AIMTo estimate the incidence of acute myeloid leukemias (AML) in Moscow adults and to evaluate the efficiency of their treatment.SUBJECTS AND METHODSData on Moscow residents who were first diagnosed with AML in 2010 were retrospectively collected. The efficiency of their treatment was evaluated from the rates of complete remissions (CR), recurrences, deaths, and 4-year overall (OS) and relapse-free survival (RFS). The data as of September 1, 2013, were analyzed.RESULTSAccording to the 2010 pooled materials of the city's municipal hematology departments, AML (non-M3 types) was diagnosed in 286 patients whose median age at diagnosis was 64.9 years (range, 18.2-92.0 years). The notified incidence rate was 2.9 (3.3 for men and 2.6 for women) cases per 100,000 population. 118 (41%) patients received intensive chemotherapy (ICT); 119 (42%) had chemotherapy with low-dose cytarabine (LDC); 7 (2%) had that with hypomethylating agents (HA); and 42 (15%) had palliative therapy (PT). During first-line therapy, none of the patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the entire group, the early (within the first 60 days) mortality rates were 42% (119 deaths); that of patients with primary refractory disease was 32% (90 deaths). CR was achieved in 77 (27%) patients: 57 (48%) on ICT, 17 (14%) on LDC, and 3 (43%) on HA. Recurrences occurred in 37 (48%) of the 77 patients who had achieved CR at a median follow-up of 43.9 months. Four-year OS in all the patients receiving PT was 9.8±1.9% (18.2±3.9% in the patients on ICT versus 4.5±2% in those of LDC; p=0.028); 4-year RFS was 36.1±5.7% (39.6±6.7% inthe patients on ICT versus 31.3±11 .6% in those on LDC; p=0.8).CONCLUSIONHigh mortality rates in the induction, which are caused by the limited resources of accompanying therapy, poor sanitary conditions, and no own opportunities to perform allo-HSCT, remain a key problem of AML therapy in adults.

Central nervous system (CNS) involvement in advanced non-Hodgkin’s lymphoma (NHL) occurs in 5–29 % of cases. Primary CNS lymphoma (PLCNS) significantly less revealed: 1–2 % of lymphoma cases and 5 % of all malignant CNS diseases. Historically, PLCNS treated with radiotherapy, but the majority of patients had no long-term remission. Combined treatment (chemotherapy + radiation therap y) has been developed to improve radiotherapy efficacy. The research results, according to several authors, allowed to develop the bas is of modern medical approaches, which includes a combination of high-doses methotrexate and cytarabine with radiation therapy for remission consolidation. New drugs — temozolomide, topotecan and rituximab — in combination with conventional preparates have been studied. Treatment results of 11 patients with primary (8) or secondary (3) CNS lymphomas treated in Botkin Municipal Clinical Hospital was analyzed. In 9 from 11 (all with primary lesion) diffuse B-large cell lymphoma w as diagnosed (by immunohistochemistry). All primary patients received 3.5–5 g/m2 methotrexate and 2–4 doses 2 g/m2 cytarabine (except 2 patients); 3 patients in addition received ifosfamide, vincristine and etoposide under a pediatric protocol BFM-90. Subsequently , all patients received 46 Gy cranial irradiation. 75 % of pa tients achieved complete or partial remission. One patient died from infectious complication after 2nd chemotherapy course. 2 patients have early progression. Five patients are alive with follow-up from 6 months to 3.5 years and 4 of them remains in remission. Therapy with methotrexate + cytarabine was accompanied by III–IV grade neutropenia in the majority of patients, but its duration w as not great. The data obtained are consistent with results of modern treatment protocols PLCNS.

The International Network of Cancer Treatment and Research (INCTR) recently organized a workshop on non-Hodgkin lymphomas (NHLs) in selected developing countries with the purpose of examining existing information relating to the pathology and management of these neoplasms, and identifying potential areas for research. This report provides a summary of the information presented and is focused primarily on the pathology of NHLs in children and adults. In most countries, the WHO classification of lymphomas was used and most participating centers included immunohistochemistry using a wide array of lymphoid antibodies as part of routine diagnosis. Some of the series had been reviewed by an external panel of experts. B-cell lymphomas accounted for 82–88% of all NHLs. The proportions of chronic lymphatic leukemia (4–6%), mantle cell lymphoma (MCL, 3–5%), and plasmacytoma (2–4%) were similar in the series presented. However, there was a significant variation in the proportion of follicular lymphoma (FL), which accounted for 15% and 11% in India and Kuwait, but less than 5% in Pakistan and Egypt. All of these frequencies are significantly lower than those reported in Western series. Diffuse large B-cell lymphoma accounted for about 35% of cases in India but for more 50% in other countries, but this difference was not accounted for by an increased incidence in a single lymphoma subtype in India, but rather an apparent paucity of several subtypes (such as mantle cell and marginal zone lymphomas (MZL)) in other series. There were relatively high frequencies of Burkitt lymphoma in Egypt (7%) and precursor T-cell lymphoblastic lymphoma in India (6–7%). Peripheral T-cell lymphomas (PTCLs) (not otherwise specified and angioimmunoblastic subtypes) accounted for 3–5% of NHLs, and extranodal lymphoma of T/NK cell type was rare (<1%). These differences in the relative proportions of NHL subtypes among developing countries and between developing countries and the rest of the world presumably arise from differences in environmental and genetic factors that influence lymphomagenesis and strongly suggest that more research in developing countries would provide valuable insights into the pathogenesis of lymphoid neoplasms.