Concurrences of multiple myeloma with myeloproliferative diseases or secondary myeloid leukemoid reactions are rather rare. The paper describes 3 cases of multiple myeloma: the first case concurrent with neutrophilic leukocytosis; the second case with secondary erythropoetin-dependent erythrocytosis, and the third case with chronic myeloid leukemia. In such cases, an accurate diagnosis requires molecular testing, besides routine clinical and laboratory studies. The paper discusses therapeutic strategy in cases of a concurrence of 2 competing tumors of the blood system: to treat them simultaneously or the most aggressive tumor now, as well as a relationship between multiple myeloma and chronic myeloid leukemia, other myeloproliferative disorders, and secondary myeloid leukemoid reactions.

Аннотация Сочетания множественной миеломы с миелопролиферативными заболеваниями или вторичными лейкемоидными реакциями миелоидного типа достаточно редки. В статье описаны 3 случая множественной миеломы: один в сочетании с нейтрофильным лейкоцитозом, второй с вторичным эритропоэтинзависимым эритроцитозом и третий с хроническим миелолейкозом. Для установления точного диагноза в таких случаях, кроме стандартных клинических и лабораторных исследований, обязательными являются молекулярные исследования. Обсуждается терапевтическая стратегия в случаях сочетания 2 конкурирующих опухолей системы крови: лечить одновременно или наиболее агрессивную в настоящее время. Обсуждена взаимосвязь множественной миеломы и хронического миелоидного лейкоза, других миелопролиферативных заболеваний, лейкемоидных реакцих миелоидного типа.

Aim. To evaluate the effect of pathogen-inactivated platelet concentrates (PIPC) on posttransfusion platelet increments, hemorrhagic syndrome relief, and transfusion intervals.Subjects and methods. This prospective study included 29 hemoblastosis patients (13 women, 16 men), median age 38 years (20-66 years). Pathogens were inactivated by the photodynamic method using the Intecept system. Each patient received two PC transfusions: one PIPC transfusion and one control one. Posttransfusion platelet increments one hour and one day after PC transfusion, the course of hemorrhagic syndrome, and the time to next platelet transfusion were analyzed.Results. Pathogen inactivation with amotosalen and ultraviolet irradiation reduced posttransfusion platelet increments in recipients by 24% after one hour and by 29% after one day after PIPC transfusion versus control ones.Conclusion. The clinical efficiency of transfusions of amotosalen-induced PIPC was comparable with that of untreated platelet concentrates. Despite a reduction in post-transfusion platelet increment with the use of PIPC, this caused no significant increase in the frequency,of transfusions.

The quality and clinical efficiency of transfusions of thawed and washed erythrocytes of different length of storage have been evaluated in oncohematological patients. All thawed and washed erythrocytes were divided into three groups depending on length of storage: 1) for up to 100 days (27 doses; 2) 101-300 days (25 doses; and 3)301-850 days (28 doses). The levels of hemoglobin and free hemoglobin were evaluated in the prepared suspensions. The time course of hemoglobin concentration, hematocrit, circulating erythrocyte counts, oxygen saturation of hemoglobin in the central venous blood (ScvO2, %) before and 24 h after transfusions were studied in the recipients. It was revealed significant reduction of hemoglobin level in the doses after longer storage, while the level of free hemoglobin increased; the clinical efficiency of cryopreserved erythrocytes transfused to patients with hematological malignancies depended on the erythrocytes' length of storage.

Extramedullary disease is an uncommon manifestation in multiple myeloma (MM) and can be observed at onset or develop at disease progression or relapse. Splenic involvement is very rare. The paper describes a 52-year-old female patient with MM who in 1990 was diagnosed with monoclonal gammopathy of undetermined significance with IgGkappa secretion and a considerably enlarged spleen. Specific therapy with bortezomib and dexamethasone was initiated in 2006 and proved to be inefficient. After splenectomy there was a 50% reduction in IgGkappa concentration. Splenic histological examination revealed monoclonal infiltration by the pleomorphic plasma cells expressing a kappa light chain.

The aim of the study was evaluation of the effects of amotosalen photodynamic inactivation of pathogens in platelet concentrates (PC) on the platelet function. Three groups of PC were analyzed: 1) native PC on the day of donation; 2) native PC after 20-24 h storage; and 3) PC after pathogen inactivation (PI) by the Intercept system 20-24 h after donation. Platelet counts, large and immature platelet fractions, phosphatidylserine (PS) and P-selection expression on inactivated platelet membranes and after their target stimulation were studied in all samples. Pathogen inactivation was associated with a significant reduction of platelet concentrations in PC. Studies of PS and P-selectin expression showed that PI suppressed spontaneous stimulation of platelets during storage. However, direct stimulation of platelets was associated with a significant reduction of PS expression in PC subjected to PI. The PI method used in our study led to reduction of cell concentrations in PC and modulated platelet function.