The aim of the study is to investigate the immunophenotype of bone marrow plasma cells in patients with multiple myeloma (MM) before and after the transplantation of autologous hematopoietic stem cells (autologous HSCT), and to assess response to the treatment determine the frequency of the lack of achievement of minimal residual disease (MRD) negativity as a result of the treatment.
Material and methods. Immunophenotyping of marrow plasma cells was performed in 17 MM patients aged from 43 to 62 years (median age 55 years). Four color flow cytometry (Cytomics FC unit 500, "Beckman Coulter", USA) and the panel of monoclonal antibodies CD138/CD38/CD45/CD19/CD117/CD56 were used. In total, there were estimated 200,000--500,000 events in the initial Gate for forward scatter (FS) vs side scatter (SS). Plasma cells were isolated in Gate CD138/CD38. MRD-negativity was determined as the achievement of threshold value less than 0.01%. 37 bone marrow samples from 17 patients were analyzed. Immunophenotyping was performed before the 1st autologous HSCT, after the 1st autologous HSCT and after the 2nd autologous HSCT.
Results and discussion. In all samples bone marrow plasma cells were characterized by the expression of both CD138/CD38 markers and weak expression or absence of expression of CD45 (CD45dim/neg-). The immunophenotype of plasma cells was presented by three markers CD19, CD117, CD56 and varied at different stages of the treatment. The analysis of the quantitative expression of aberrant markers before and after the 1st autologous HSCT revealed a statistically significant reduction of aberrant plasma cells. In 6 (35.3%) of 17 patients MRD-negativity was successfully achieved after the 1st autologous HSCT.
Conclusion. Immunophenotyping by flow cytometry is a highly sensitive method. It permit to detect the expression of aberrant markers of plasma cells, to obtain their changes during the therapy. The efficacy of high-dose chemotherapy with following autologous HSCT was confirmed. The heterogeneity of aberrant expression of plasma cells was found.

The aim of the study is to evaluate the spectrum and epidemiology of infectious complications in patients with acute myeloid leukemia (AML) during induction and consolidation chemotherapy. Prospective study (2013–2015) included 66 patients with de novo AML (median age: from 39 (17–64) years. Patients received 208 chemotherapy courses (94 inductions, 114 consolidations). Patients were followed up for 180 days. Most patients were admitted from other hospitals (89%). On admission hyperleukocytosis was revealed in 33% of patients, ECOG score 3–4 points had 65% of patients, 38% of patients had severe infections, including pneumonia (21%) and cellulitis (17%). The mean number of febrile neutropenic episodes (FNE) per patient was 2.9 (1–4). FNE occurred in 93% of chemotherapy courses (98% of induction chemotherapy and 93% of consolidation chemotherapy; OR = 5.9; p = 0.01). The majority of FNE were attributable to clinically documented infections (44%), followed by fever of unknown origin (39%) and bloodstream infection (BSI) (17%). Gram-negative and Gram-positive bacteria accounted for 53% and 47% of BSI pathogens, consequently. Most prevalent BSI isolates were Escherichia coli (25%) and Streptococcus viridans (22%). Among Enterobacteriacae (n = 12) the production of β-lactamases of the extended spectrum was detected in 42% of positive isolates. Invasive mycoses (IM) were in 23% of patients. Invasive aspergillosis (IA) was the most frequent (60% of all invasive mycoses) (14% in the induction – 9%, 6% in the consolidation). Thus, infection complications were dominated both in the induction and consolidation and were caused by bacteria and fungi.

We have investigated the dynamics of post-transplant recovery of CD4+FOXP3+ T cells in patients with multiple myeloma (MM). The relationship between CD4+FOXP3+ T cell counts and clinical outcomes of MM patients after high-dose chemotherapy and autologous hematopoietic stem cell transplantation (AHSCT) also has been evaluated. Fifty-nine patients were included in the study. The content of circulating CD4+FOXP3+ T cells has been assessed with the use of flow cytometry before AHSCT, at the day of engraftment, and 6 and 12 months later. After AHSCT the relative count of CD4+FOXP3+T cells in MM patients restored rapidly, it became higher than initial level at the day of engraftment and then subsequently decreased for a 1 year to values in healthy donors. A relative count of CD4+FOXP3+T cellsat the time of engraftment increased in patients with relapsed disease during 12 months after AHSCT. Receiver operating characteristic (ROC) analysis showed that evaluation of CD4+FOXP3+ T cells at the day of engraftment allowed to predict the early relapse of MM after AHSCT.

Aim to perform the analysis of different agonists of thrombopoietin receptors - romiplostim and eltrombopag in adult patients with chronic idiopathic thrombocytopenic purpura (ITP) in Russia.
Methodology. There has been developed model of medical care patients with ITP based on the research hypothesis suggesting the possible low level of compliance in certain categories of patients for long-term independent daily intake of the drug eltrombopag (50 mg tablets). To evaluate the clinical practice for ITP patients in Russia the interview of experts was performed. Direct medical costs were calculated per 1 patient.
Results. Total costs of the treatment per ITP patient within the 1 year period were 3,895,692 rubles with romiplostim and 1,788,537 rubles with eltrombopag. However, taking into account a possible low level of compliance of certain categories of patients in clinical practice in Russia and therefore the probable decline of the efficacy of therapy the cost-effectiveness ratio for romiplostim amounted to 4,693,605 rubles/1 case of the effective treatment if compared with 6,387,631 rubles/1 case of the effective treatment for eltrombopag. The difference amounted to 1,694,026 rubles in favor of the drug romiplostim.
Conclusion The use of romiplostim in the treatment of adult ITP patients was both effective and economically justified as treatment option in real practice in patients with low compliance in Russia.

The functional activity of phagocytes of peripheral blood was analyzed. 63 children with acute lymphoblastic leukemia (ALL) were included in the study. The age of the patients (36 male and 17 female) was from 1 to 14 years. All patients received chemotherapy. The control group consisted from 79 healthy children (35 male and 44 female, aged from 10 to 14 years). The effect of myelosuppression of the chemotherapy in ALL children was revealed, which was manifested as the decline of the average cytochemical coefficient under the detection of the content of cationic complex protein and the decrease of phagocytic and metabolic activity of neutrophils in the nitro blue tetrazolium test.

Transplantation of allogeneic hematopoietic stem cells is the most effective therapy for patients with hematological malignancies and other hematological disorders. The most preferable donors of allogeneic hematopoietic stem cells are the HLA-identical siblings (descendants of the same parents) because they inherit the identical with patient HLA-haplotypes. The aim of the article was to analyze the segregation of HLA-haplotypes in families of patients with hematological disorders and assessment of the probability to find HLA-identical related donor for patients from families with different number of siblings. HLA-haplotypes are inherited in accordance with Mendelian inheritance regardless of number of siblings in the family of patient with hematological disorder.The more number of siblings, the higher the probability to find HLA-identical related donor. Thus, the probability of the finding of HLA-identical related donor for patients with one sibling accounted near 27%, for patients with two siblings – 37%, for patients with three siblings – 47%. However, HLA-identical related donor can be absent for the patient in need of allogeneic hematopoietic stem cell transplantation regardless of number of his/her siblings.

The residual risk of transfusion infection by hepatitis B virus (HBV) and C (HCV) in Russia is several tens of times higher than in the USA. In developed countries for many years there is widely used the testing the blood samples by means of the polymerase chain reaction (PCR) of individual donors and mini-pools. This is an advantageous economic decision, because it reduces the cost of preparing of blood components.
The aim of the study was to analyze the proper level of the viral safety. Molecular markers of viruses were detected in plasma samples of seronegative donors (n = 33,799) in pools out of 6. The levels of viral molecular markers were calculated in 72 positive samples: 21 – HBV DNA, 51 – HCV RNA. There were investigated prepared experimentally 17 plasma pools contained HBV DNA, HCV RNA positive specimen. Commercial reagent kits were used.

Pathogen inactivation (PI) treatment of platelet concentrates (PCs) improves the transfusion safety. PI technology allows to store of PCs up to 7 days. The usage of platelet additive solution (PAS) reduces the risk of non-hemolytic transfusion reactions and enhances platelet quality during storage. The influence of the combinations of PI and PAS and PI and 100% plasma on the biochemical parameters of PCs remained unclear. The aim of the study was to analyze the impact PI technology on the biochemical parameters and functional activity of platelets suspended in 100% plasma or 70% PAS and 30% plasma. The pathogens reduction does not influence on the glucose consumption and citrate content, accelerates the accumulation of lactate and lowers the pH of the medium storage donor platelet concentrates. In the samples with additive solution SSP+ changes of biochemical parameters were expressed to a lesser degree.

Introduction The application of point-of-care devices for the hemoglobin measurement with the aim of admission to donor blood donations can decrease the time of the primary analysis and its invasiveness, reduce the cost of the donation. Introduction of new methods of hemoglobin measurement requires their clinical validation.
The purpose of this study was to compare the results of hemoglobin determination in capillary and venous blood with the use of an absorption photometer HemoCue® and percutaneous reflective spectrometer Haemospect, as well as detection thresholds for donation admission for the latter approach.
Material and Methods. The study included 484 healthy volunteer donors. Hemoglobin levels were measured in the venous and capillary blood samples. The portable absorbent photometer HemoCueHb 201+ was used. For non-invasive measurement was performed by reflective spectrometer Haemospect.
Results. The mean differences of hemoglobin levels between non-invasive spectrometric and invasive photometric measurements were -2.7 g/l for venous blood and -2.1 g/l for capillary blood (goodness of fit chi-square test). The sensitivity of noninvasive hemoglobin measurement was 55.7%, specificity was 89.9%. The positive predictive value for Haemospect was 51.8%, negative – 91.2%, with the likelihood ratio (in the form of odds ratios) – 11.2.
Conclusion. Noninvasive hemoglobinometer Haemospect, comparable to the chi-square test (for goodness of fit) and predictive value with other similar portable devices, can be used for screening of donors with the establishment of restrictions to the admission donations for men with hemoglobin less than 135 g/l, for women – less than 117 g/l.

National Hematological Society initiated in 2013 the epidemiological study of acute leukemia (AL) in five regions of the Russian Federation. For this purpose, Web-System of data collection has been created for the registration of new cases of herpes zoster by SSC coordination.
The aim of the study was to estimate the incidence, distribution of AL types and their dependence on the major demographic indices.
Results. On-line registration of all de novo AL cases was executed from April 01, 2013 to December 2016, with signing of the necessary informed consent of the patient. There were included 334 AL patients (185 women and 149 men) aged of from 16 to 85 years (median age 57 years) from Ryazan, Kirov, Tambov, Kaluga Region, Republic of Mordovia. Standardized incidence rates ranged from 1.39 to 2.43 per 100 000 population.
Conclusion. The recorded incidence of AL remains low. This incidence does not differ from the AL incidence (2.71) according to the Russian Cancer Register (RR) in 2008. However, this incidence significantly lower than incidences in European and US registers (4–5 cases per 100 000 inhabitants per year).

The case report of the patient with hairy cell leukemia. The first manifestation of the disease was acute respiratory failure due to pneumonia. Initially, the clinical improvement was achieved due to splenectomy, which resulted in the increase of the blood granulocytic cells. A specific microbiological diagnosis was not established by thoracoscopy and lung biopsy. However after surgery bronchoalveolar lavage was revealed invasive aspergillosis. Successful treatment with voriconasole was started. BRAF-V600E mutation was searched out. After the clinical improvement the therapy with vemurafenib was started. This treatment helps to avoid further neutropenia and progression of infection complications. The clinical and hematological remission was achieved within 4 months.

There is a necessity for effective drugs in patients with relapsed/refractory chronic lymphocytic leukemia (CLL) treatment that would not worsen the patients quality of life. Clinical case of a patient with chemoresistant CLL, who got Ibrutinib treatment, is discussed. The drug has a fairly quick response, high efficiency efficacy and emissionslow toxicity. Of particular interest are rare side effects detected while therapy and require correction doses of the drug.