Abstract:
AIM:to analyze well-known risk factors (RFs), such as age, immunophenotype, baseline leukocytosis, enhanced lactate dehydrogenase (LDH) activity, time to achieve complete remission, a risk group, and cytogenetic abnormalities) in patients with acute lymphoblastic leukemia (ALL) in the use of the ALL-2009 protocol. SUBJECTS AND METHODS:The protocol covered 298 patients (137 women (including 13 pregnant women) and 161 men) aged 15 to 55 years (median age 28 years) with Ph-negative ALL. The phenotype was unknown in 6 patients. Three (1%) were ascertained to have a biphenotypic variant. 182 (62.4%) patients were found to have B-cell ALL (early pre-B ALL (n=51); common ALL (n=92), and pre-B ALL (n=39); 107 (36.6%) patients had T-cell ALL (early T-ALL (n=56); thymic T-ALL (n=41), and mature T-ALL (n=10). According to the baseline clinical and laboratory parameters (leukocytosis of 30·109/l and more for B-ALL; and that of 100·109/l and more for T-ALL; phenotype В-I for B-ALL, phenotype Т-I-II-IV for T-ALL; LDH activity was more than twice the normal values; the presence of translocation t(4;11)), the high-risk group included most patients with B-ALL (n=110 (72.8%)) and T-ALL (n=76 (76%)). Thirty-five patients with T-ALL underwent autologous bone marrow transplantation (BMT). Allogeneic BMT was performed in 18 (7%) of the 258 patients who had undergone an induction phase. RESULTS:Five-year overall survival for all the patients included in the investigation was 59%; relapse-free survival was 65%, which was significantly different in the patients with B-ALL and in those with T-ALL: the overall survival rates were 53.3 and 67.5% (p=0.1); the relapse-free survival was 56 and 79% (p=0.005), respectively. Multivariate analysis including the well-known RFs demonstrated that the latter for T-ALL were of no independent prognostic value and only the patient's age was identified for B-ALL (p=0.013). CONCLUSION:A lower chemotherapeutic load and a small number of allogeneic BMTs did not affect total positive treatment results in adult patients with ALL, by complying with the principle achieving the continuity of cytostatic effects and by preserving the total cytostatic loading dose. The results of the Russian investigation casts some doubt on the necessity of using very intensive consolidation cycles and performing a large number of allogeneic BMTs in adult patients with ALL. :Цель исследования - проанализировать общеизвестные факторы риска - ФР (возраст, иммунофенотип, исходный лейкоцитоз, повышенная активность лактатдегидрогеназы - ЛДГ, время достижения полной ремиссии, группа риска, цитогенетические аномалии) у больных острыми лимфобластными лейкозами (ОЛЛ) при использовании протокола ОЛЛ-2009. Материалы и методы. В протокол включили 298 больных Ph-негативным ОЛЛ в возрасте от 15 до 55 лет, медиана 28 лет, 137 женщин (среди них 13 беременных) и 161 мужчина. У 6 фенотип неизвестен. У 3 (1%) установлен бифенотипический вариант. У 182 (62,4%) пациентов определен В-клеточный (у 51 ранний пре-В ОЛЛ, у 92 common-ОЛЛ, у 39 пре-В ОЛЛ) и у 107 (36,6%) Т-клеточный вариант ОЛЛ (у 56 ранний Т-ОЛЛ, у 41 тимический Т-ОЛЛ, у 10 зрелый Т-ОЛЛ). К группе высокого риска на основании исходных клинико-лабораторных параметров (лейкоцитоз для В-ОЛЛ 30·109/л и более, для Т-ОЛЛ 100·109/л и более, фенотип В-I для В-ОЛЛ, фенотип Т-I-II-IV для Т-ОЛЛ, активность ЛДГ более чем в 2 раза выше нормы, наличие транслокации t(4;11)) отнесено большинство больных с В-ОЛЛ (n=110, 72,8%) и с Т-ОЛЛ (n=76, 76%). У 35 пациентов с Т-ОЛЛ осуществлена аутологичная трансплантация костного мозга (ТКМ). Аллогенная ТКМ (алло-ТКМ) выполнена лишь 18 (7%) из 258 больных, переживших индукционную фазу. Результаты. Пятилетняя общая выживаемость для всех больных, включенных в исследование, составила 59%, безрецидивная - 65%, что достоверно отличается у больных с В-ОЛЛ и Т-ОЛЛ: общая 53,3 и 67,5% (р=0,1), безрецидивная 56 и 79% (р=0,005) соответственно. Многофакторный анализ, выполненный с включением общеизвестных ФР, продемонстрировал, что для Т-ОЛЛ общеизвестные ФР не имели независимой прогностической значимости, а для В-ОЛЛ выделялся как значимый только возраст больного (р=0,013). Заключение. Снижение химиотерапевтической нагрузки и малое число алло-ТКМ не влияли на общие положительные результаты лечения взрослых больных ОЛЛ, при соблюдении принципа непрерывности цитостатического воздействия и сохранении общей дозы цитостатической нагрузки. Результаты российского исследования ставят под сомнение необходимость использования у взрослых больных ОЛЛ очень интенсивных курсов консолидации и выполнения большого количества алло-ТКМ.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Parovichnikova EN,Sokolov AN,Troitskaya VV,Klyasova GA,Rusinov MA,Akhmerzaeva ZK,Kuzmina LA,Bondarenko SN,Baranova OY,Kaporskaya TS,Zotina EN,Zinina EE,Samoilova OS,Gavrilova LV,Kaplanov KD,Konstantinova TS,Lapin VA,Kradoi
10.17116/terarkh201688715-24subject
Has Abstractpub_date
2016-01-01 00:00:00pages
15-24issue
7eissn
0040-3660issn
2309-5342journal_volume
88pub_type
杂志文章abstract::The most important condition for effective prophylactic medical examination is early detection of diseases. The efficacy of prophylactic medical examination of rheumatic fever patients rises considerably under the conditions of stage-by-stage therapy. Another important condition for early detection and diagnosis is ra...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::The 5- and 10-year survival rates of all 114 patients with primary DM were 89 and 81%, respectively. Significantly lower survival rates were noted in the patients receiving late and inadequate therapy. Corticosteroid therapy radically changed the outcome of DM, mainly due to early diagnosis and adequate therapy. A sta...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 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 study was made of immunologic cell markers in 32 patients with acute myeloid leukemia by indirect immunofluorescence with the aid of xenogeneic antisera and monoclonal antibodies obtained by the authors. Ia-like antigen demonstrated by monoclonal antisera IKO-I expressed in myeloblastic leukemia with maturation in m...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:AIM:To study causes of death of rheumatic patients in Moscow. MATERIAL AND METHODS:Autopsy protocols for 1999-2002 were analysed for two pathoanatomic departments of Moscow. RESULTS:Rheumatic diseases were detected in 165 cases (2.0% of overall number of autopsies in these departments). Rheumatic heart disease (RHD) ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract:AIM:To try arthrotek, a combined drug, in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS:10 RA women aged 30 to 60 years with endoscopically verified minimal affection of gastroduodenal mucosa (not more than 25 hemorrhages and/or 5 erosions) received arthrotek (1 tablet 3 times a day for 3 months). The...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:AIM:To compare hypotensive and antiischemic efficacy of enalapril combination with trimetazidine or placebo, effects on plasmic lipid spectrum and membrane-cell parameters of erythrocytes and platelets in hypertensive patients with ischemic heart disease (IHD) in the presence of metabolic disturbances. MATERIAL AND ME...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2005-01-01 00:00:00
abstract::Mucous barrier resistance was studied in 232 duodenal ulcer patients with signs of exacerbation as shown by PAS-positive substances and acid mucopolysaccharides in antral mucosa of the stomach and duodenum as well as by gastric juice levels of gastromucoproteins, fucose and sialic acids. In addition, measurements were...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::This article describes several clinical cases of acute ischemic stroke among patients suffering from essential thrombocytemia. Ambiguity of etiological factors of stroke is demonstrated among patients with this pathology. Thrombocytosis and high allele load in the Jak2 gene play an important role (even with normal pla...
journal_title:Terapevticheskii arkhiv
pub_type:
doi:10.26442/terarkh2018907102-104
更新日期:2018-08-17 00:00:00
abstract:AIM:European Registry on the management of Helicobacter pylori infection («Hp-EuReg») - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pyl...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,多中心研究
doi:10.26442/terarkh201890235-42
更新日期:2018-02-15 00:00:00
abstract::It has been shown with special reference to the studied risk factors of coronary heart disease that at present a differentiated approach to the evaluation of epidemiological and experimental data is required. The pathogenetic interpretation of the data may seem relatively obvious, whereas the practical evaluation of i...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:AIM:To estimate the level of knowledge in adults and adolescents about the issues related to viral hepatitis B and C: the transmission modes, course, and outcomes of acute and chronic hepatitis B (CHB) and C (CHC), as well as about current measures for their prevention and treatment. SUBJECTS AND METHODS:A total of 85...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh2016881137-42
更新日期:2016-01-01 00:00:00
abstract:AIM:To elucidate the effects of combined therapy with glucocorticosteroids (GCS) and recombinant human interferon alpha or gamma (IFN) on proliferative responses of T-lymphocytes activated by various surface molecules (CD3 and CD2) in patients with SLE. MATERIALS AND METHODS:A 3-month trial entered 3 groups 15 patient...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Analysis of the clinical efficacy and long-term survival of patients with grave and not grave forms of aplastic anemia, subjected to splenectomy or treated with antilymphocytic globulin has shown that in grave aplastic anemia, the clinical efficacy of antilymphocytic globulin is higher than the efficacy of the operati...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:AIM:To investigate clinical efficacy of angiotensin-converting enzyme inhibitor trandolapril and its effects on myocardial function. MATERIALS AND METHOD:20 patients with ischemic heart disease (IHD) aged 33-74 years with chronic cardiac failure NYHA class II-IV. 4 of them survived myocardial infarction. In addition t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:AIM:To estimate the prevalence of some modified cardiovascular risk factors (RFs) among the students of two Moscow higher education institutions to further test the technology of individual medical prevention counseling. SUBJECTS AND METHODS:A questionnaire survey was conducted among 1912 first-year students (boys and...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201587157-63
更新日期:2015-01-01 00:00:00
abstract::Analysis of the results of the diagnostic bronchoalveolar lavage (BAL) in 108 patients has shown that based on the study of the cellular composition of the bronchoalveolar washing (BAW) one can form a judgment about the activity of chronic bronchitis and disseminated processes in the lungs. In individual patients, the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:AIM:To study the effects of enalapril and telmisartan on hemodynamic parameters and diastolic function (DF) of the left ventricle (LV) in patients with type 2 diabetes mellitus (DM) concurrent with arterial hypertension (AH). SUBJECTS AND METHODS:The study included 64 patients (mean age 54.3 +/- 5.2 years) with type 2...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::Aortocoronary shunting was performed in 15 patients with unstable and early postinfarction angina pectoris. Coronarography revealed an isolated lesion of a coronary artery in all the patients. Two years after the operation the patients had no angina pectoris; no myocardial infarctions occurred. ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Despite the success in increasing the effectiveness of treatment of arterial hypertension (AH), frequency of achieving target levels of blood pressure (BP) in hypertensive patients and the scope of their regular supervision in most countries of the world, including in the Russian Federation are insufficient. Modern te...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh20189014-8
更新日期:2018-01-09 00:00:00
abstract::The authors describe the results of a study into antioxidants (superoxide dismutase and catalase) and production of the active forms of oxygen (superoxide anion radical, hydrogen peroxide, hydroxyl radical, and singlet oxygen) by blood and bone marrow leukocytes from patients with Fanconi's anemia. The generation of t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Data are presented on external respiration at rest and during exercise (bicycle ergometry) in 20 patients with chronic circulatory insufficiency due to a variety of heart diseases, as well as variation in the above in the course of treatment with digoxin and calcium antagonist corinfar. External respiration parameters...
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 the association of adiponectin gene G276Т (ADIPOQ) polymorphism with the development of metabolic syndrome (MS) in ethnic Kyrgyz patients. MATERIAL AND METHODS:A total of 171 patients with MS (a study group) and 117 patients without MS (a comparison group) were examined. MS was defined on the basis of the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh2015871085-90
更新日期:2015-01-01 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::The paper considers current approaches to mucoregulatory therapy for various inflammatory diseases of the respiratory system. It gives the advantages and disadvantages of common drugs used in their treatment. Emphasis is laid on the use of inhaled hypertonic saline of NaCl in combination with hyaluronic acid (Hyaneb)....
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh2017898110-112
更新日期:2017-01-01 00:00:00
abstract::It has been demonstrated that the basal gastrin level in the blood of patients with peptic ulcer of the duodenum is similar to that in normal subjects. Food stimulation raises blood gastrin in normal subjects and patients. However, in patients, the peak of the blood hormone rise is higher, with this rise lasting for a...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Left and right ventricular diastolic function was investigated at doppler echocardiography in patients with myocardiodystrophy exposed to organic aromatic solvents (30 female house painters). The control group consisted of healthy females and females with autonomic-dyshormonal myocardiodystrophy. The study group exhib...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Interrelationship of the peculiarities of the psychoemotional status, the activity of lipid peroxidation and the content of blood free fatty acids were studied in 64 CHD patients with arrhythmia. It was shown that prolonged and pronounced psychoemotional strain, high levels of the activity of free radical lipid oxidat...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::The paper shows more than 40 years' experience with ursodeoxycholic acid (UDCA) used as a drug; during this period it has demonstrated its rather high clinical efficacy. Due to the range of its inherent pleiotropic (choleretic, cytoprotective, immunomodulatory, antiapoptotic, hypocholesterolemic, and litholytic) prope...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh201587484-90
更新日期:2015-01-01 00:00:00
abstract::In three patients with multiple myeloma, stage IIIA, a complete remission lasting from 6 to 8 years was attained, in spite of the fact that not all of them received treatment. In the latter case the remission lasted from 5 to 6 years. One of the patients had diffuse Gk + BIk myeloma, one presented with multiple focal ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00