Aim. To evaluate the efficacy of DSP30 in combination with IL2 in cultivating blood cells/bone marrow/lymph nodes in chronic lymphocytic leukemia (CLL) patients to detect clonal abnormalities. Materials and methods. The study included 50 patients with CLL, all of whom underwent both chromosome banding analysis (CBA) (46 patients with DSP30+IL2 and LPS+TPA; 4 patients with only DSP30+IL2) and FISH with DNA probes to detect trisomy 12 and deletions of 13q14, 11q22 and 17p13. Results. Under cell cultivation with DSP30+IL2 and LPS+TPA, CBA was successfully performed in 41 (82 %) and 38 (83 %) patients. Chromosome aberrations were observed in 36 (72 %) and 15 (33%) cases, while a complex karyotype was detected in 13 (26%) and 5 (11%) cases, respectively. A significant difference was found between the number of metaphases with chromosomal abnormalities obtained by cultivation with DSP30+IL2 and LPS+TPA (V = 490.5, p < 0.05). CBA revealed balanced translocations in 6 patients, with the involvement of the IgH/14q324 locus being confirmed in 4 cases. Unbalanced translocations and various combinations of translocations were detected in 11 and 6 patients, respectively. In 5 cases, according to CBA, the results of 13q14, 11q22, 17p13 deletions identified by FISH were accompanied by balanced or unbalanced translocations in these loci. Unbalanced t(12;16)(q14;q23) — a case of partial trisomy — was detected only by CBA with DSP30+IL2. Conclusions. An abnormal karyotype was detected in CLL patients twice as more frequently under cultivation with DSP30+IL2 compared to LPS+TPA. CBA is an important method allowing the structure of chromosomal abnormalities to be specified and translocations to be identified. As a result, patients running the highest risk of CLL — those with a complex karyotype — can be singled out for selecting an optimal strategy of their management.

Aim. The article deals with comparing strength indicators of shin muscles and anatomical cross-section area (ACSA) in persons with hypokinesia as a result of orthopedic pathology and in trained persons from acyclic sports. Materials and methods. We studied five groups of people. The first group (n = 12) consisted of patients aged 18.7 ± 1.23 years with a lengthened shin according to Ilizarov technique. The second group included apparently healthy patients of the same age not engaged in sports. The third group consisted of professional athletes-wrestlers aged 18.8 ± 1.99 years (n = 10). The fourth group comprised apparently healthy men, non-athletes aged 44.1 ± 5.38 years (n = 12). The fifth group included wrestlers aged 47.8 ± 5.89 years (n = 10). We established the moment of force (MF) in lateral and plantar foot flexors (LFF and PFF). We calculated the anatomical cross-section area of LFF using ultrasonography. We also established the specific force of LFF and PFF. Results. We established the decrease in the specific force of LFF in the affected shin by 36.9 % in comparison with a healthy shin. The specific force of LFF in young non-athletes and athletes of the same age varied between 41.6 ± 3.59 N·m to the right and 41.1 ± 5.22 N·m to the left. In the third group this parameter varied from 42.7 ± 9.44 N·m to 43.9 ± 7.90 N·m. In the older age groups, the specific force of LFF was higher than in young non-athletes and young wrestlers. The specific force of LFF in the affected shin varied from 2.8 ± 0.81 N·m/cm2, in a healthy shin – from 3.2 ± 0.62 N·m/cm2. The same parameter in young non-athletes varied from 3.9 ± 0.25 (to the right) to 3.9 ± 0.44 (to the left) (р < 0.05); in young wrestlers – from 4.5 ± 0.44 to 4.5 ± 0.36 respectively. This was higher than in the second group (р < 0.05). In the older group this parameter varied from 4.2 ± 0.74 to 4.2 ± 0.67 N·m/cm2 respectively. This is significantly lower than in young wrestlers. We registered the slightest changes in the moment of force of PFF in both shins (р < 0.05). In young athletes this parameter equaled 249.0 ± 26.42 N·m (to the right) and 252.0 ± 28.21 (to the left), which is higher by 15–20.5 % than in young-non-athletes. In older wrestlers the moment of force of PFF was higher by 17.4–21.8 % than in older non-athletes (p < 0.05). Conclusion. Patients with hypokinesia demonstrate the lowest functional properties and specific force of frontal muscles in comparison with the representatives from other groups. As a result of regular acyclic loads, the specific force of frontal muscles is higher in young athletes and older athletes than in non-athletes.

The aim of the study is to present a successful case in treating primary cutaneous anaplastic large cell lymphoma (PCALCL) occurring with common lesions of the skin and lung tissue. Materials and methods . For the verification of the diagnosis in a patient with three types of skin elements (spot, thin plaque with and without ulceration), differential diagnosis was performed between ulcerative pyoderma gangrenosum, PCALCL, large-cell transformation of mycosis fungoides, and secondary skin lesions under the nodal ALK-negtaive ALCL. A complex of studies, including histological, immunohisto - chemical, cytogenetic studies of skin tumor biopsy, allowed the verification of the PCALCL diagnosis. For the treatment of the patient, intensive induction chemotherapy was used followed by high-dose consolidation and autologous transplantation of hematopoietic stem cells. Results . The selected treatment tactics allowed a long-term complete remission of the disease to be achieved in a patient from the poor prognosis group. Conclusion . An algorithm for the differential diagnosis and tactics of treating is presented for a patient with primary anaplastic large cell lymphoma with a widespread skin lesion and extradermal foci.

Представлено клиническое наблюдение больного хроническим миелолейкозом (ХМЛ), получавшего лечение иматинибом мезилатом, у которого на фоне полного цитогенетического ответа через 6 лет с момента установления диагноза в Ph-негативных клетках костного мозга (КМ) обнаружена inv(3)(q21q26), характерная для миелодиспластического синдрома (МДС) и острого миелоидного лейкоза (ОМЛ). Транслокация t(9;22)(q34;q11) в клетках КМ больного в этот период и при последующих исследованиях не выявлена. Обнаружение inv(3)(q21q26) ассоциировалось с появлением симптомов МДС: первоначально с лейкопенией, затем с анемией и тромбоцитопенией, которые прогрессировали на протяжении последующих 3,5 лет на фоне персистенции inv(3)(q21 q26) в клетках КМ больного. Количество бластных клеток в миелограмме постепенно нарастало, достигнув 11,5% к февралю 2014 г. В этот период, через 3 года после первичной регистрации inv(3)(q21q26), по результатам гистологического исследования КМ отмечали трансформацию МДС в ОМЛ. Приведен обзор данных литературы о частоте и сроках выявления клональных хромосомных аномалий в Ph-негативных клетках КМ больных ХМЛ при терапии препаратами ингибиторов тирозинкиназы, о наиболее часто выявляемых аномалиях кариотипа у этих больных и их возможном клиническом значении.