The clinical analysis of blood and main metabolites of ferrokinetics was implemented before treatment in 46 patients with colorectal cancer mainly in stage III-IV. The analysis of obtained results demonstrated that the technique of detection of hepcidin 25 can be used as an additional diagnostic criterion of anemic syndrome in complex with ferritin, soluble receptors of transferrin and expanded clinical analysis of blood. This is especially important in differential diagnostic of anemia of chronic diseas combined with iron-deficiency anemia and anemia of chronic disease with functional iron deficiency because treatment differs in the main. The perspective consists in pathogenic approach to treatment of anemia of chronic disease in oncologic patients using anti-hepcidin medications on the basis of antibodies to hormone, inhibitors and blockers of its expression under control of concentration of hepcidin.

The surgical interventions in patients with malignant tumors of liver cause a development of various forms of syndrome of disseminated intravascular coagulation (DIC) with significant increasing of concentration of markers of intravascular blood coagulation against the background of dramatic decreasing of activity of factors of prothrombin complex, level of natural anti-coagulants and components of fibrinolytic system. The thrombosis of veins of various localization developed in 12 patients with subacute form of DIC. The application of low-molecular heparin in combination with concentrate of anti-thrombin III and freshly frozen plasma decreases intensity of intra-vascular blood coagulation and results in reduction of factors of coagulation and is an efficient and adequate method of treatment of thrombosis and thromboembolism of pulmonary artery in oncologic patients. The significant increasing of level of D-dimer, von Willebrand factor against the background of dramatic decreasing of prothrombin activity, content of antithrombin III and level of plasminogen are hemostasiologic factors of development of severe liver insufficiency. The corresponding timely diagnostic and correction permits to ameliorate results of surgical treatment of patients with malignant tumors of liver.

Rationale: Extended resections or extended lobectomies are the most common types of surgical interventions in patients with liver malignancies, and they are associated with serious post-operative complications. Aim: To characterize the role of hemostasis abnormalities in the pathophysiology of post-operative hepatic insufficiency, as well as that of thrombotic and hemorrhagic complications in patients with liver malignancies. Materials and methods: One hundred and twenty patients with liver malignancies were recruited into the study (20 patients with primary hepatic tumors and 100 with colorectal cancer and liver metastases). Extended liver resections (right and left simple and extended lobectomies, both simple and extended) were performed in 100 (84%) of patients; multi-segmental liver resections, in 20 (16%). Assessment of hemostasis was done pre-operatively and at days 1 to 20 after surgery (hemostasis analyzer system STA-R Evolution and Chrono-log aggregometer). Results: After surgical intervention in the liver, subacute disseminated intravascular coagulation (DIC) was found in 34 patients. It was most common (65%) after the right lobectomy and was associated with a decrease in fibrinogen levels to 121 mg/dL (p<0.01), prothrombin complex factors, to 45% (р<0.05), antithrombin III to 48% (р<0.05), with a significant increase in D dimmer levels of up to 14.5 mcg/mL (р<0.05). Twelve patients with subacute DIC developed deep venous thrombosis of the lower extremities, and 9 patients had severe hepatic insufficiency. Patients with severe hepatic insufficiency had a statistically significant decrease in prothrombin activity to 45% (p<0.05), antithrombin III to 44%, plasminogen<50%, with high D dimer (>20 mcl/mL) and von Willebrand factor levels. Conclusion: Surgical interventions in patients with liver malignancy may lead to the development of DIC. Early diagnosis and correction of hemostasis-related risk factors of hepatic insufficiency allows for improvement of the results of surgery in patients with secondary hepatic malignancies.

The work deals with the separation of the lymphocytes of healthy patients from blasts of patients with acute myeloblastic leukemia (different variants of the disease). In this study the evaluation of textural characteristics has been done for nuclei of blood cells for cells classification and for the determination of a variant of acute myeloblastic leukemia.

AIM:To make a differential diagnosis of true and functional iron deficiency (ID) in anemia of chronic diseases (ACD).MATERIALS AND METHODS:A total of 540 patients (785 investigations) and 311 healthy individuals (a control group) were examined. Among them, there were 118 cancer patients admitted for surgical treatment and 226 for chemotherapy (CT), 56 blood cancer patients, 86 with breast diseases without anemia, and 54 workers of the institute with the signs of ID. An enzyme immunoassay was used to determine the plasma levels of ferritin (FR), soluble transferrin receptor (sTFR), and endogenous erythropoietin (EPO).RESULTS:183 cancer patients did not receive specific treatment, 161 had different cycles of CT. In true ID, anemia was microcytic (average red blood cell size, <80.0 fl) and hypochromic (mean corpuscular hemoglobin concentration, <27.0 pg) with low FR levels (less than 20 ng/ml) and high sTFR concentrations (more than 4.0 µg/ml). The EPO level corresponded to the degree of anemia and was 4-5-fold the normal values. In ACDs, 292 (55%) patients had normocytic normochromic anemia with high FR levels (more than 100 ng/ml), the level of sTFR was low and that of EPO did not correspond to the degree of anemia in 74% of the patients. Functional ID was detected in 108 (37%) cancer patients in the presence of ACD. Despite high FR levels and low sTFR, anemia in Hodgkin's and non-Hodgkin's lymphomas was hypochromic microcytic, which may be considered as severe functional ID in ACD.CONCLUSION:In addition to a clinical blood test, the pharmacokinetic parameters (FR, sRFR, and EPO) should be determined for the differential diagnosis of true and functional ID.

Venous thromboembolism is a frequent complication associated with increased mortality in patients with cancer. The main factor in the pathogenesis of thrombotic complications in hematological malignancies is changes in the hemostatic system caused by tumor itself as well as methods of treatment. Antineoplastic therapy is an independent risk factor of venous and arterial thrombotic complications in these patients. The use of low-molecularweight heparin is an effective and appropriate way of prophylactics of thrombotic complications, it prevents fatal pulmonary embolism.