Hemophagocytic lymphohistiocytosis is a severe hyperinflammatory syndrome induced by aberrantly activated macrophages and cytotoxic. T cells, the cause of which is most often infection. The article presents a clinical case of hemophagocytic lymphohistiocytosis in a 34-year-old patient with a history of follicular lymphoma, who was treated at the A.F. Tsyba Medical Radiological Research Center. Six courses of R-CHOP were performed for follicular lymphoma with a complete response and further supportive therapy with rituximab. A month after the end of therapy, the patient complained of pain in his right side. According to morpho-immunohistochemical examination, the diagnosis of B-lymphoblastic lymphoma was established. Treatment according to the ALL-2016 protocol at the stage of consolidation III was complicated by a long period of three-stage cytopenia with the addition of sepsis. According to the results of an additional examination and assessment according to risk scales, the diagnosis of hemophagocytic lymphohistiocytosis was confirmed. After a few days of therapy with ruxolitinib, the general somatic status of the patient improved, blood parameters were restored and hematopoiesis was normalized according to myelogram data. A generalized infectious process can be assumed as the cause of the development of hemophagocytic lymphohistiocytosis in this patient.

Background. Metabolic tumor volume (MTV) is an insufficiently studied parameter of positron emission tomography, combined with computer tomography (PET/CT), which has been gaining increasing interest in modern oncology in recent years. It is important to use MTV as a prognostic marker in diffuse large B-cell lymphoma (DLBCL). Aim. To analyze the results of therapy in patients with DLBCL and to identify their relationship with MTV, determined by PET/CT data before the start of treatment, after 2 and 6 courses of therapy. Materials and methods. The prospective study included 80 patients with a morphologically verified diagnosis of DLBCL who were treated at the A.F. Tsyba Medical Radiological Research Center from 2021 to 2024. All patients underwent therapy using R-CHOP regimens (66.25 %) and R-CHOP-like regimens (33.75 %). Each of the patients underwent 3 PET/CT studies with MTV registration – at the staging stage, after 2 and after 6 treatment courses. The median follow-up was 19.5 (4.97–45.53) months. The survival rate was calculated using the Kaplan–Mayer technique, the MTV threshold values were calculated using ROC analysis taking into account the Yuden index. Results. On the initial PET/CT, the threshold value of MTV was 37.12 cm3 (p = 0.006). In patients with a value above the threshold, failures of classical first-line therapy were statistically significantly more common. The threshold value of MTV in PET/CT after 2 courses of treatment was 19.15 cm3 (p = 0.032), in PET/CT after 6 courses – 8.73 cm3 (p = 0.028). In patients with an MTV value above the threshold, according to the results of PET/CT performed after the 2nd and 6th courses, cases of disease progression were also statistically significantly more frequent. Conclusion. MTV is a new prognostic factor in modern oncological practice and should be evaluated in all patients with DLBCL and taken into account when making decisions regarding therapy tactics.

AIM. To assess chemotherapy outcomes in patients with primary mediastinal large B-cell lymphoma (PMBCL) treated at the AF Tsyb Medical Radiological Research Center from 2016 to 2023. MATERIALS & METHODS. The analysis focused on the data from 58 patients with the morphologically verified diagnosis of PMBCL. The patients were aged 17–62 years (median 34 years), there were 39 women and 19 men. The median follow-up was 51.2 months (range 0.4–200.9 months). Depending on drug chemotherapy regimens, patients were divided into 3 groups: R-NHL-BFM-90 (n = 9), R-CHOP (n = 17), and R-MACOP-B (n = 32). Most patients (90 %) received mediastinal radiotherapy of total 30–46 Gy. RESULTS. The 5-year overall survival in the therapy groups was 66.7 %, 88.2 %, and 100 %, respectively (p = 0.007), progression-free survival was 66.7 %, 70.6 %, and 96.9 % (p = 0.006), and event-free survival was 66.7 %, 54.7 %, and 90.6 % (p = 0.038). On the whole, the toxicity profile of chemotherapy was quite acceptable. Neither low blood values nor other adverse events essentially affected a complete implementation of chemoradiotherapy program. The intermediate outcomes were based on PET-CT data after 2–4 therapy cycles in 37 (64 %) patients. PET-CT showed that at the stage of drug chemotherapy, complete response (CR) was achieved in 27 (73 %) patients, and partial response (PR) was achieved in 4 (11 %) patients. With respect to the CR and PR criteria, there were 6 (16 %) non-responders. CONCLUSION. PMBCL is one of extranodal lymphomas with thymic B-cells being primary source of tumor growth. PMBCL is characterized by aggressive course and extreme heterogeneity of clinical manifestations. Up to now, the first-line chemotherapy decision making in PMBCL has remained an issue with practical importance. This paper reports immediate and long-term outcomes of the program chemoradiotherapy regimen R-MACOP-B with subsequent consolidation radiotherapy. The results obtained can be termed quite satisfactory and noninferior to the data from national and international sources. Nevertheless, more effective chemoradiotherapy programs for PMBCL continue to be elaborated. In this context, immune checkpoint inhibitors as part of therapy programs seem to hold promise for the treatment of newly diagnosed PMBCL.

The problem of the cancer-associated thrombosis development is currently one of the most relevant topics of concomitant therapy in oncology. The incidence of thrombosis in oncological diseases depends on many factors: the nosological form of the malignant tumor, the treatment regimen used, concomitant diseases and individual factors. The cancer-associated thrombosis pathogenesis is also not completely clear. It is known that both the well-known Virchow's triad and a number of factors discovered relatively recently, such as neutrophil extracellular traps or prothrombotic state in patients with cancer, make a significant contribution to their development. Besides, treatment methods of malignant tumors are constantly being improved, new approaches and drugs for the oncological treatment with unknown effects on the mechanism of thrombosis are also emerging. To date, there is no consensus on the prevention of thrombotic complications. Adding that, the side effects frequency of antithrombotic therapy remains high. In this regard, it is necessary to develop new methods of patient risk stratification for the cancer-associated thrombosis to determine the need for the complications prevention of venous thromboembolism (VTE), as well as continuous improvement of methods for thrombosis prevention using an individual approach KEYWORDS: cancer-associated thrombosis, venous thromboembolism complications, thrombotic complications, neutrophil extracellular traps, prothrombotic state, risk stratification, thromboprophylaxis, low molecular weight heparins, new oral anticoagulants, concomitant oncological therapy. FOR CITATION: Kovalskaya V.Yu., Iofik V.V., Poluektova M.V., Falaleeva N.A. Patient management with venous thrombosis associated with oncological diseases: current state of the problem. Russian Medical Inquiry. 2024;8(6):350–355 (in Russ.). DOI: 10.32364/2587- 6821-2024-8-6-6.

Combined positron emission tomography/computed tomography (PET/CT) is broadly used not only during initial staging of non-Hodgkin lymphomas (NHL) but also during as well as after treatment. Due to an increasing body of accessible data on classical Hodgkin lymphoma revealing high significance of PET/CT, the amount of relevant information on NHL is also growing day by day. At the moment, there is a consensus that PET/CT results can be effectively used in prognostic risk stratification of patients with different NHL variants, including diffuse large B-cell lymphoma (DLBCL). However, a huge volume of information collected by now hinders a full insight because of clinical variability of DLBCL, different time-points and methods of evaluating PET/CT results. The present review focuses on the role of PET/CT in the diagnosis and assessment of response to DLBCL therapy.

About 7% of all cancer deaths are caused by pancreatic cancer (PCa). PCa is known for its lowest survival rates among all oncological diseases and heterogenic molecular profile. Enormous amount of genetic changes, including somatic mutations, exceeds the limits of routine clinical genetic laboratory tests and further stagnates the development of personalized treatments. We aimed to build a mutational landscape of PCa in the Russian population based on full exome next-generation sequencing (NGS) of the limited group of patients. Applying a machine learning model on full exome individual data we received personalized recommendations for targeted treatment options for each clinical case and summarized them in the unique therapeutic landscape.

Background. High-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) is currently regarded as a standard treatment for patients with relapsed/refractory classical Hodgkin lymphoma (cHL). The efficacy of transplantation correlates with the depth of antitumor response achieved on pre-transplantation chemotherapy. A combination of PD-1 inhibitors with chemotherapy is a new forward-looking approach ensuring a higher rate of complete responses prior to auto-HSCT as well as better outcomes of the treatment in general. Aim. To assess the efficacy and safety of the combined program with Nivo-DHAP and subsequent HDCT and auto-HSCT in patients with relapsed/refractory cHL. Materials & Methods. From March 2020 to January 2022, 38 patients were enrolled in the study. The Nivo-DHAP program consisted of two stages. At stage 1 nivolumab immunotherapy was administered: two 240 mg/day IV infusions as a monoregimen 14 days apart. Stage 2, Nivo-DHAP immunochemotherapy, started in 14 days after stage 1: nivolumab 480 mg/day IV infusion on Day 1 in combination with DHAP chemotherapy, total of 4 cycles. The efficacy of this therapy was evaluated after 2 nivolumab infusions as well as after 2 and 4 Nivo-DHAP cycles. The program was fully implemented in 36 patients. HSCs were collected after remission had been reported, in most cases it was after 2 Nivo-DHAP cycles. For various reasons, auto-HSCT was performed only in 23 out of 36 patients. The median follow-up of patients after auto-HSCT was 24 months. Results. After completing the pre-transplantation stage of the program to the full extent, which included Nivo, Nivo, and 4 Nivo-DHAP cycles, 36 patients showed a 100 % overall objective response. Complete response was achieved in 27 (75 %) patients, and partial response was reported in 9 (25 %) patients. The signs of hematological toxicity grade 3/4 were manifested in 26 % of patients. In the total cohort of 36 patients with (n = 23) and without (n = 13) auto-HSCT, progression-free survival (PFS) was 81 % with the follow-up of 12 months, 78 % with the follow-up of 24 months, and 74 % with the follow-up of 36 months. Overall survival (OS) in the total cohort with the same follow-up end-points was 95 %. A comparative assessment revealed that PFS was 87 % in the cohort with auto-HSCT with the follow-up of 12, 24, and 36 months and 70 %, 64 %, and 48 % in the cohort without auto-HSCT with the same follow-up end-points, respectively (p = 0.056). Conclusion. A combination of PD-1 inhibitors with chemotherapy as a stage prior to HDCT followed by auto-HSCT is a promising strategy resulting in high PFS and OS rates. Preliminary data on using PD-1 inhibitors combined with chemotherapy cannot yet provide substantial basis for disregarding HDCT with subsequent auto-HSCT which is considered to be the optimal method for remission consolidation.

Over the past two decades, immunotherapy has been developing rapidly and is making a real revolution in oncology. But unfortunately, not all expectations have been fulfilled to date, the relatively low effectiveness of immune checkpoint inhibitors (about 30%) forces clinicians to move forward in the search for new strategies. The march of immunotherapy, which began in metastatic patients, continued in the first line and adjuvant therapy, reached the starting point of treatment of operable patients – neoadjuvant systemic therapy. This review presents the latest research results on the use of various immuno-oncological drugs in the treatment of patients with non-metastic solid tumors. In addition, the role of nonspecific immunocorrection is sanctified, since there is no doubt that an oncological patient is an immunocompromised patient in need of accompanying therapy.

Background. Among malignant neoplasms in HIV-infected patients lymphomas occupy a special place due to the high incidence, course characteristics, and difficulties that arise during diagnosis and during antitumor drug therapy. Hodgkin’s lymphoma (HL) is not an AIDS indicating disease, but the risk of its development in people infected with HIV is 5–25 times higher than the incidence of HL in the general population. Prior to the use of antiretroviral therapy, the results of standard chemotherapy in HIV-infected patients with HL were significantly worse than in HIV-negative patients. One of the main requirements for drug treatment of this group of patients is the simultaneous use of antiretroviral therapy and chemotherapy. The aim was to study the clinical characteristics and results of treatment of HL in the presence of HIV infection. Materials and methods. The analysis included 24 HL patients with HIV infection who received treatment in the Department of Radiation and Drug Therapy of Hemoblastoses of the MRRC in the period from 2018 to 2022. Treatment program selection was in accordance with the HL treatment protocol developed at our Center. Patients received 4–6 cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or 6 cycles of BEACORP (bleomycin, vepesid, doxorubicin, cyclophosphamide, vincristine, dacarbazine, prednisolone) chemotherapy according to the stage of the disease and the risk factors generally accepted for patients with HL. The response to therapy was assessed according to the Lugano-2014 criteria. Descriptive statistics methods were used. Overall survival and progression-free survival were analyzed using the Kaplan-Meier method. Results. HL occurring against the background of HIV is most often represented by a widespread nodal and extranodal lesion, accompanied by symptoms of intoxication (B-symptoms). The use of standard CT regimens as induction therapy for HL in the presence of HIV makes it possible to obtain satisfactory immediate and long-term results of treatment. In our study complete and partial responses were achieved in 94.1 %. With a median follow-up of 12 months survival without progression and overall survival were 75 % and 100 % respectively.

The article presents a draft of clinical recommendations for the diagnosis and treatment of differentiated thyroid cancer in adult patients, which provides a modern examination algorithm, discusses the basic principles of laboratory, instrumental diagnostics and treatment approaches.

The staging of Hodgkin lymphoma lays the groundwork for optimal treatment decision making. For a long time, bone marrow assessment has been an integral part of staging. The study of bone marrow involvement in tumor progression includes radiological method and morphological analysis of its core biopsy samples. During the last five decades of using bone marrow core biopsy, the attitude of oncologists and hematologists to this invasive and painful procedure remained ambivalent between denying and affirming the need to carry it out in all or most Hodgkin lymphoma cases. The present review provides the historical background of bone marrow core biopsy and considers its appropriateness for patients with classical Hodgkin lymphoma.

Aim. To study the efficacy and safety of combined immunochemotherapy according to the DHAp protocol + nivolumab in patients with refractory/relapsed classical Hodgkin's lymphoma before autologous hematopoietic stem cell transplantation.Materials and methods. The study consisted of 2 phases: 1st - immunotherapy with nivolumab (2 injections as monotherapy at a dose of 240 mg/day with 14 days interval); 2nd - combined immunochemotherapy according to the DHAp protocol + nivolumab (14 days after the 2nd administration of nivolumab): nivolumab 480 mg/day on day 1 in combination with chemotherapy according to the DHAp protocol, 4 cycles in total. The effectiveness of therapy was evaluated after 2 injections of nivolumab, after 2 and 4 cycles of combination therapy. from March 2020 to November 2021, 32 patients were included in the study. The median age was 34 (18-55) years.Results. As of November 2021, the result was evaluated in 32 patients after the 1st stage of treatment (nivolumab monotherapy). A complete response was obtained in 4 (12.5 %) patients, a partial response in 20 (62.5 %) patients, disease stabilization was noted in 5 (16 %) patients, an indeterminate response in 3 (9 %) patients. At the 2nd phase, the efficacy after the 2nd cycle of DHAp + nivolumab was evaluated in 31 patients (complete response was obtained in 19 (61 %), partial response in 11 (36 %)); the final efficacy evaluation (after the 4th cycle of DHAp + nivolumab) was performed in 30 patients, and all patients achieved response to therapy (complete response in 25 (83 %), partial response in 5 (17 %)). 2 patients were excluded from the study.Conclusion. preliminary results of combined immuno- and chemotherapy according to the DHAp protocol showed high efficacy and relatively low toxicity in patients with refractory/relapsed classical Hodgkin's lymphoma before autologous hematopoietic stem cell transplantation.

Introduction. Immunotherapy, which is part of the complex and combined cancer therapy, is one of the priority areas in the treatment of cancer patients. However, the effectiveness of the use of immunotherapeutic drugs of the latest generation is not so high, and in some patients the effect of therapy was short-lived. Factors that prevent the full realization of the antitumor effect of cytostatics and immunopreparations may be the features of the antigenic composition of the tumor, as well as its cellular and stromal microenvironment. These facts contributed to the development of a new strategy, designated as immunoredaction of cancer by exposure to various biologically active agents that can change the body – tumor ratio in favor of the patient and make the tumor available for the implementation of antitumor effects of the host immune system.The study objective – experimental substantiation of the development of new immunotherapeutic approaches in the treatment of aggressive forms of cancer.Materials and methods. An experimental study of the effect of human recombinant interferon-gamma (IFNγ) on the growth of Ehrlich’s carcinoma during subcutaneous bilateral transplantation of tumor cells to animals was carried out. Transplantation of Ehrlich’s carcinoma to male F1 hybrids (SWAhC57Bl6) was performed by subcutaneous injection of 2.0 × 106 tumor cells (7‑day culture) in 0.1 ml of suspension into the lateral surface of the right and left femur with imitation of multicentric growth.Results. A day after the course of drug administration (day 6 of tumor node growth), the effect of suppressing tumor growth in relation to growth in the control group was noted. The maximum inhibition effect of 19.8 % (p <0.05) of tumor growth was obtained 5 days after the course of the drug (10 days of tumor growth, right node) and 18.5 % (p <0.001) 9 days after administration (14 days of tumor growth, left node).Conclusion. Thus, a distinct, statistically significant antitumor effect of IFNγ was established in relation to a tumor with a multicentric growth pattern.

Second malignant tumors occurring in classical Hodgkin’s lymphoma (cHL) patients after treatment include mainly solid neoplasms and far more rarely acute myeloid leuke-mias (AML). At the same time, a relative risk of developing secondary AML substantially exceeds the risks of second (solid) tumors, and the efficacy of secondary AML treatment is considerably lower compared to the outcomes of primary AML treatment. All that implies the importance and relevance of this issue. The present literature review discusses the epidemiology of developing secondary AMLs in patents after cHL treatment. In addition to that, it focuses on modern drugs and technologies for effective treatment of secondary AMLs.

Rationale. In the early stages of classical Hodgkin’s lymphoma (cHL), the cure rate reaches 85–95 %, but the long-term effects of therapy can worsen overall survival. Current trials for early stages of Hodgkin’s lymphoma with favorable prognosis address the task of maintaining cure rates while reducing sequelae. For early unfavorable stages, the challenge is to improve cure rate without increasing toxicity.Purpose. To assess the potential significance of individual risk factors for optimal choice of the first line chemotherapy in early-stage Hodgkin lymphoma.Materials and methods. This single-center retrospective study included 290 patients with early stage cHL who had received ABVD – based (n = 249; 86 %) or BEACOPP‑21 – based (n = 41; 14 %) combined modality therapy from 2000 to 2017. Progression-free survival (PFS) and overall survival (OS) were assessed in Cox regression analysis including 12 clinical parameters.Main results. At a median follow up of 60 months for the entire group, OS was 95 % and PFS was 89 %. In a multivariate analysis PFS, at 5 years, was significantly inferior in patients with mediastinal bulk, baseline lymphocytopenia (≤ 0.6 × 109/L, р = 0.002; < 1.0 × 109/L, р = 0.000) and male gender; OS was inferior only in patients with an absolute lymphocytopenia (AL). In patients with AL, PFS after ABVD-based regimen was, respectively, 12 % in the high-risk group with mediastinal bulk and 56 % without it. PFS of patients without AL when treated with ABVD did not differ compared to BEACOPP‑21 within the same prognostic group: 95.2 % vs. 92.3 % for non-bulky and 86.4 % vs. 84.2 % for bulky disease. In the absence of AL, mediastinal bulk remained the main and only risk factor in multivariate analysis.Conclusions. The ABVD regimen is highly effective in the first line of chemotherapy for cHL, except for cases with baseline lymphocytopenia, in which the early usage of the BEACOPP regimen in the escalated or 14-day variants might be justified. In patients with mediastinal bulk, standard chemotherapy is not effective enough even in the absence of AL; therefore, if an intermediate PET/CT scan is available, it seems more appropriate to use a milder ABVD regimen on the first line and leave intensive therapy for patients with proven refractory disease. Prospects for improving the efficiency are opened with the new N-AVD and A-AVD schemes, the benefits of which should be evaluated, first of all, in patients with AL and mediastinal bulk.

Adipose tissue mostly composed of different types of fat is one of the largest endocrine organs in the body playing multiple intricate roles including but not limited to energy storage, metabolic homeostasis, generation of heat, participation in immune functions and secretion of a number of biologically active factors known as adipokines. The most abundant of them is adiponectin. This adipocite-derived hormone exerts pleiotropic actions and exhibits insulin-sensitizing, antidiabetic, anti-obesogenic, anti-inflammatory, antiatherogenic, cardio- and neuroprotective properties. Contrariwise to its protective effects against various pathological events in different cell types, adiponectin may have links to several systemic diseases and malignances. Reduction in adiponectin levels has an implication in COVID-19-associated respiratory failure, which is attributed mainly to a phenomenon called ‘adiponectin paradox’. Ample evidence about multiple functions of adiponectin in the body was obtained from animal, mostly rodent studies. Our succinct review is entirely about multifaceted roles of adiponectin and mechanisms of its action in different physiological and pathological states.

Background. Genetic predisposition to Hodgkin's lymphoma (HL) can be directly evidenced through observing familial HL. The literature data available on the familial aggregation samples of HL are extremely limited. Aim. To systemize and assess observation data on familial aggregation in patients with classical HL based on the sequence of tumor development in blood relatives. Materials & Methods. Data on families with HL diagnosed more than in one member were gathered from 4700 HL patients, who received chemotherapy from 1970 to 2019 at the AF Tsyb Medical Radiological Research Centre. Results. Among the blood relatives 27 HL cases were identified, which amounted to 0.57 % of the total of 4700 patients. The families were arranged into four groups: group I with HL diagnosis in a child born before HL detection and treatment of a parent (15 families); group II with HL diagnosis in a child born after HL treatment of a parent (4 families); group III with HL diagnosis in several children of a family with lymphoma-free parents (6 families); group IV - other categories (2 families). The total number of HL patients was 54. Group I comprised 30 patients (15 children and 15 parents), group II included 8 parents (4 daughters and 4 mothers), group III consisted of 12 patients, and group IV included 4 patients. Conclusion. The proportion of patients with familial aggregation of HL was 0.57 %. The age of all 54 HL patients enrolled in the study corresponded to the first age peak of HL onset. In the pairs “parent-child” children born before HL treatment of a parent accounted for 78.9 % and children born after HL treatment of a mother accounted for 21.1 % (all of them were girls). There were no HL cases in children born after HL treatment of a father. The data obtained show no effect of a parent's chemotherapy on the occurrence of HL in a child. This is confirmed by the HL cases of siblings whose parents never received HL treatment as well as by the diagnosis of this malignant tumor first in a grandson and then in his grandmother.

Introduction. Uveal melanoma is the most common primary intraocular tumor in adults. Despite some achievements in primary tumor treatment, 50% of patients develop distant metastases in various times (3 years to decades). Hematogenous spread is typical for uveal melanoma, and in 90% of the cases liver is the target. Median survival of patients with liver metastases is 4 to 9 months according to various researchers. And the result of treatment is extremely poor, unlike the results of skin melanoma treatment.The aim is to evaluate the immediate results of treatment of patients with uveal melanoma metastatic to the liver using isolated hepatic perfusion technique.Materials and methods. Considering a high risk of developing a metastatic liver disease in patients with uveal melanoma, local therapy is particularly interesting. This article describes the results of 10 metastatic uveal melanoma patients’ Isolated Hepatic Perfusion (IHP) Treatment. IHP was conducted using the standard methods with 100 mg of Melphalan for 60 min.Results and discussion. IHP treatment shows low complication rate. The data for response assessment is available on 9 out of 10 patients, because 10th patient received this treatment less than a month ago. Follow-ups a month after 9 patients underwent IHP showed an objective response to treatment in 6 patients (complete response in 1, partial response in 5 patients).Conclusion. The use of isolated liver chemoperfusion in a small group of patients according to the standard procedure allowed achieving an immediate response in 67% of cases.

Advances in cancer molecular profiling have enabled the development of more effective approaches to the diagnosis and personalized treatment of tumors. However, treatment planning has become more labor intensive, requiring hours or even days of clinician effort to optimize an individual patient case in a trial-and-error manner. Lessons learned from the world cancer programs provide insights into ways to develop approaches for the treatment strategy definition which can be introduced into clinical practice. This article highlights the variety of breakthroughs in patients’ cancer treatment and some challenges that this field faces now in Russia. In this report, we consider the key characteristics for planning an optimal clinical treatment regimen and which should be included in the algorithm of clinical decision support systems. We discuss the perspectives of implementing artificial intelligence-based systems in cancer treatment planning in Russia.

The article analyzes the use of immunocorrection of hematological toxicity that occurs during chemotherapy in cancer patients. Hematological toxicity, along with cardiotoxicity and hepatotoxicity often prevents the implementation of the entire planned volume of chemotherapy.Standard therapy (colony stimulating factor use) may not be always available and there is a need to develop new and more effective strategies for supportive care. Among the various methods and approaches, the most promising may be the use of systemic immunecorrecting therapy, the possibilities of which are far from being realized in oncological practice.The analysis of the studies summarized in this review demonstrates the effectiveness of the immunomodulator/immu‑ noadjuvant – azoximer bromide in hematological toxicity prevention in patients with various types of cancer.