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S R Karagiulian,
S A Shutov,
A V Grzhimolovskiĭ,
V S Shavlokhov,
E A Lukina, E E Zvonkov,
E M Shulutko,
A Iu Bulanov,
S A Vasil'ev,
G A Sukhanova,
N A Shutova,
I B Kaplanskaia,
I I Shaforostova
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ABSTRACT: To define an optimal diagnostic and therapeutic algorithm when the acute abdominal syndrome occurs in hematological patients.
The results of 145 emergency surgeries made in 2006-2008 for acute abdominal syndrome were studied in patients with blood system diseases.
Clinical manifestations of acute abdominal syndrome emerge in 1-1.4% of all the patients treated at the Hematology Research Center, Russian Academy of Medical Sciences. There is a need for surgery in 0.5-0.7% of all the patients admitted. In this group of patients, annual postoperative mortality is 12-16%.
The routine algorithm for a diagnostic search in hematological patients with acute abdominal syndrome can lead to both hyperdiagnosis and unwarranted surgery, and incorrect choice of expectant policy as well.
Terapevticheskii arkhiv 01/2010; 82(12):39-43. · 0.14 Impact Factor
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A U Magomedova,
S K Kravchenko,
A M Kremenetskaia,
I B Kaplanskaia,
E E Zybunova,
R S Samoĭlova,
I A Vorob'ev,
T N Obukhova,
V V Ryzhko, E E Zvonkov,
A I Vorob'ev
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ABSTRACT: To investigate characteristics of the course and efficacy of treatment of diffuse large B-cell lymphosarcoma (DLBL) with primary lesion of the spleen.
From 1998 to 2006, primary splenic lesion was registered in 15 of 120 patients with DLBL and affected lymph nodes (LN), spleen and Waldeyer's ring. The diagnosis was made according to WHO criteria. Of them 14 patients had splenectomy as the first stage of therapy. The operation was followed with 6 to 8 courses of CHOP-21 (8 patients), 4 courses of R-CHOP-21 and radiotherapy (one patient). One patient received 7 courses of CHOP-21 followed by splenectomy. Because of the presence of several signs of unfavourable prognosis 5 patients under 60 years were given intensive therapy: 4-6 courses of the modified program NHL-BFM-90, 2 of 5 patients received radiotherapy.
All the patients with primary DLBL of the spleen had two and more signs of unfavourable prognosis: elevated concentration of serum LDG, size of the tumor more than 10 cm, high proliferative activity of tumor cells, B-symptoms, severe condition. Seven patients had centroblastic, 8--anaplastic variants of DLBL. Tumor cells in primary DLBL of the spleen had no specific immunophenotype. Complete remission of the disease was achieved in 9 (90%) of 10 patients treated on programs CHOP-21, R-CHOP-21, in 4 of 4 patients on the modified program NHL-BFM-90. Mean follow-up was 39.3 months (from 7 to 103 months).
For primary DLBL of the spleen characteristic are long-term remissions on first line therapy according to CHOP-21 program irrespective of morphology and immunophenotype.
Terapevticheskii arkhiv 02/2007; 79(7):62-6. · 0.14 Impact Factor
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A U Magomedova,
S K Kravchenko,
A M Kremenetskaia, E E Zvonkov,
E A Bariakh,
O V Margolin,
I B Kaplanskaia,
I A Vorob'ev,
R S Samoĭlova,
T N Obukhova,
T N Moiseeva,
E E Zybunova,
E G Gemdzhian,
A I Vorob'ev
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ABSTRACT: To investigate efficacy of the modified protocol NHL-BFM-90 in patients with diffuse large B-cell lymphosarcoma (DLBCLS).
A total of 13 DLBCLS patients with stage II-IV of the disease with affection of lymph nodes at the disease onset (nodal lesion) and stage II with tumor size more than 10 cm (bulky disease) received first-line treatment according to the modified program NHL-BFM-90 from 2002 to 2005. The diagnosis was made by WHO criteria.
A complete remission was achieved in 76.9% patients. Resistance to therapy was observed in the patients with bone marrow affection. The 2.5-year overall survival was 74%, 2-year event-free survival was 75% (the events were recurrence and resistance). Follow-up continued from 5 to 47 months.
The efficacy of the modified protocol NHL-BFM-90 in DLBCLS patients with stage III-IV of the "nodal" disease and stage II of the "bulky" disease was high.
Terapevticheskii arkhiv 02/2006; 78(10):44-7. · 0.14 Impact Factor
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L S Biriukova,
B T Dzhumabaeva,
V B Daumova, E E Zvonkov,
A M Kremenetskaia,
I B Kaplanskaia,
E Iu Varlamova,
I A Vorob'ev,
E M Gretsov,
S K Kravchenko,
E G Moseshvili,
R B Akhmetshin
Terapevticheskii arkhiv 02/2006; 78(10):48-51. · 0.14 Impact Factor
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E E Zvonkov,
B B Krasil'nikova,
V A Makhinia,
I B Kaplanskaia,
S K Kravchenko,
S R Karagiulian,
A V Grzhimolovskiĭ,
A N Kuznetsov,
A U Magomedova,
I M Shukhman,
E A Bariakh,
E A Giliazitdinova,
A V Gubkin,
Iu Iu Lorie,
A M Kremenetskaia,
A I Vorob'ev
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ABSTRACT: To assess efficacy of a modified program NHL-BFM-90 in adult patients with primary diffuse large B-cell gastric lymphosarcoms (PDLBGL) with unfavourable prognosis.
Modified courses of NHL-BFM-90 were conducted in 5 patients aged 27-67 years from January 2004 to September 2005. Four patients received chemotherapy of the first line, in one patient block therapy followed monotherapy with chlorambucil and a CHOEP course. All the patients were in a severe clinical condition and had several initial factors of unfavourable prognosis: size of the tumor more than 10 cm; stage IE and more advanced; B-symptoms; proliferative activity above 70%. The program NHL-BFM-90 was modified because of the patients' age. Chemotherapy was conducted according to the middle arm of the original program NHL-BFM-90, but methotrexate was introduced in a dose 1 g/m2 for 12 hours, while leukovorin was given 18 hours after the start of methotrexate injection. In two cases the blocks were enhanced with rituximab, 2 patients had doxorubicin in block A, in one case block C was enhanced with methotrexate. A total of 23 modified blocks NHL-BFM-90 were performed: one patient was given 6 blocks, two patients--5, one patient--4 blocks and one patient--3 blocks.
Four patients after block 2 and one patient after block 3 of polychemotherapy NHL-BFM-90 achieved remission of the disease of 6 to 22 months duration which still continues. Infectious complications related to hematological toxicity arose more frequently at the latest courses of chemotherapy.
Treatment according to the modified program NHL-BFM-90 in adult patients with PDLBGL and unfavourable prognosis is highly effective. For a mean follow-up of 10.2 months no recurrences occurred. The number of courses can be reduced to decrease accumulated hematological toxicity and in case of rapid achievement of remission.
Terapevticheskii arkhiv 02/2006; 78(7):38-46. · 0.14 Impact Factor
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A U Magomedova,
S K Kravchenko,
A M Kremenetskaia,
Iu Iu Lorie,
E A Bariakh, E E Zvonkov,
I B Kaplanskaia,
I A Vorob'ev,
T N Obukhova,
R S Samoĭlova,
E A Giliazitdinova,
N G Chernova,
T N Moiseeva,
E E Zybunova,
Ia S Pustovoĭt,
A V Gubkin,
A V Grzhimolovskiĭ,
A Iu Bulanov,
E K Egorova,
A I Vorob'ev
Terapevticheskii arkhiv 02/2006; 78(7):76-84. · 0.14 Impact Factor
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E A Bariakh, E E Zvonkov,
A M Kremenetskaia,
S K Kravchenko,
A U Magomedova,
T N Obukhova,
R S Samoĭlova,
I A Vorob'ev,
I B Kaplanskaia,
T N Moiseeva,
E E Zybunova,
Iu Iu Lorie,
N G Chernova,
D S Mar'in,
E K Egorova,
B B Krasil'nikova,
N G Gabeeva,
A I Vorob'ev
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ABSTRACT: To compare programs of chemotherapy used in adult Berkitt-like lymphoma (ABLL); to assess efficacy and toxicity of the protocol AblL-M-04.
31 ABLL patients (23 males, 8 females, mean age 27 years) participated in the study performed in Hematological Research Center in 1995-2004. ABLL stage I, II, III and IV was diagnosed in 3, 5, 8 and 15 patients, respectively. 10 patients had diffuse large B-cell lymphoma. 9 patients received 2 to 6 courses of CHOP, 1 patient--6 courses of Pro-Mace-Cytabom, 11 patients with newly diagnosed ABLL and 5 pretreated with CHOP--NHL-BFM-90. The modified protocol ABLL-M-04 of intensive short-term therapy included 10 patients, 2 of them pretreated.
Of 10 patients given CHOP or CHOP-like courses 9 were resistant to therapy, 2 died of rapid progression, 7 were converted to the program therapy. 5 patients on the protocol NHL-BFM-90 died after short-term improvement. None of them achieved remission. Of 10 patients with newly diagnosed ABLL treated according to NHL-BFM-90 protocol, remission was achieved in 4 patients, follow-up median--34 months (2-56). Six patients died: 4 of progression, 2 of chemotherapy complications. BLL-M-04 therapy was made in 9 patients: 7 patients persisted on the first remission, 2 patients died of chemotherapy complications. Overall duration of the treatment was 3-3.5 months.
The protocol ABLL-M-04 seems to be more effective than a classic NHL-BFM-90, but this must be supported by more cases. CHOP therapy cannot be recommended for patients with ABLL because of poor efficacy (all the CHOP patients died).
Terapevticheskii arkhiv 02/2005; 77(7):53-8. · 0.14 Impact Factor
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A U Magomedova,
S K Kravchenko,
A M Kremenetskaia, E E Zvonkov,
T N Moiseeva,
E E Zybunova,
I B Kaplanskaia,
R S Samoĭlova,
I A Vorob'ev,
Iu Iu Lorie,
O V Margolin,
E A Giliazitdinova,
A V Gubkin,
N G Chernova,
V V Ryzhko,
E G Gemdzhian
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ABSTRACT: To examine efficacy of polychemotherapy (PCT) CHOP-21 in patients with diffuse large B-cell lymphosarcoma (DLBCL).
Fifty-five DLBCL patients received first-line therapy according to CHOP-21 program in 1996-2004. The diagnosis was made by WHO criteria.
Initially, 37 patients had lymph node lesions, 18--nonlymphatic lesions. Complete remissions were achieved in 49% (56.7% in nodal lesions, 33.3% in extranodal ones). Overall 5-year survival was 35%, event-free--25%, for patients with nodal lesions--36 and 32%, respectively, extranodal lesions--35 and 22%, respectively. Overall 5-year and event-free survival in patients with local lesions was 85 and 75%, generalized--25 and 20%, respectively. In patients with involvement of the gastrointestinal tract 3-year overall and event-free survival reached 50 and 45%. Event-free survival was not seen in patients with extranodal lesions of other locations in overall 3-year survival 45%.
PCT program CHOP-21 was effective in DLBCL patients with local nodular lesions except cases with large-size tumors, invasion in the adjacent organs and tissues and isolated gastric lesion.
Terapevticheskii arkhiv 02/2005; 77(7):58-61. · 0.14 Impact Factor
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B B Krasil'nikova, E E Zvonkov,
T N Obukhova,
S K Kravchenko,
Iu N Sindeeva,
I V Efimov,
I B Kaplanskaia,
A M Kremenetskaia,
V A Makhinia,
R S Samoĭlova,
Iu Iu Lorie
Terapevticheskii arkhiv 02/2005; 77(7):83-5. · 0.14 Impact Factor
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E E Zvonkov,
E A Boriakh,
A U Magomedova,
S K Kravchenko,
A M Kremenetskaia,
T N Obukhova,
I B Kaplanskaia,
R S Samoĭlova,
V A Makhinia,
V S Shavlokhov,
B B Krasil'nikova,
E K Egorova,
K I Danishian
Terapevticheskii arkhiv 02/2005; 77(7):85-8. · 0.14 Impact Factor
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Terapevticheskii arkhiv 02/2004; 76(7):90-1. · 0.14 Impact Factor
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Terapevticheskii arkhiv 02/2002; 74(7):76-80. · 0.14 Impact Factor
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ABSTRACT: Trepanobiopsy of the bone marrow followed by a histological study was performed in 3 patients with sarcoidosis diagnosed in peripheral lymph node (LN) biopsies. Granulemas revealed in trepanobiopsies were identical to those found in LN. Trepanobiopsy is advisable in patients with sarcoidosis having some changes in hemogram.
Arkhiv patologii 65(6):49-51.