Hormonal contraceptives (GC) are among the most commonly prescribed drugs. According to a 2019 UN report, they are used by over 150 million women worldwide. GC has become widespread not only due to the emergence of new, more convenient, including prolonged, dosage forms, but also due to the minimization of ‘classic’ side effects. Nevertheless, a number of undesirable phenomena associated with the use of GC remain underestimated. The article highlights one of the most frequent and urgent problems when prescribing HCV to women of reproductive age – vitamin deficiency of group B.

This article reviews the role of recombinant erythropoietin in the management of anemia in cancer patients based on literature data and our experience. We describe the problem of toxicity and report clinical recommendations and cautions for usage of drugs appertain to this pharmaceutical group.

Natural killers (NK) were first described as large granular lymphocytes capable of destroying tumor and virus-infected cells without prior sensitization. The article deals with NK biology and specific features of their maturation and “licensing”. Particular attention is given to NK mechanisms and their differences from other lymphocytes. The article focuses on the role of NK in antitumor immune development in oncohematological patients as well as healthy individuals, potential bone marrow donors.

58 samples of stimulated bone marrow (39 – oncology patients, 19 healthy donors) obtained for transplantation in cancer patients were analysed and compared to control group (13 bone marrow samples from women with mastopathies). It was noted the significant increase of blast cells in cancer patients compared to donors and control group (p<0.037). Neutrophyl maturation index was higher in stimulated bone marrow (p<0.001) and decrease of lymphocyte percentage (p<0.008) compared to control group: elevation of CD3+ and CD8+ lymphocytes (p<0.0001) as well as decrease of NK-cells CD56+ CD3- and/ or CD16+ CD3-).

60 samples of G-CSF-primed bone marrow (39 cancer patients and 21 healthy donors) to be used for transplantation to cancer patients were analyzed and compared by main characteristics with historical control and 13 bone marrow samples from control patient with mastopathy. Basing on morphological and multicolor flow cytometry findings certain characteristics of G-CSF-primed bone marrow were discovered, such as a significant increase in blast count in cancer patients as compared to donors and control patients (p<0.037), a higher neutrophil maturation index (p<0.001) and a lower percentage of mature lymphocytes (p<0.008) as compared to the control group. Among lymphocyte populations G-CSF-priming was associated with a significant increase in the total of mature CD3+ T-cells and CD8+ T-killers (p<0.0001) and a decrease in CD56+CD3- and/or CD16+CD3- NK-cells (p<0.006) both in cancer patients and healthy donors in comparison with the controls.

Materials of the 44th Congress of the European Society for Blood and Marrow Transplantation (March, 2018; Lisbon)

Hematopoietic stem cells transplantation is a current standard treatment for many oncohematological diseases. The milestone of any type of transplantation is the choice of conditioning regimen. This article presents the principles of classification of conditioning regimens in terms of myeloablativity and discusses the concepts of “autologous transplantation”, “high-dose chemotherapy supported by hematopoietic stem cells”, “allogeneic transplantation” and “immunotherapy”. Up-to-date uniform classification of conditioning regimens may serve an important prognostic component in assessing both the risks and efficacy of hematopoietic stem cells transplantation.

Introduction. The role of autologous hematopoietic stem cell transplantation (autoHSCT) in adult patients with acute myeloid leukemia (AML) with poor prognosis factors is not completely defined.Purpose: to present the results of a multicenter prospective study of autoHSCT efficacy in AML patients with initially unfavorable prognostic factors.Materials and methods. From 2007 to 2014, 42 patients with primary AML with one or more poor prognosis factors were included in the study. AutoHSCT was performed in 16 patients (9 women) aged 20–57 years (median 38 years) without available compatible allogeneic (related or unrelated) donor. In order to identify the role of different prognostic factors the long-term results were analyzed.Results. With a median follow up of 49 months (range 5–86 months) 5-years overall survival, event-free survival and relapse-free survival were 47, 47 and 51 %, respectively. Rate of mortality associated with transplantation in 100 days and 2 years after autoHSCT reached 0 and 6 %, respectively. AML relapse was observed in 44 % of patients. Favorable prognostic influence of total body irradiation in conditioning regimens on the overall survival has been identified (р = 0.045).Conclusion. AutoHSCT in AML patients with initially poor prognosis factors has a long-term anti-tumor effect. In the absence of a fully compatible allogeneic donor, autoHSCT may be considered as an alternative treatment.

The development of dose-limiting toxicities, including myelotoxicity, can significantly limit cytostatic therapy of malignant tumors. Neutropenia associated with high risk of febrile neutropenia (FN) and infectious complications that may interfere with therapy intensity and significantly increases the cost of diagnosis and treatment. With the development of recombinant forms of human granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor, therapy of iatrogenic neutropenia has undergone significant changes. The use of G-CSF (filgrastim, lenograstim, pegfilgrastim) reduces FN incidence in patients receiving myelosuppressive chemotherapy. Until recently, the only original preparation of G-CSF with prolonged action was pegfilgrastim. Lipegfilgrastim (Lonquex, Teva) is a new highly effective long-acting pegylated G-CSF, which has been approved by European Medicines Agency experts for FN prevention in patients receiving chemotherapy. This review summarizes the characteristics of chemical structure, pharmacokinetics, safety and efficacy of lipegfilgrastim.

Today the role of single or double Autologous Stem Cell Transplantation (ASCT) in patients (pts) with refractory Hodgkin Lymphoma (HL) is still unclear. Aim. To present the results of a single-center prospective trial which aim was to show the significance of single and double ASCT in patients with HL, who did not achieve complete response after first-line chemotherapy. Material and Methods. Between 2007 and 2014 62 patients were enrolled in the study. First ASCT was administered to 53 patients, 10 of those 53 patients received second ASCT. Results. 5-year overall survival (OS) and progression-free survival (PS) were 52 and 27% after single ASCT versus 38 and 30% after double ASCT respectively. According to our study extensive previous treatment (radiotherapy and chemotherapy) followed by ASCT had a negative prognostic impact on overall survival (OS) (p=0.03). Moreover, initial response to the first ASCT was found to be an independent prognostic factor of OS (p=0.004). According to our results, achievement ofpartial response or disease stabilization after the first ASCT was the main indication for double ASCT. In this case second ASCT is preferable to alternative treatment (p=0.004). Disease progression (PD) after the first ASCT seems to be a contraindication to the necessity of the second course of ASCT as low effectiveness and high level of toxicity do not improve treatment results in comparison to alternative treatment (p=0.6). Achievement of complete remission associated with disease free long-term survival and high quality of life. Achievement of complete remission was crucial at any treatment stage. Conclusion. ASCT is an effective treatment option for patients who never achieved CR. Second ASCT is a treatment of choice for patients with PR/SD after 1st ASCT. Nevertheless second ASCT does not improve outcome for patients with PD after 1st ASCT. Alternative variants of treatment are needed for this patient group.

Introduction. The role of autologous hematopoietic stem cell transplantation (autoHSCT) in adult patients with acute myeloid leukemia (AML) with poor prognosis factors is not completely defined. Purpose : to present the results of a multicenter prospective study of autoHSCT efficacy in AML patients with initially unfavorable prognostic factors. Materials and methods. From 2007 to 2014, 42 patients with primary AML with one or more poor prognosis factors were included in the study. AutoHSCT was performed in 16 patients (9 women) aged 20–57 years (median 38 years) without available compatible allogeneic (related or unrelated) donor. In order to identify the role of different prognostic factors the long-term results were analyzed. Results. With a median follow up of 49 months (range 5–86 months) 5-years overall survival, event-free survival and relapse-free survival were 47, 47 and 51 %, respectively. Rate of mortality associated with transplantation in 100 days and 2 years after autoHSCT reached 0 and 6 %, respectively. AML relapse was observed in 44 % of patients. Favorable prognostic influence of total body irradiation in conditioning regimens on the overall survival has been identified (р = 0.045). Conclusion . AutoHSCT in AML patients with initially poor prognosis factors has a long-term anti-tumor effect. In the absence of a fully compatible allogeneic donor, autoHSCT may be considered as an alternative treatment.

Chimerism monitoring after allogeneic bone marrow transplantation (alloBMT) using quantitative polymerase chain reaction (PCR) is important for assessment of efficiency of transplantation, early detection of recurrence, and timely treatment adjustment. This article presents cases of mixed chimerism after alloBMT.