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To treat patients with different concurrent cancers, including lympho- and myeloproliferative neoplasms, is a difficult task. The paper presents the experience in successfully treating lymphogranulomatosis occurring in a female patient with chronic myeloid leukemia (CML). A combination of the BEACOPP-14 polychemotherapy regimen and imatinib induced no severe complications. Grade 2 neutropenia requiring no use of granulocyte colony-stimulating factors is the only manifestation of hematological toxicity. Infectious complications were successfully eliminated by first-line antimicrobial therapy in the intercourse periods. Remission in lymphogranulomatosis was achieved by polychemotherapy. The authors conclude that the chosen therapy option is effective and relatively safe in treating patients with CML concurrent with lymphogranulomatosis.

Aim: To compare efficacy of NHL-BFM-90 and CHOP-like courses in the treatment of anaplastic large cell lymphoma (ALCL)., Material and Methods: Twenty-two patients with ALCL participated in the study. The diagnosis was made basing on the findings of clinical, device, morphological, immunohistochemical and molecular-genetic examinations with application of a panel of monoclonal antibodies to CD30, ALK, CD3, CD4, CDS, CD7, CD34, CD15, CD68, CD20, CD45RO, CD45RA, Ki-67. 14 cases of 22 were negative by kinase of anaplastic lymphocytes (ALK-) and 8 were positive (ALK+). Mean age of ALK-ALCL patients was 39.6 +/- 4.1 years, of ALK+ALCL patients - 23.4 +/- 2.6 years. 14 patients were treated by the protocol NHL-BFM-90, 8 were initially treated with other schemes (CHOP, MACOP-B, BEACOPP and others). All 14 patients treated according to NHL-BFM-90 had ALCL stages III-IV with B-symptoms. 12 patients who completed treatment by the above protocol achieved complete remission after the forth course, 2 patients failed the treatment. Of 8 ALCL patients treated initially according to other schemes, a complete remission was achieved in 4 patients (2 had stage II). One of 4 patients with remission had recurrence. Four patients who had failed to achieve complete remission died of the disease progression., Conclusion: ALCL occurs more frequently in young and middle-aged patients. The disease has an aggressive course with rapid generalization. For such processes it is more preferable to use a modified protocol NHL-BFM-90.

Aim: To analyse overall recurrence-free survival of lymphogranulomatosis (LGM) patients given polychemotherapy (PCT) MOPP (mustargen-caryolisin, vincristine, natulan, prednisolone) - ABVD (adriamycin, bleomycin, vinblastin, dacarbasin) in combination with radiotherapy (RT) for 10 years., Material and Methods: The trial included 211 LGM patients admitted to Hematological Research Center in 1990-1996 from other hospitals without random selection. The patients were examined by the standard program including biopsy of the affected organ or lymph node, bilateral trephine biopsy. Splenectomy was performed in 17 patients, 83 patients received PCT in other hospitals, 128 untreated patients received MOPP-ABVD therapy (3 courses of MOPP and 3 courses of ABVD). Forty one patients had defects in PCT, 16 of them rejected PCT and RT. The latter was performed 4 weeks after the 6th course, contraceptives were not prescribed to women. At LGM stage II-III RT was performed by the subradical program (no radiation to ilioinguinal lymph nodes) in doses 40-44 Gy on the foci and 32-36 Gy preventively, on massive and residual foci after PCT - 5-10 Gy additionally., Results: Ten-year overall and recurrence-free survival in the untreated group reached 83 and 80%, respectively, for pretreated patients - 46 and 36%, respectively. Causes of death of 26 patients were LGM progression, infection (tuberculosis, as a rule), secondary tumors and acute myeloblastic leukemia (AML). After remission 25 women gave birth to a healthy child and 12 healthy children were born to 9 males., Conclusion: MOPP-ABVD plus radiotherapy program according to subradical and radical variants was in the past effective but invalidating rescue therapy. Present-day programs consider the histological variant, stage and prognostic factors allowing an individual therapeutic approach with step-by-step reduction of RT in the treatment of LGM patients. Involvement of the bone marrow in primary patients had no influence on the treatment results. This refers this affection not to a generalized stage IV, but to stage III along with involvement of the lymph nodes and the spleen.

The latest technologies, introduced into neurosurgery during the last 2 decades of the 20th century, ensured progress in the diagnostics and treatment of brainstem tumors--pathologies that remain until now a most complicated problem in neurooncology. The modern diagnostic tools comprising profound dynamic neurological and neurophysiological examinations (AVP, EEG) visualization techniques (CT, MRT with contrasting, MRT, spectroscopy, PET) provide for detecting not only the initial signs of stem tumors and their sizes but also their topographic interaction with the stem structures; it, in its turn, opens up a possibility to choose between the combined surgical treatment and the radiotherapy or chemotherapy alone. The clinical course, diagnosis and combined treatment of 333 children and adults with tumors bordering on the brainstem are analyzed within the case study.

Aim: To define the scope of combined therapy in patients having local Hodgkin's disease (LHD) with massive mediastinal lesion., Material and Methods: From 1980 to 1997 the treatment was given to 75 LHD patients with massive lesion of the mediastinum (mediastinal-thoracic index, MTI, > or = 0.33). The patients have received combined chemoradiotherapy according to 3 cycle CVPP (cyclophosphamide 600 mg/m2, vinblastine 6 mg/m2, prokarbasin 100 mg/m2, prednisolone 40 mg/m2) with a 2-week interval + radiation to all the lymphatic collectors above the diaphragm with a single focal dose 2 Gy to total focal dose 36-38 Gy + 3 cycle CVPP. According to the size of the mediastinum the patients were divided into 3 groups: group 1--MTI = 0.33, 27 patients; group 2--MTI = 0.33 > 0.45, 32 patients; group 3--MTI > or = 0.45, 16 patients. The response was estimated according to the latest EORTC recommendations. Survival curves were plotted according to the E.L. Kaplan and P. Meier procedure., Results: Complete remission was achieved in 93, 94 and 56% of group 1, 2 and 3 patients, respectively. 6-year recurrence-free survival reached 84, 71 and 32%, while survival free of treatment failure 80, 66 and 27%, respectively. 6-year overall survival and uneventful survival made up 94, 97 and 70%; 72, 66 and 27%, respectively., Conclusion: Treatment of LHD patients of group 1 is performed according to the standard scheme (6 cycles of first-line polychemotherapy plus radiotherapy). Patients of group 2 can be treated more intensively, while for patients of group 3 more intensive treatment is a treatment of choice.

The course of histioproliferative diseases was analyzed in 308 children treated at the All-Union Cancer Research Center, USSR AMS. Of these, there were 8 children with benign proliferation (Rosai-Dorfman disease). Histiocytosis-X was revealed in 232 children. The authors describe the regularities of histiocytic proliferation manifestations depending on the patients' age. Provide morphological (cytological) criteria for different types of histioproliferative diseases and characterize the treatment data.

As many as 104 patients with lymphogranulomatosis, clinical stages I-II, having an unfavourable prognosis were examined for the efficacy of polychemotherapy and combined treatment. Polychemotherapy was received by 47 patients, combined treatment (chemo- plus radiotherapy) by 57 patients. Complete remissions were attained significantly more often in patients given combined treatment (92%) as compared to patients on polychemotherapy alone (64%). After complete remissions relapses occurred in 60% of the patients on polychemotherapy and in 13% of the patients receiving combined treatment. The 7-year survival without any relapses was significantly higher (85%) in patients on combined therapy as compared to patients given polychemotherapy (36%). However, the 10-year survival appeared the same in both the groups (87 and 88%). Splenectomy affected neither the rate of relapses in both the groups nor the immediate treatment efficacy or survival.

The study was concerned with patterns of stage IV lymphogranulomatosis (Hodgkin's disease) recurrence as well as factors affecting it. A combined therapy relying mostly on MOPP scheme was used. Out of 109 children treated, primary complete remission was obtained in 78 (71.6%). However, remission continued throughout the study in 46 cases (59.0%) only. Relapse was more frequent (29 out of 32 cases) in the involved parts of the lymphatic system which had not been exposed to radiation during complete remission. The rate of recurrence formation was found to be in a significant correlation with general symptoms, age, size of the largest cluster of involved lymph nodes, combination of drugs and type of consolidating therapy.

Fourty two patients with lymphogranulomatosis (LG), mainly in stage IIIB and IVB, received polychemotherapy- a combination of N-nitrosomethyl urea, vinblastine, natulan and prednisolone (scheme L-I). The treatment comprised repeated courses. The first course lasted for 3 weeks, the remaining-for 2 weeks. An objective effect estimated by figure "3" was noted in 33 (78.6%) patients, "2"--in 6 (14.3%), "1"--in 2 (4.7%) and "o"-in 1 patients (2.4%). In 25 out of 33 patients with the objective effect "3" the complete clinical remission was gained, being maintained in 21. An average duration of the remission was 14 months. In overwhelming majority of case the maximum effect of the treatment was observed after the first (1-3) course of polychemotherapy. No grave complications relative to the treatment were noted.

The results of natulan therapy in III patients with spread lymphogranulomatosis are reported. An analysis of the dependence of the remission frequency and duration on different morphological variants of lymphogranulomatosis has shown that the incidence of remissions was high and practically identical in patients with nodular sclerosis, the lymphocytic and mixed cell type. The effect of natulan was found to be limited in the variant "Lymphocytic depletion".

The author presents an analysis of the results of the combination chemotherapy with natulan, vincristin, novembichine and prednisolone in 43 patients showing generalized lymphogranulomatosis, mainly with recurrences following radiation and chemotherapy with different antitumor substances. The results of the combination chemotherapy were compared with the data obtained in management of 94 patients having lymphogranulomatosis, stage III-IV, with natulan solely. It is shown that the combination therapy is effective, in principle, and provides an opportunity to gain objective remission in 65% of cases. A therapeutic effect of polychemotherapy depends on the administered total doses of the substances. A regimen consisting of no less than 5-6 cycles seems to be an optimum one, since it yields the greatest incidence and duration of remissions. As compared with the results of polychemotherapy in the fiven contigency of patients, natulan, used as a single tool of the specific therapy, shows a somewhat better effect.