Abstract:
AIM:To determine the possible boundaries of high-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HDIT-autoHSCT) for autoimmune diseases (AUDs), such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and multiple sclerosis (MS). SUBJECTS AND METHODS:A long-term trial was conducted at one center to evaluate the efficiency and safety of HDIT-autoHSCT in patients with AUDs. The previous standard therapy was noted to be resistant or lowly effective. The age of 10 patients with systemic connective tissue diseases was 27.6±2.8 years; the pre-HDIT-autoHSCT disease duration was 5.9±1.3 years; the median posttransplantation follow-up was 39.3 months. The age of 49 patients with MS reached 34.9±1.33 years; the pretransplantation disease duration was 8.4±0.69 years; the median post-HDIT-autoHSCT follow-up was 42 months. The efficiency of transplantation was evaluated on the basis of clinical findings, by using scales, laboratory tests, and magnetic resonance imaging. Pretransplantation conditioning was carried out according to the protocols: a) BEAM + antilymphocyte globulin (ALG); b) fludarabine + melphalan + ALG. No fatal outcomes due to a transplant procedure were observed. RESULTS:Overall 5-year survival after transplantation was 80% for systemic connective tissue diseases and 95% for MS; 5-year progression-free survival rates were 30% in the RA and SLE groups and 45% in the MS group. HDIT-autoHSCT turned out safe and reduced the activity of the process and further disease progression for a long period of time, as confirmed by regression of clinical symptoms and/or status stabilization in 9 patients with SLE or RA and in all patients with MS. CONCLUSION:The favorable factors associated with the results of transplantation are age younger than 35 years in collagenoses with their short-term duration and moderate signs; age younger than 40 years in MS with a disease duration of less than 10 years and expanded disability status scale scores of not more than 6.5. Of importance are functional system scores, duration of first remission, and an index of disease progression in different types of MS. :Цель исследования. Определение возможных границ применения высокодозной иммуносупрессивной терапии с аутотрансплантацией стволовых кроветворных клеток (ВИСТ-аутоТСКК) при аутоиммунных заболеваниях (АИЗ): системной красной волчанке (СКВ), ревматоидном артрите (РА), рассеянном склерозе (РС). Материалы и методы. Проведено многолетнее одноцентровое исследование по оценке эффективности и безопасности применения ВИСТ-аутоТСКК у больных с АИЗ. Отмечена резистентность или низкая эффективность предшествующей стандартной терапии. Возраст 10 больных с системными заболеваниями соединительной ткани составил 27,6±2,8 года, длительность заболевания до ВИСТ-аутоТСКК - 5,9±1,3 года, медиана наблюдения после трансплантации - 39,3 мес. Возраст 49 больных РС достигал 34,9±1,33 года, длительность заболевания до трансплантации - 8,4±0,69 года, медиана наблюдения после ВИСТ-аутоТСКК 42 мес. Оценку эффективности трансплантации осуществляли на основании клинических данных с применением шкал, лабораторных методов, магнитно-резонансной томографии. Предтрансплантационное кондиционирование проводили по протоколам: а) ВЕАМ + антилимфоцитарный глобулин (АЛГ); б) флударабин + мелфалан + АЛГ. Летальных исходов, связанных с процедурой трансплантации, не отмечено. Результаты. Общая 5-летняя выживаемость от даты трансплантации при системных заболеваниях соединительной ткани составила в среднем 80%, при РС - 95%; 5-летняя выживаемость без прогрессирования в группе РА и СКВ - 30%, в группе РС - 45%. ВИСТ-аутоТСКК безопасна, снижала активность процесса и дальнейшее прогрессирование заболевания на длительный срок, что подтверждено регрессом клинических симптомов и/или стабилизацией состояния у 9 пациентов с СКВ, РА и у всех больных РС. Заключение. Благоприятными факторами, связанными с результатами трансплантации, являются при коллагенозах возраст моложе 35 лет с небольшой длительностью заболевания и умеренными признаками активности болезни; при РС возраст моложе 40 лет с длительностью заболевания менее 10 лет при показателе по расширенной шкале инвалидизации (EDSS) не более 6,5 балла. Имеют значение данные шкалы функциональных систем (FS), длительность первой ремиссии, индекс прогрессирования болезни при различных типах течения РС.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Makarov SV,Rossiev VA,Mishchenko OV,Kozlov VA,Semagina OV,Alexandrova IY,Grishina GV,Minaev YLdoi
10.17116/terarkh201688153-59subject
Has Abstractpub_date
2016-01-01 00:00:00pages
53-59issue
1eissn
0040-3660issn
2309-5342journal_volume
88pub_type
杂志文章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: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::The content of IgA, IgM, IgG and IgE was measured in 55 male patients with uncomplicated essential hypertension (EH) running a labile course (25 patients) and a stable course (30 patients). Analyzing the material, account was taken of aggravated heredity factor as regards arterial hypertension, established according t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To analyze the influence of clinical and pharmacogenetic factors on the risk of resistance to original or generic clopidogrel and that of cardiovascular events (CVE) during 12 months of follow-up. SUBJECTS AND METHODS:Two hundred and fifty patients admitted to Moscow hospitals in October 2011 to September 2012 wer...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract::There was No correlation between the state of immunological reactivity in patients with acute pneumonia and the nature of infiltration of the pulmonary tissue (focal, confluent). Indices characterizing the cellular and humoral immunity links, were, to a large extent, related to a course of disease (complicated, uncomp...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Hemostasis was investigated in 2 groups of patients with systemic scleroderma (SSD) with minimal (12 patients) and moderate (9 patients) activity of the process. It has been shown that in SSD, the triggering factor of intravascular blood coagulation is the release of Willebrand's factor, an activator of platelets, fro...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:AIM:To study dynamics of ischemic heart disease in exposure of the population of an industrial city to social-economic stress. MATERIAL AND METHODS:Official annual records of Saratov city Health Administration for 1989-1998. In public health evaluation, cardiovascular morbidity is the index rapidly reacting to social-...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2005-01-01 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::Overall 75 references concerning the etiology, pathogenesis and the clinical picture of eosinophilic lesions of the lungs were analyzed. Sixteen patients with drug-induced disease were placed under the author's observation. Of these, 8 patients fell ill due to penicillin, 3 to tetracycline, 3 to sulfanilamide intake a...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::Renal failure (RF) is detected in 20-30% of patients at the onset of multiple myeloma (MM), in 50% of patients during its progression. The advent of new, highly effective agents has considerably expanded the possibilities of treatment in MM patients. Unfortunately, patients with RF, especially those with severe RF, we...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh2017897112-117
更新日期:2017-01-01 00:00:00
abstract:AIM:to investigate time course of changes in the adrenoreactivity (AR) of erythrocyte membranes (EM) after radiofrequency ablation of the synaptic nerves of the renal arteries (RA) in patients with resistant hypertension (RH) and to assess whether this indicator can be used for the early evaluation of the efficiency of...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:10.17116/terarkh201688810-13
更新日期:2016-01-01 00:00:00
abstract::A total of 118 patients with erysipelatous inflammation were examined for functional-metabolic activity of leukocytes. The consistent changes in the content of glycogen, cationic protein, in phosphatase and myeloperoxidase activity and in the NBT test of neutrophils--the most important components of the microbicidal s...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::A study was made of exercise tolerance and indices of central hemodynamics in 151 patients with "isolated" angina and its combination with cardialgia, arterial hypertension and postinfarctional cardiosclerosis. Daily attacks of angina of effort (III functional class) were noted in all the patients. In patients with "i...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:1986-01-01 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 study changes in left atrial volume, geometry and function in myocardial infarction (MI) patients treated with beta-adrenoblocker and ACE inhibitor. MATERIAL AND METHODS:65 patients with Q-wave myocardial infarction (MI) were followed up for 6 months. Regular check-ups included clinical examination, ECG, echo-C...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:AIM:To study coronary-myocardial reserve in patients with a programmed pacemaker. MATERIALS AND METHODS:Stress-echocardiography was performed in 64 patients with coronary heart disease (CHD). The stress was induced by a gradual increase in the frequency of electrostimulation (ES) by 10 imp/min from initial 90 imp/min ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::After the analysis of the long-term outcomes of aortic coarctation isolated resection the authors noted that many of the patients had valvular defects missed for diagnosis before the operation. ECG and X-ray of the heart established valvular defects in 37% of the operated patients. 61% of them had bicuspid valve assoc...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:AIM:To study the incidence, pattern, and predictive factors of concurrent kidney and liver dysfunctions in patients with decompensated heart failure (HF). SUBJECTS AND METHODS:The kidney and liver function indicators were estimated in 322 patients aged 69.5±10.6 years with decompensated HF (hypertension in 87%, myocar...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201688640-44
更新日期:2016-01-01 00:00:00
abstract::The authors analyze the sonography data on the abdominal organs and thyroid in 1092 blue-collar and white-collar workers of one of the Moscow enterprises. The studies were carried out using the up-to-date outfits manufactured in Japan, working in the real time mode. Deviations from normal were revealed in 285 persons ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::External respiration, circulation and gas exchange trends were investigated in acute pneumonia convalescents followed up on an outpatient basis. It was found that 72% of patients admitted to hospital for acute pneumonia, upon discharge demonstrated residual clinicoroentgenological effects. Cardiorespiratory distress, ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To study vascular endothelium in patients with systemic vasculitis (SV) with non-invasive methods. MATERIAL AND METHODS:A total of 65 SV patients entered the trial: 20 patients with Henoch-Schonlein purpura (HSP), 20 patients with thromboangitis obliterans (TO), 10 patients with polyarteritis nodosa (PN), 15 patie...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:AIM:To evaluate contribution of endothelial dysfunction and impairment of endothelial proliferation/ regeneration to mechanisms of development of tubulointerstitial fibrosis (TIF) in chronic glomerulonephritis (CGN) basing on urinary levels of markers of endothelial activation/impairment and angiogenesis factors. MATE...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::A clinical-morphological study of bronchobiopsies from 78 patients with endoscopic picture of atrophic endobronchitis was carried out. Two forms of morphogenesis of chronic atrophic process in the bronchial mucosa are distinguished: primary dystrophic and primary inflammatory. Primary dystrophic bronchopathy is a clin...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:AIM:To identify the gender differences of cardiovascular events in patients with chronic glomerulonephritis (CGN) at the pre-dialysis stage of chronic kidney disease (CKD). SUBJECTS AND METHODS:A total of 170 patients (median age 40±11 years) with CGN who did not receive hemodialysis were examined. According to gender...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201789656-61
更新日期:2017-01-01 00:00:00
abstract:AIM:To investigate prognostic implications of the calcium index estimated tomographycally for identification of patients at high risk to develop cardiovascular complications (non-fatal myocardial infarction, lethal coronary hear disease, coronary revascularization) in the absence of clinical manifestations. MATERIAL A...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,meta分析
doi:
更新日期:2006-01-01 00:00:00
abstract::A study was made of the presence of antinuclear antibodies to Ro, La, nDNA, RNP and Sm in 18 patients with Sjögren's disease (SD) and in 13 patients with Sjögren's syndrome (SS). Anti-Ro and/or anti-La were revealed in 12 SD patients (67%) and in 3 SS patients (23%, P less than 0.05) only. Anti-nDNA and anti-RNP were ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Recent revolution in the knowledge about structure, physiological and pathophysiological effects of renin-angiotensin-aldosteron system (RAAS) took place recently when it was discovered that local synthesis of all the RAAS components occurs in target organs and their tissues (the heart, kidneys, vessels, brain tissues...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
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...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.07.000756
更新日期:2020-09-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2004-01-01 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