Abstract:
:Treatment programs for patients with acquired aplastic anemia include two main therapeutic options: allogeneic bone marrow transplantation and combined immunosuppressive therapy (IST). However, combined IST remains the method of choice for most adult AA patients. This study included 120 AA patients who received IST at the National Research Center for Hematology in 20072016. The analysis was applied to 120 patients. Median age was 25 (1765) years, M/F: 66/54, SAA/NSAA: 66%/34%. Effectiveness of IST was carried out in 120 patients with AA. This group did not include 8 SAA patients who died during the first 3 months from the start of treatment from severe infectious complications (early deaths 6.2%) and 2 AA patients who dropped out of surveillance. The observation time was 55 (6120) months. Paroxysmal nocturnal hemoglobinuria (PNH clone) was detected in 67% of AA patients. The median PNH clone size (granulocytes) was 2.5 (0.0199.5)%. The treatment was according to the classical protocol of combined IST: horse antithymocytic globulin and cyclosporin A. Most of patients (87%) responded to combined immunosuppressive therapy. To achieve a positive response, it was sufficient to conduct one course of ATG to 64% of patients, two courses of ATG 24% of patients and 2% of patients responded only after the third course of ATG. A positive response after the first course was obtained in 64% of patients included in the analysis. Most of the responding patients (93%) achieve a positive response after 36 months from the start of treatment. Therefore, the 3rd6th months after the first course of ATG in the absence of an answer to the first line of therapy can be considered the optimal time for the second course of ATG. This tactic allows to get an answer in another 58% of patients who did not respond to the first course of ATG. The probability of an overall 10-year survival rate was 90% (95% confidence interval 83.696.2). :Современные программы лечения больных апластической анемией (АА) включают два основных терапевтических направления: трансплантацию аллогенного костного мозга и комбинированную иммуносупрессивную терапию (ИСТ). Методом выбора для большинства взрослых больных АА остается комбинированная ИСТ. В данную работу первоначально включены 130 пациентов с АА, получавших ИСТ в ФГБУ НМИЦ гематологии в 20072016 гг., анализ эффективности ИСТ проводился у 120 больных. Медиана возраста составила 25 (1765) лет, 70 мужчин и 50 женщин, у 66% больных диагностирована тяжелая АА и у 34% нетяжелая. Анализ эффективности ИСТ выполнялся у 120 больных АА. В группу анализа не включены 8 больных тяжелой АА, умерших в течение первых 3 мес от начала лечения от тяжелых инфекционных осложнений (ранние смерти 6,2%), и 2 больных АА, течение заболевания которых неизвестно. Медиана продолжительности наблюдения 55 (6120) мес. Клон пароксизмальной ночной гемоглобинурии выявлен у 67% больных АА, медиана его размера по гранулоцитам 2,5 (0,0199,5)%. Лечение проводилось по классическому протоколу комбинированной ИСТ: лошадиный антитимоцитарный глобулин (АТГ) и циклоспорин А. У 87% больных достигнут положительный ответ на комбинированную ИСТ. Для получения положительного ответа оказалось достаточным проведение одного курса терапии АТГ 74% больных, 2 курсов АТГ 24%, и 2% потребовалось 3 курса АТГ. У большинства больных (93%) гематологический ответ получен через 36 мес от начала лечения. Поэтому 36-й месяцы после 1-го курса АТГ при отсутствии ответа на 1-ю линию терапии можно считать оптимальным сроком проведения 2-го курса АТГ. Такая тактика позволяет получить ответ еще у 58% больных, не ответивших на 1-й курс терапии АТГ. Вероятность 10-летней общей выживаемости составила 90% (95% доверительный интервал 83,696,2).
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Mikhaylova EA,Fidarova ZT,Abramova AV,Luchkin AV,Troitskaya VV,Dvirnyk VN,Galtseva IV,Kliasova GA,Kovrigina AM,Kulikov SM,Chabaeva YА,Parovichnikova EN,Savchenko VG,Obukhova TNdoi
10.26442/00403660.2020.07.000756subject
Has Abstractpub_date
2020-09-01 00:00:00pages
4-9issue
7eissn
0040-3660issn
2309-5342journal_volume
92pub_type
杂志文章abstract:AIM:To study the proportion of CD8+CD28+ and CD4+CD28+ cells among the CD8+ and CD4+ lymphocytes and the changes in these indicators in patients with HIV infection/tuberculosis (HIV/TB) versus those with HIV infection and those with TB. SUBJECTS AND METHODS:One hundred and six persons were examined and included into 4...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::The therapeutic effect of human immunoglobulins was assessed in 29 patients with nonspecific ulcerative colitis, as was their influence on intestinal flora. A 5 to 15 ml dose of immunoglobulin was administered intramuscularly every other day, 3 injections altogether. The clinical and endoscopic effect of treatment was...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:To study possible correction of bone disorders (osteopenia, Ca/P-imbalance, bone pain, limited volume of indolent movements) which are still a serious complication associated with renal diseases and pathogenic therapy (steroids). MATERIALS AND METHODS:The bone disorders were treated in 10 uremic hemodialyzed patie...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:AIM:To study the safety and clinical efficacy of an outpatient coronary angiography in various groups of patients according to a 6-year experience of the laboratory of endovascular diagnostic and treatment methods in the outpatient setting of the NMRC of Cardiology. MATERIALS AND METHODS:2166 patients which underwent ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2019.04.000209
更新日期:2019-05-16 00:00:00
abstract:AIM:To investigate effects of polymorphic variants of surfactant protein C gene (SFTPC) on the course of the disease in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS:Sixty COPD patients were examined with COPD of stage 0-IV. The following parameters were studied: smoking index (SI), ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::Therapy with tyrosine kinase inhibitors (TKI) allows to achieve a deep molecular response in 6070% of patients with chronic myeloid leukemia (CML). According to the current guidelines CML patients receive a long-term treatment with TKI in standard dose. The frequently observed adverse effects (AE) of TKI therapy are m...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.07.000789
更新日期:2020-09-01 00:00:00
abstract:AIM:to evaluate brachial artery (BA) endothelial vasomotor function in patients with systemic lupus erythematosus (SLE) and scleroderma systematica (SDS), by using noninvasive studies. Subjects and methods. Sixty-five patients, including 25 with SLE, 20 with SDS, and 20 with atherosclerosis (AS) obliterans of lower ext...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:AIM:To study the results of mobilizing and collecting autologous hematopoietic stem cells (HSC) in patients with multiple myeloma (MM) receiving bortezomib as part of induction therapy regimens. MATERIALS AND METHODS:In June 2001 to April 2010, the Department of Bone Marrow Transplantation, Hematology Research Center,...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:AIM:To elicit the most sensitive and reliable method of control over administration of indirect anticoagulants. MATERIAL AND METHODS:Sixty patients with acute coronary syndrome were studied. They received varfarin under the control of international normalized ratio (INR) calculated by the tables in cases of prothrombi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract:AIM:To study effects of ACE inhibitors in patients with diffuse renal diseases at the stage of chronic renal failure (CRF). MATERIAL AND METHODS:Acute changes in renal filtration and in renal hemodynamics in response to 100-200 mg captopril were studied in 7 patients with CRF and 6 patients with intact renal function....
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:AIM:To assess changes in quality of life (QL) and cognitive functions in patients with end-stage renal failure (ESRF) treated with hemodialysis using a succinate-containing dialyzing solution (SCDS). SUBJECTS AND METHODS:Sixty-seven patients with ESRF on hemodialysis using SCDS were examined. The investigators determi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:AIM:To study the urinary excretion of the molecular factors regulating angiogenesis, such as vascular endothelial growth factor type A (VEGF-A), thrombospondin 1 (THBS1), and angiopoietin 2 (ANGPT2), versus that of the urinary markers of renal injury and fibrogenesis, such as neutrophil gelatinase-associated lipocalin ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201587675-82
更新日期:2015-01-01 00:00:00
abstract::The purpose of the investigation was to study the relationship between indicators of the bicycle ergometry test and temporary disability degree in males aged 40 to 59 residing in the area of 2 district outpatient clinics in Moscow. Disability (temporary, stable) was studied by a method of standard interviewing. The bi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Application of a modern method of introscopy--electroimpedance tomography (EIT) for diagnosis of different types of lung diseases is described. The EIT system including measurement and collecting data devices, 16-electrodes array and IBM PC 486 computer was used. The results of analysis of electrotomograms have demons...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:AIM:To assess carotid blood flow in healthy subjects and hypertensive patients, to specify prognostic significance of factors affecting carotid circulation with use of a multivariate analysis. MATERIAL AND METHODS:Clinical examination, ultrasonic dopplerography of the internal carotid arteries (ICA), echocardiography,...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract:AIM:To determine the effects of menopausal hormone therapy dosage on levels of proinflammatory cytokines and immunoglobulins in bodily fluids of patients with type 2 diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) during perimenopause. MATERIALS AND METHODS:The study included 119 perimenopausal...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh2018901079-83
更新日期:2018-11-22 00:00:00
abstract:AIM:The expression of CD95(Fas/APO-1) antigen was studied on bone marrow cells of 19 MDS patients, peripheral blood blast cells of 15 acute myeloid leukemia (AML) patients, blast cells and granulocytes of 68 patients with chronic myeloid leukemia (CML)--24 in chronic, 9 in accelerated phase and 35 in blastic crisis (BC...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::The authors studied the activity of cholesterol esters transport (CET), concentrations of apolipoprotein E in the blood and high density lipoproteins (HDLP) in parallel with other parameters of lipoprotein metabolism in 79 males and 62 females. 122 of them had ischemic heart disease (IHD) and primary hyperlipoproteine...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:AIM:To ascertain whether high arterial rigidity is obligatory in arterial hypertension (AH) and the presence of AH is obligatory in patients with rigid arteries. MATERIAL AND METHODS:Volume sphygmography (VS) was made in 153 patients aged 60-86 years: 96 patients with untreated AH of degree 1-3 (40 males aged 71.0 +/-...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:AIM:To study effectiveness and tolerance of monoclonal antibodies to tumor necrosis factor (the drug remicade) in patients with rheumatoid arthritis (RA). MATERIAL AND METHODS:Remicade treatment results are considered for 25 RA patients receiving methotrexate the activity of which was inadequate for these patients. Re...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::Altogether 136 patients with thyrotoxicosis complicated by atrial fibrillation were treated. After drug treatment alone and strumectomy if indicated, over two-thirds of the patients showed sinus rhythm recovery after the attainment of euthyrosis even before institution of the treatment with antiarrhythmic drugs. It is...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:AIM:To determine the effect of plasma homocysteine (Hc) on the structure and function of the left ventricle (LV) in patients treated by programmed hemodialysis. SUBJECTS AND METHODS:109 patients on programmed hemodialysis were examined. Blood Hc levels were determined and echocardiography was performed in all the pati...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::A total of 160 persons including 50 patients with duodenal ulcer (DU) and 38 with gastric ulcer (GU) were examined for antibodies to the parietal cells of the stomach (PCA) and cell cellular immunity responses to autologous antigen from the gastric mucosa. It was shown that both PCA of the stomach and cell immunity re...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The antigenic composition of tissues was shown to be of importance in the formation of bronchial asthma on the basis of the clinicoimmunological data with regard to histocompatibility antigens in 235 patients suffering from bronchial asthma and preasthma. Well-defined correlations were established between the developm...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Clinical and instrumental manifestations of disorders of the regional blood circulation were studied in 47 patients with sclerodermia systematica. Hemodynamic changes of the lesser circulation were marked in patients under 44 with more active disease, longer disease duration, pulmonary pathology and cardiac decompensa...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:To reveal the metabolic parameters of lipoproteins (L), which determine the benefits of hypolipidemic effects of simvastatin (S) and fluvastatin (F); to trace changes in the activity of lecithin-cholesterol acyltransferase (LCA) and cholesterol (C) ester transfer (CET) from high density lipoproteins to very low den...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Respiratory tuberculosis in a pulmonary inpatient setting is not rare but, as a rule, is not diagnosed in time. Tuberculosis-directed alertness, especially in patients with an atypical lingering course of disease, the absence of the effect of nonspecific antibacterial therapy, risk factors (immunodeficiency state, dia...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:To establish the specific features of the taxonomic and functional composition of the enteric microbiota in patients with alcoholic liver cirrhosis (LC). SUBJECTS AND METHODS:Metagenomic analysis was used to study the taxonomic composition and functional potential of the enteric microbiota in 20 patients with alco...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh2015871259-65
更新日期:2015-01-01 00:00:00
abstract:AIM:To specify causes of discontinuation of the disease-modifying antirheumatic drugs (DMAD) used in rheumatoid arthritis (RA) by the results of special questionnaire survey. MATERIAL AND METHODS:The study included 298 RA patients treated in the Institute of Rheumatology (34 males and 264 females aged 18-82, mean age ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00