-resistant patients. The "7 + 3" scheme was the most beneficial. The most common adverse reactions were nausea and vomiting.
The authors relate the results of a clinico-morpho-instrumental analysis of the clinical course of lymphosarcomas in 38 patients with different morphological patterns of the disease with primary injury to the spleen. The patients received multimodality therapy including splenectomy. It has been established that later the short-term effect of splenectomy permits the implementation of different polychemotherapy programs, favouring a better lymphosarcoma prediction.
Repeated plasmapheresis sessions attended by chemiluminescent evaluation of cellular immunity parameters lead to the recovery of the whole blood leucocyte activity in patients with unhealing gastroduodenal ulcers. The kinetic analysis of the cellular chemiluminescent response has shown that, among all the components of the plasmapheresis procedure, hemorrhage is the most important factor increasing the functional activity of phagocytes.
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