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)

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)

Chronic myeloid leukemia (CML) is a hemopoietic condition caused by chromosomal translocation t(9;22)(q34;q11) or bcr-abl fusion gene. The predominant variants of bcr-abl oncogene rearrangement are b3a2 and b2a2. The present study evaluated the efficacy of interferon-a therapy of CML patients and molecular prognostic factors. Cytogenetic response and complete hematological remission were more frequent in CML b3a2 treatment with interferon-a. Moreover, after therapy, chronic phase lasted in that group (p = 0.026) much longer. Overall survival in the group was significantly longer, too (p = 0.046).

The investigation deals with a simplified modification or molecular-genetic detection of translocation t(9;22) using a combination of reverse transcription and polymerase chain reactions (RT-PCR). Unlike the available protocols, analysis is carried out using one enzyme--TET-Z polymerase--(instead of two) which has both revertase and DNA-polymerase activities. The present modification is highly sensitive, less time-consuming and cheaper. The method has proved useful for both diagnosing t(9;22) translocation and diagnosing and monitoring minimal residual disease remaining after marrow transplantation.