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Biomedical subjects

A V Pivnik

Publications and source records attributed to A V Pivnik.

At least 37 records · Page 2Linked to original sources
PubMed2000

[The 1st results of the combined therapy of recurrent and refractory forms of lymphogranulomatosis (polychemotherapy, radiation therapy and the removal of the residual mediastinal formation)].

AIM: To achieve a maximal complete remission rate in patients with recurrent and refractory Hodgkin's disease. To find out a group of patients in whom surgical removal of the residual mediastinal mass would be most effective. MATERIAL AND METHODS: 46 patients with Hodgkin's disease received Dexa-BEAM chemotherapy followed by radiotherapy. Surgical removal of the residual mediastinal mass was made in 12 patients. RESULTS: Second-line Dexa-BEAM therapy produced a 50% complete remission rate. Overall survival was 45.5%, the disease-free survival--43.5%. Removed mediastinal masses were indicative of Hodgkin's disease in 7 cases and fibrosis in 4 cases. CONCLUSION: Dexa-BEAM is an effective program in the treatment of recurrent and refractory Hodgkin's disease. Surgical removal of the residual mediastinal mass with radiotherapy and high-dose chemotherapy improves prognosis in very unfavorable, primary progressive form of Hodgkin's disease.

Adolescent↗
PubMed2000

[A comparison of the forms of chronic lympholeukemia in relation to the mutational status of the genes of the immunoglobulin variable region].

AIM: To compare forms of chronic lymphoid leukemia (CLL) regarding mutational status of immunoglobulin variable genes. MATERIAL AND METHODS: We have compared clinical, prognostic and immunophenotypic data obtained on 25 cases with different mutational status of IgV genes. There were 10 patients in the mutated group (median age 49.2 years, male to female ratio = 7:3), and 15 patients in unmutated group (median age 46.5, M:F = 13:2). RESULTS: Statistically significant differences were noted in overall survival and CD38 expression. 5-year overall survival in unmutated group was 35%, in mutated group 80% (p = 0.07). In unmutated group CD38 was expressed on more than 50% of cells in 7 out of 14 patients, while in the mutated group in 0 of 8 patients (p = 0.007). We noted high frequency of VH1-69 gene usage in unmutated group (7 of 15 patients), while in mutated group it was used in only 1 case of 10. CONCLUSION: We confirm the differences between groups of CLL with different mutational status of IgV genes. Highly restricted usage of VH-genes and CD38 expression possibly suggest that unmutated group also arises from antigen driven cells.

Adult↗
PubMed2000

[Fludarabine treatment of chronic lymphoid leukemia].

AIM: To try effectiveness of fludarabine monotherapy in verified chronic lymphoid leukemia (CLL) in pretreated patients. MATERIAL AND METHODS: The treatment effectiveness according to the international criteria of complete and partial remission was assessed in 37 patients with progressive, splenic, tumor and bone marrow forms of CLL given 5-day courses of fludarabine in a single daily dose 25 mg. RESULTS: In progressive CLL, the remission was achieved in 45% of the patients (10% complete and 35% partial), in splenic form--62.5% (12.5% complete, 50% partial), in tumor form--50% (100% partial). In bone marrow form no remissions were obtained. CONCLUSION: Fludarabine is effective in therapy of pretreated CLL patients. The treatment should be adjusted to CLL form.

Adult↗
PubMed2000

[Immunogenetic markers in hemoblastosis].

AIM: To establish for hemoblastoses general and individual associations between HLA genes and predisposition or resistance to malignant transformation of hemopoiesis. MATERIAL AND METHODS: Antigens of class I and class II genes were determined by microlymphocytotoxic test and DNA typing (PCR-SSP) in 30 patients with acute myeloblastic leukemia (AML), 47 patients with acute lymphoblastic leukemia (ALL), 52 patients with chronic myeloblastic leukemia (CML), 58 patients with lymphogranulomatosis (LGM) and 224 donors. RESULTS: HLA specificities were elucidated frequency of which was high in all the above nosological entities: Cw7 (RR 2.5 to 5.22), DRB1*11 (RR 2.3 to 4.88). Frequency of antigen B5 was high in three diseases (RR 2.14-2.6). A number of specificities have distribution deviations typical for only one or two diseases (A19--AML and CML, B27--ALL, DRB1*08--AML). The HLA-gene was detected the frequency of which was low in three diseases--DRB1*07 (RR 0.39 to 0.11). Individual preventive HLA genes for AML, ALL, LGM were A2, B8; A1, B8, B40; DRB1*01, respectively. CONCLUSION: Cw7, DRB1*11, B5 are HLA-specificities marking hemopoiesis predisposition to malignant transformation in general. Development into a certain nosological entity depends on combination of general HLA-genes with markers of individual hemoblastosis. DRB1*07 is a general preventive gene. Preventive HLA genes can be also individual for the above hematological diseases.

Acute Disease↗
PubMed2000

Quantitation of red cell-bound immunoglobulins and complement in lymphoma patients.

Quantitative ELISA may be useful for determining the amount of red blood cell (RBC)-associated immunoglobulins (Igs) in patients with autoimmune hemolytic anemia (AIHA). In idiopathic AIHA, there is about 20 times more RBC-associated IgG and complement than in normal persons. In patients with low-grade lymphomas (particularly, B-CLL and splenic marginal zone lymphoma) autoimmune hemolysis is a component of their anemia. In high-grade malignant lymphomas (i.e, diffuse large B-cell lymphoma and peripheral T-cell lymphoma), as well as in Hodgkin's disease, autoimmune hemolysis contributes little, if any, anemia. The quantitative ELISA for RBC-associated IgG and complement is useful for following the effects of treatment in patients with immune hemolysis.

Journal Article↗
PubMed1999

[Results of clinical trials in the treatment of acute myeloid leukemia in adults during a 7-year period].

AIM: Comparison of effectiveness of induction regimens varying in intensity and maintenance variants in patients with acute myeloid leukemia (AML) included in a randomised multicenter trial. MATERIALS AND METHODS: Clinical trial 1 enrolled 185 AML patients. Vepesid-free induction was used in 85 patients (group 1), induction with vepesid--in 99 patients (group 2). 223 AML patients entered trial 2. Of them 37 patients were treated for 3 years 7 + 3 with daunorubicin in the dose 45 mg/m2 in the induction phase (group 1), 85 and 101 patients received 7 + 3 with daunorubicin for a year in the dose 45 mg/m2 and 60 mg/m2, respectively, (group 2 and 3). RESULTS: For group 1 in trial 1 the remission rate, early lethality, resistance were, respectively, 60, 20 and 20%, respectively. For group 2 in trial 1--66, 22 and 12%, respectively. 5-year recurrence-free survival reached 32 and 37% for group 1 and 2, respectively. For trial 2 relevant figures made up 75.5, 16.2, 8.1% for group 1; 60, 17.6 and 22.4% for group 2; 63, 20.8 and 16% for group 3, respectively. The 3.5-year recurrence-free survival in groups 1, 2 and 3, was 16, 46 and 50%, respectively. For both trials, the differences between the groups were insignificant. CONCLUSION: The results evidence that the treatment can be shorter (not 3 but 1 year or even 6 months), the induction more intensive (the dose of anthracycline antibiotics can be elevated up to 60 mg/m2 without a rise in early lethality).

Acute Disease↗
PubMed1999

[Effectiveness of trans-retinoic acid in the treatment of acute promyelocytic leukemia: initial results of a multicenter study].

AIM: Evaluation of trans-retinoic acid (ATRA) in combination with cytostatic drugs in treatment of acute promyelocytic leukemia (APL). MATERIALS AND METHODS: In a multicenter study APL was treated according to protocols APL 01.97 and APL 06.87 in 28 patients (14 males and 14 females, median age 36 years). RESULTS: Administration of ATRA in combination with standard program 7 + 3 (cytosine-arabinoside 100 mg/m2 twice a day v.v. day 1-7, daunorubicin 60 mg/m2 v.v. day 1-3) induced a complete remission in 25 patients (90%). Early lethality was 10% (3 patients died). Resistant APL was not registered. Retinoid syndrome was diagnosed in 15 patients, one patient died. 2-year overall and recurrence-free survival made up 72 and 82%, respectively. CONCLUSION: ATRA combination with cytosine-arabinoside and daunorubicin is a novel treatment of acute promyelocytic leukemia providing a high rate of complete remission and long-term survival.

Adolescent↗
PubMed1999

[Acute and chronic renal failure in patients with myeloma].

AIM: To analyze causes of reversible and irreversible renal failure in myeloma patients, lethal outcomes, treatment policy. MATERIALS AND METHODS: 43 myeloma patients with renal failure entered the trial. The replacement therapy consisted of hemodialysis, hemofiltration, hemodiafiltration. All the patients received full-dose polychemotherapy according to the programs M-2 and VAD. RESULTS: 69% of the patients retained normal renal function. 23% of the patients died. Partial recovery of renal function was observed in 1 patient who had to undergo dialysis once in 10-12 days. The patients survived from 5 days to 36 months (mean 20.6 months). The main causes of death in renal failure were sepsis (38%) and hemorrhagic stroke (14%).

Acute Kidney Injury↗
PubMed1999

[Protection of reproduction function in women with Hodgkin's disease in the course of polychemotherapy].

AIM: To evaluate efficiency of estrogen-gestagen treatment for protection of the ovaries during polychemotherapy. MATERIALS AND METHODS: Ultrasonography of the pelvic organs, radioimmunoassay of LH, FSH, prolactin, E2, testosterone were performed in 95 women of child-bearing age with different stages of Hodgkin's disease. RESULTS: Cytostatic therapy of Hodgkin's disease had ovariotoxic effects and led to amenorrhea in 83% of the examinees. Regular estrogen-gestagen treatment protected ovaries in 86% of the patients. CONCLUSION: It is recommended for women to take estrogen-gestagen drugs to protect ovaries during polychemotherapy of Hodgkin's disease.

Adolescent↗
PubMed1998

[The factors of hereditary predisposition to lymphogranulomatosis].

AIM: To determine genetic factors of predisposition marked HLA with reference to serological and molecular characteristics. MATERIALS AND METHODS: Four groups of patients were included in the study: 51 patients with lymphogranulomatosis (LGM), 33 healthy relatives of these patients, 37 patients with chronic myeloid leukemia (CML), 24 healthy relatives of these CML patients. 224 donors served control. HLA-antigens were identified with the lymphocytoxic test and PSR-MSSR. Results of typing of class II antigens were taken into consideration in coincidence of serological and DNA typing. The significance of the differences was estimated according to the chi-square criterion. RESULTS: Differences in frequency of distribution of HLA-antigens (subloci A and B) were not found. Antigen CW7 was present in 70, DR5 in 60, DR6 in 50% of LGM patients. This frequency was much higher than in control groups. Carriers of CW7 are at 7 times higher risk to develop LGM. Among LGM patients the number of homozygous individuals is higher than in healthy ones (50 and 15.6%) while the number of individuals with a complete set of HLA-A.B antigens is significantly less. CONCLUSION: Genetic predisposition to LGM is predetermined by HLA antigens CW7, DR5, DR6. Genes HLA-DR1 and HLA-DR7 protect carriers from factors provoking LGM. Common HLA genes in the parents predispose their children to LGM. Insufficiency of the phenotype is a factor predisposing to LGM.

Chi-Square Distribution↗
PubMed1998

[Coagulation system in patients with blood malignancies treated with estrogens in the course of cytostatic therapy].

AIM: To evaluate the effect of estrogen gestagenic drugs (EGD) on blood coagulation in patients with blood malignancies treated by polychemotherapy. MATERIALS AND METHODS: 32 females of reproductive age treated with ovarioprotector marvelon during cytostatic therapy. The following indices were determined: activated partial thrombin time, prothrombin index of the ethanol test, fibrinogen and antithrombin III levels, factor XIIa dependent time of fibrinolysis, thrombin time. Dopplerography of the lower limb vessels was carried out. RESULTS: No significant alterations in coagulograms of the patients treated with cytostatics in combination with EGD were recorded. CONCLUSION: It is safe to use EGD as ovarioprotectors in females with hematological malignancies in hypercoagulation.

Adolescent↗
PubMed1997

The relevance of cytological studies and Ki-67 reactivity to the clinical course of chronic lymphocytic leukemia.

The aim of the study was to investigate whether the growth fraction and cytology of peripheral blood and lymphoid tissues relate to response to treatment in CLL. Growth fraction was assessed using the monoclonal antibody Ki-67. Peripheral blood (PB) films and lymph node and spleen touch imprints or aspirates were examined in 35 patients (pts) with CLL: smouldering CLL (4 pts) (no therapy), progressive CLL but responsive to chlorambucil and cyclophosphamide (15 pts) and resistant CLL (16 pts). Cytological studies of lymphoid tissues showed that pts with resistant CLL had an increased proportion of prolymphocytes and blasts and the highest Ki-67 expression (mean 6,6%). PB morphology was not different between the groups of resistant and responsive CLL. However, the cases with resistant CLL showed a higher percentage of Ki-67 positive PB cells (p<0,05). Four pts with indolent CLL had typical CLL morphology in the PB and the lowest numbers of prolymphocytes and blasts with Ki-67 positive cells in lymphoid tissues.

Adult↗
PubMed1997

[A benign form of chronic lympholeukemia].

According to the classification of chronic lymphocytic leukemia (CLL) proposed by A. I. Vorob'ev and M. D. Brilliant in 1983, benign CLL is a distinct form of CLL which is characterized by low level of absolute lymphocytosis, absent or mild peripheral lymphadenopathy, slow progression. No specific therapy is needed. The paper presents clinical, morphological and immunological analysis of 34 cases of benign CLL (17 males and 17 females, mean age 58 years). Patients were included in the study if they had lymphocyte count less than 30,000 and no significant growth of lymphoid tissue for at least 3 years. They were followed up from 3 to 24 years (11 years, on the average). The main features of benign CLL are the following: no "B" symptoms, no essential enlargement of the lymphoid organs, a stable low level of absolute lymphocytosis, low prolymphocyte count in the blood smear (0.95% +/- 0.2), nodular or nodular-interstitial proliferation in the bone marrow. We failed to find any cases with paraprotein secretion. There was immunophenotype typical for CLL in 91% of cases (CD19+, CD20+, CD23+, CD5+, EM+, CR1-/CR2+, sIg+(-)). None was positive for CD38 activation marker. One trisomy 12 cases was detected by FISH method. 8 patients died so far, but not because of the tumor progression or transformation, median survival was 22 years.

Aged↗
PubMed1997

[Idiopathic and symptomatic hypereosinophilic syndromes (their comparative characteristics based on 14 cases)].

Clinical, hematological, cytogenetic and pathohistological findings in 14 patients with high eosinophilia allowed the authors to distinguish 2 groups of patients: with symptomatic (secondary) and idiopathic hypereosinophilic syndromes (6 and 8 patients, respectively). The latter was characterized by hepato- and splenomegaly, specific cardiac lesion (thromboplastic endocarditis), non-infectious fever, anemia and thrombocytopenia, marked hypercellularity of the bone marrow with inhibition of erythro- and megakaryocytopoiesis. Ph'-chromosome occurred in 2 out of 8 cases. Biopsy and autopsy histology in all cases of idiopathic hypereosinophilic syndrome were typical for myeloproliferative diseases. In symptomatic hypereosinophilic syndrome the above features were not registered.

Adolescent↗