Recent diagnostic and therapeutic advances in pediatric oncology have led to increased survival rates in children with malignancies. Today many investigations are devoted to the adverse effects during and after anticancer treatment, possible methods of their prevention and control. Menorrhagia is a serious complication in post-pubertal females who suffer from thrombocytopenia during myelosuppressive treatment. The issues of the effective prevention of this complication is highly discussed and a great interest is devoted to Gonadotropin-releasing hormone (GnRH) analogues. This option was not chosen by chance: the perspective method of prevention ovarian function is hormonal gonadoprotection. There are no definite data about the effectiveness of GnRH analogs yet, and it remains controversial. In this issue we’d like to summarize international data and our experience of the use of GnRH agonists in adolescents during chemotherapy.

Treatment results in children with acute lymphoblastic leukemia (ALL) treating in St.-Petersburg hospitals according to two modified version of German protocol CO ALL-92 from 01.01.1993 to 01.01.2007 are presented. 438 primary A LL patients aged from 4 months to 17 year s have been included in the study . ALL diagnosed according to international criteria. Based on prognostic factors patients were a llocated to one of two risk groups, which determined therapy intensity . The total treatment duration in both groups w as 2 years and consist ed of 5.5–8 months intensive phase with subsequent maintenance therapy . A comparative treatment results analysis in children with A LL according to two modified versions of COALL-92 is presented.

В статье представлены результаты лечения детей с острым лимфобластным лейкозом (ОЛЛ) в Санкт-Петербурге за период с 01.01.1993 по 01.01.2007. В качестве терапевтической программы использовались две модифицированные версии немецкой программы COALL-92: протоколы PECO-92 и COALL-С-Петербург-92, основанные на применении интенсивной химиотерапии. В исследование было включено 438 первичных пациентов с ОЛЛ в возрасте до 18 лет, проживающих в Санкт-Петербурге и Ленинградской области. Диагноз острого лимфобластного лейкоза устанавливали на основании международных критериев, с последующей стратификацией пациентов на 2 группы риска. Приводится сравнительный анализ результатов лечения в соответствии с двумя версиями немецкого протокола COALL 92. Обсуждаются причины различной терапевтической эффективности протоколов PECO-92 и COALL-С-Петербург-92 и пути дальнейшей оптимизации терапии ОЛЛ у детей.

Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS) was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048), probability of relapse-free survival (рRFS) was 65 and 74% (plog-rank = 0,002), probability of overall survival was (pOS) 78 and 70%, correspondingly (plog-rank = 0,079). Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy. Key words: children, acute lymphoblastic leukemia, intensive chemotherapy. (Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 33–42)

Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS) was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048), probability of relapse-free survival (рRFS) was 65 and 74% (plog-rank = 0,002), probability of overall survival was (pOS) 78 and 70%, correspondingly (plog-rank = 0,079). Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy.Key words: children, acute lymphoblastic leukemia, intensive chemotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 33–42)

The article demonstrates the treatment results on the protocol the treatment of children with acute lymphoblastic leukemia (ALL) (COALL-92–Saint-Petersburg) after 10 years of follow-up. Between January, 1999 and August, 2008, a total of 272 children and adolescents 0–18 yr of age, from Saint-Petersburg and its area were eligible for the protocol. All the patients have met diagnostic criteria for ALL. Those with a mature B-cell phenotype and FAB-L3 morphology were excluded. The diagnosis was based on morphological evaluation of the peripheral blood and bone marrow smears, immunophenotyping and cytogenetic analysis. All patients were classified as being at lower (LR, 47%) or higher (HR, 53%) risk of relapse. The intensive phase of treatment lasted 5, 5 months in low risk group and 8 months in high risk group and consisted of 4 parts (induction, consolidation, CNS-treatment and reinduction). It was followed by maintenance treatment until 2 years from date of diagnosis. After an observation time of 11 years, the estimate for EFS of all 272 evaluable patients was 67,7 ± 3,1%, the estimate of probability of RFS was 74,1 ± 3,3%, and probability of overall survival was 75,6 ± 3,0%. Key words: acute lymphoblastic leukemia, intensive chemotherapy, children. (Pediatric Pharmacology. – 2010; 7(6):50-56)

The article presents the results of the treatment of children with acute lymphoblast leukemia (all) according to the coall 92 program in St.-Petersburg from 01.01.1999 to 01.01.2005. 160 primary all patients, aged 4 months to 17 years 4 months were included in the study. International criteria were used to diagnose acute lymphoblast leukemia. A 2 years course of treatment in both risk groups included a 5,5–8 months phase of intensive chemotherapy followed by maintenance therapy. 6 years after the protocol introduction in the common group of patients the following survival rate indices were obtained: the 6 years uneventful survival rate was 63 ± 4,6%, the 6 years relapses free survival rate was 69 ± 4,7%, the 6 years general survival rate was 79 ± 3,7%.Key words: acute lymphoblast leukemia, children, intensive chemotherapy.

AIMTrial of the modified protocol BFM in the treatment of children with B-cell lymphomas.MATERIALS AND METHODS26 children with B-cell lymphoma were treated. Of them 2 children were treated according to the program for risk 2 group and 24 children were treated as risk 3 group.RESULTSComplete remission was achieved in 23 patients. Two children were resistant. There were 2 cases of early recurrence, 1 case of early death, 1 case of death in remission. 20 patients are in complete remission. The 4-year survival is 78%.CONCLUSIONThe modified protocol BFM proved to be highly effective against B-cell lymphoma in children. Its drawback is high toxicity.

A retrospective analysis of treatment of 67 children suffering localized osteogenic sarcoma received at the Institute's Clinic (1977-1995) has been carried out. The best 5-year survival results were obtained with the COSS-91 and PECOSS programs and those for pre- and post-operative COMBAP chemotherapy (77.8 and 70.0%, respectively). Another randomized comparative study of the effectiveness of different polychemotherapy and pre-operative radiation schedules are being planned.