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Background . Prostate cancer (PCa) is one of the most common malignant diseases in men worldwide, with over 1.1 million cases of PCa reported annually. In the Russian Federation, the proportion of patients with stage I—II PCa from 2008 to 2018 increased from 37.6 % to 56 %, which in turn allows more and more patients to perform radical treatment methods. However, it should be noted that the number of patients with both recurrent PCa after radiation therapy (external beam radiation therapy (EBRT) or brachytherapy) and with local recurrence after radical prostatectomy (RPE) is steadily increasing. Objective . Improve treatment outcomes for patients with recurrent PCa. Materials and methods. A. F. Tsyb Medical Radiological Research Center — branch of the National Medical Research Radiological Center, since 2016, has been treating patients with recurrent PCa using salvage high-dose brachytherapy (SHDR) (192Ir) after radical radiation treatment (EBRT, brachytherapy) or with local recurrence after RPE. Patients with recurrent PCa were divided into three groups, depending on the type of initial radical treatment: patients with recurrent disease after RPE, after EBRT and after brachytherapy. Results . The most favorable results of SHDR were registered in the group of patients with local recurrence after RPE: in 7 patients out of 8 (87 %), one year after the PSA, the prostate-specific antigen (PSA) level was less than 0.1 ng/mL. In 1 patient, the PSA level dropped to 0.71 ng/mL (baseline 2.47 ng/mL) two years after salvage treatment. Currently, there is a further decrease in PSA levels. Results after SHDR ( 192 Ir) in patients with relapse after EBRT: of 8 patients, 2 (25 %) had PSA levels less than 0.2 ng/mL after a year. In 4 patients, the PSA level two years after treatment was more than 2.0 ng/mL. In these patients, a relapse was registered. Another 2 patients also had a repeated relapse after SHDR. The following results were obtained after carrying out SHDR in patients with relapse after braahythempy (both low- and high-dose). Of the 12patients, 7patients (58 %) had PSA levels less than 0.5 ng/mL two years after SHDR. SHDR was performed in the mode of two fractions of 12.5 Gyerahwith an interval of two weeks between them. In 3 patients, the PSA level exceeded 0.5 ng/ mL two years after the salvage treatment, and therefore, a second relapse is determined in them. Another 2 patients also had a repeated relapse. Conclusion . This article provides preliminary results of our research. We would like to reiterate that as possible options for the treatment of local recurrence of PCa, it is possible to choose salvage prostatectomy, salvage radiation therapy, hormonal therapy or SHDR brachytherapy. In some cases EBRT is used in this category of patients, however, this can lead to the development of severe radiation damage. The choice of a treatment method in case of recurrent PCa is a complex problem, the decision of which is based on many factors. The clinical course of PCa, the prevalence of the disease, the level of markers, and molecular genetic data are taken into account.

The pattern of the interaction between powder particles and metal vapors is developed. To ensure a guaranteed supply of PAs to the heated region with the use of laser irradiation, a model for theoretically analyzing the motion paths of PA particles carried to the zone of construction with a gas jet in 3D Metal Printing is proposed.

Currently, the main pathogenetic method for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) is the treatment with recombinant monoclonal antibodies that block the C5 component of the complement system. Eculizumab is the first biotechnological drug, which is a monoclonal antibody, with proven clinical efficacy and safety for the treatment of patients with PNH, which is used in world clinical practice. In Russia, in the framework of the state program Development of the pharmaceutical and medical industry for 20132020 was developed Elizaria (JSC GENERIUM) the first biosimilar of the original drug eculizumab.To evaluate the pharmacokinetic and pharmacodynamic parameters, as well as safety and immunogenicity parameters of the drug Elizara in the induction phase of therapy in previously untreated patients with PNH.The study included 11 patients with PNH aged 26 to 75 years who had not previously received eculizumab. Each of the study participants was injected with the studied drug Elizaria at a dose of 600 mg intravenously once a week for 4 weeks.During the clinical study, it was noted that the concentration of the studied drug significantly increased by the time the infusion was completed and then gradually decreased to a minimum at the end of the dosing interval. The average concentration of eculizumab 5 minutes before the administration of the study drug at all visits exceeded 35 g/ml, the minimum concentration sufficient to completely inhibit intravascular hemolysis in patients with PNH. The pharmacodynamic efficacy of the drug Elizaria was confirmed by a decrease in the concentration of the membrane-attack complex (MAC) after the first infusion of the drug was maintained at stable levels until visit 5. A persistent decrease in the level of MAC and a four-fold decrease in the average values of lactate dehydrogenase to visit 5 from 1286.4 to 280.9 U/l demonstrated a marked decrease in activity and stabilization of the hemolytic process against the background of the induction of therapy with Elizaria at a dose of 600 mg once a week and confirmed the effecacy of the study drug. Among the 9 adverse events, only 5 had a relationship with the studied drug, including one serious adverse event in the form of an allergic reaction, which, according to the researcher, had a possible cause-effect relationship with the infusion of the studied drug. In 2 patients, low-titer binding anti-drug antibodies were detected without neutralizing activity during treatment with the studied drug, which may indicate its low immunogenicity.The study evaluated the pharmacokinetic and pharmacodynamic properties of the drug Elizaria in the regimen of induction therapy in previously untreated patients with PNH, confirming its efficacy. The study demonstrated the safety and low immunogenicity of the study drug.В настоящее время основным патогенетическим методом лечения пароксизмальной ночной гемоглобинурии (ПНГ) является терапия рекомбинантными моноклональными антителами, блокирующими С5-компонент системы комплемента. Экулизумаб первый биотехнологический лекарственный препарат, являющийся моноклональным антителом, с доказанной клинической эффективностью и безопасностью для лечения больных ПНГ, который используется в мировой клинической практике. В России в рамках реализации государственной программы Развитие фармацевтической и медицинской промышленности на 20132020 гг. разработан препарат Элизария (АО ГЕНЕРИУМ) первый биоаналог оригинального препарата экулизумаб. Цель. Изучение фармакокинетических и фармакодинамических показателей, а также параметров безопасности и иммуногенности препарата Элизария в фазе индукции терапии у ранее не леченных больных ПНГ. Материалы и методы. В исследование включены 11 пациентов с ПНГ в возрасте от 26 до 75 лет, ранее не получавших экулизумаб. Каждому из участников исследования вводили исследуемый препарат Элизария в дозе 600 мг внутривенно капельно один раз в неделю в течение 4 нед. Результаты. В ходе клинического исследования отмечено, что концентрация исследуемого препарата значительно увеличивается к моменту окончания инфузии и далее постепенно снижается до минимума в конце интервала дозирования. Средние значения концентрации экулизумаба за 5 мин до введения исследуемого препарата на всех визитах превышали 35 мкг/мл, минимальную концентрацию, достаточную для полного ингибирования внутрисосудистого гемолиза у больных ПНГ. Фармакодинамическая эффективность препарата Элизария подтверждалась снижением концентрации мембраноатакующего комплекса (МАК) после окончания первой инфузии препарата с поддержанием ее на стабильных уровнях до визита 5. Стойкое снижение концентрации МАК и четырехкратное снижение средних значений лактатдегидрогеназы к визиту 5 с 1286,4 до 280,9 Ед/л демонстрировало выраженное снижение активности и стабилизацию гемолитического процесса в результате индукции терапии препаратом Элизария в дозе 600 мг один раз в неделю и подтверждало эффективность исследуемого препарата. Из 9 нежелательных явлений только 5 имели связь с применением исследуемого препарата, включая одно серьезное в виде аллергической реакции, имевшее, по мнению исследователя, возможную причинно-следственную связь с инфузией исследуемого препарата. У 2 больных выявлены связывающие антилекарственные антитела в низком титре без нейтрализующей активности во время лечения исследуемым препаратом, что может свидетельствовать о его низкой иммуногенности. Заключение. В ходе исследования оценены фармакокинетические и фармакодинамические свойства препарата Элизария в режиме индукции терапии у ранее не леченных больных ПНГ, подтверждающие его эффективность. В исследовании продемонстрированы безопасность и низкая иммуногенность исследуемого препарата.

The correct determination of the blood types of the recipient and the donor is very importante for the choice of blood components for transfusion. As a result of the study, it was established that 18.0% of patients, admitted to the hematology clinic, have difficulties in interpreting of the results of immunohematological tests. Most often, a double population of red blood cells was detected when determining antigens of the Rhesus system (10.9%), auto- (3.9%) and alloantibodies (2.8%). The proposed algorithm for the selection of donor red blood cells in difficult diagnostic cases helps to prevent the development of post-transfusion complications.

Aim. To analyze the regularities of the prevalence of allergic diseases in patients of different age groups. Materials and methods. Epidemiological indices of allergic diseases were studied in children, adolescents, adults and elderly persons using official statistical data. Results. The general and primary morbidity, allergopathology structure and its dynamics were evaluated in patients of different age groups. The data, obtained in Perm Krai and the Russian Federation, were compared. Conclusions. The level of atopic dermatitis (AD) is the highest in children, allergic rhinitis (AR) – in adolescents, bronchial asthma (BA) – in adolescents and elderly persons. The cases of BA prevail in the structure of allergopathology in all age groups, besides children. Among children AD cases make 50.5 % of all allergic diseases. In dynamics, AD has a tendency to reduction of general morbidity in all age groups, BA – in children; a tendency to elevation is typical for AR in children and adolescents, BA – in adolescents, adults and elderly persons.

Carcinoembryonic antigen (CEA) is widely used to evaluate the effectiveness of treatment in patients with rectal cancer.The aim of the studywas to investigate whether the CEA levels measured before and after neoadjuvant chemoradiotherapy (nCRT) can be used to predict pathological complete response (pCR) in patients with locally advanced rectal cancer.Material and methods.179 patients with locally advanced rectal cancer were treated with nCRT followed by surgical treatment. The serum CEA level was measured before and 610 weeks after the completion of nCRT. Preand post nCRT CEA levels were compared with pCR. The factors associated with pCR were studied.Results.pCR after nCRT was achieved in 12 % (22/179) patients. The incidence of pCR was higher in patients with normal (vs8 %, p=0.019). In patients with the elevated pre-treatment CEA level (> 5 ng/mL), there were no significant differences in the incidence of pCR between cases with normalization and without normalization of CEA level after treatment (p=0.08). The maximum likelihood of pCR determined by the ROC curve was Conclusion.Low CEA before and after nCRT is a predictor of pCR. Well differentiated tumors increase the probability of pCR after nCRT.

Background. Follicular lymphoma (FL) is the most common type of indolent lymphomas and accounts for 20–30 % of all non-Hodgkin’s lymphomas detected. High risk of recurrence and elderly patients make it difficult to choose induction therapy for FL. The R–B course in comparison with the R–CHOP course increases the progressive free survival (PFS) of FL patients and is less toxic. International studies have not studied the efficacy and toxicity of the R–B course due to various cytological types of FL. Aim of the study – assessment of the effectiveness and toxicity of the R–B course (with R support) in general and depending on the different cytological types of FL, the assessment of overall survival (OS) and PFS (adverse events: progression, relapse, death); identification of risk factors for an adverse event in general and death, in particular. The main endpoint of this study is selected BPV. Materials and methods. We performed a prospective, multicenter, open-label trial in Russia since June 1, 2013 till June 1, 2018. The study included 74 patients with FL. Median age of patients was 59 years (from 30 to 78 years). Treatment was completed in 66 patients, so this group of patients was analyzed. Ratio between men and women was 1:2. 32/66 of patients (48 %) were older than 60 years old. Patients received rituximab 375 mg/m2 on day 1 and bendamustine 90 mg/m2 on days 1 and 2 of a 4-week cycle (6 cycles). 49/66 (74 %) of patients were diagnosed with FL grade 1, 10/66 (15 %) – grade 2, 7/66 (11 %) – grade 3A. 34/66 (52 %) patients had nodular tumor growth type, 28/66 (42 %) – nodular-diffuse, 4/66 (6 %) – diffuse. High risk according to FLIPI had 25/59 (42 %) of patients with cytologic grade of FL 1–2 and 7/7 (100 %) of patients with FL grade 3A. Extranodal lesions were revealed in 26/66 (39 %) of cases: in 4/66 of cases – orbit, in 2/66 – parotid gland, in 5/66 – lungs, in 4/66 – intestines, in 2/66 – stomach, 2/66 – pancreas, 2/66 – uterus, 2/66 – skin, 1/66 – subcutaneous tissue, 3/66 – vertebrae, in 1/66 – latticed maze and nasal passages, 1/66 – kidneys, 1/66 – root of the tongue. In 23/26 (88 %) of cases extranodal lesion was revealed in generalized stage of FL (including lymph nodes and bone marrow). Extranodal lesions were found in 37 % of patients with FL grade 1–2, and 57 % with FL grade 3A. Bulky also was observed more frequently in pts with FL grade 3 3/7 (43 %) than in patients with FL grade 1–2 20/59 (34 %). (The risk factors of an adverse event are also its predictors in this study.) Results. Complete remission of disease was achieved in 40/66 (61 %) patients, partial remission – 13/66 (19 %) patients. Tumor progression observed in 11/66 (17 %) cases, patients were withdrawn from the protocol. А partial tumor response was achieved in 2/66 cases (3 %) and patients received high-dose therapy after 4 courses of R–B. Five-year (as well as the 3-year) overall survival (OS) of all patients (n = 66) in R–B was 90 % (95 % confidence interval (CI) 78–96), 5-year PFS – 70 % (95 % CI 55–85) and a 3-year PFS – 75 % (95 % CI 60–89). The cumulative incidence of relapse (considering competing risks of progression and death) at the 3th year after initiation of treatment was 11 % (95 % CI 3–19). The following independent statistically significant (p ≤0.05) predictors of PFS (measured in the onset of the disease) were determined (as a result of a stepwise multivariate cox regression analysis): 1) cytological type of tumor (only type 3A is significant); 2) involvement of nodal zones (more than 4); 3) presence of a conglomerate of tumor lymph nodes larger than 6 cm (bulky); 4) Ki-67 protein expression (more than 35 %). The first 3 characteristics (as well as the sign «presence of extranodal foci», close to the level of significance) are independent statistically significant predictors of OS. In the single factor analysis the following characteristics (besides the above) were significant: index FLIPI (significant only 5 points against all others), bone marrow damage, β2-microglobulin (more than 2.2 mg/L), age (over 68 years) and hemoglobin (less than 110 g/dL). Conclusion 1. The independent negative predictors of OS and PFS in follicular lymphoma were determined. 2. Of the predictors of an adverse event identified, the greatest risk (as a result of a multivariate analysis) is associated with a 3A cytological type of tumor. 3. The FLIPI index has a predictive value not only for the determination of OS, but also for the PFS (moreover, in reduced dichotomous form: 5 points against all the others combined). 4. An increase in the time interval between the first manifestations of follicular lymphoma (lymph node enlargement / appearance of a tumor formation) and the start of therapy beyond a certain threshold value (estimated to be approximately 22 months) is associated (according to the results of univariate analysis) with an increased risk of an adverse event. One of the reasons for the increase in this time interval is associated with expectant medical tactics adopted during the slow development of the clinical picture of the disease. The obtained result shows that the low rate of development of the clinical picture of the disease does not correlate with the low risk of adverse events, and, therefore, cannot be a determining factor when deciding whether to start treatment. 5. The morphology of the tumor is the determining factor in the choice of induction therapy. 6. After achieving full/partial remission of FL, there is a constant risk of recurrence of the disease (by the age of 3 from the termination of treatment, the risk is 11 % (95 % CI 3–19)). 7. The R–B course effectively sanitizes the bone marrow. 8. The R–B allows performing stem cells mobilization and autoSCT that is actual in FL patients with bone marrow involvement. 9. The treatment regimen of R–B is effective and has a relatively low toxicity, so it is advisable in the treatment of elderly patients.

The issues of diagnosis and management of allergic rhinitis (AR) in pediatric patients are considered on the basis of the current Russian clinical guidelines. The article presents the paediatrician tasks on the collection of anamnesis, the assessment of clinical symptoms, the setting of a preliminary diagnosis, the development of a diagnosis and therapy plan taking into account the modern medical care quality criteria. It also discloses the general principles of AR treatment, approaches to emergency symptomatic therapy using a combined intranasal drug Vibrocil (dimethindene + phenylephrine). The paper provides recommendations for the management of patients with allergic rhinitis in the district covered by child health care.

A case of Norwegian scabies is described in a patient of 19 years with a lesion of the scalp, face, trunk, upper and lower extremities that occurred against the background of acute lymphoblastic leukemia. A good effect was obtained from conducting etiotropic, pathogenetic and symptomatic therapy in combination with specific treatment of the underlying disease.

The purpose of the study was to evaluate the prognostic significance of carcinoerembryonic antigen in patients with rectal cancer and correlate its baseline with the degree of therapeutic pathomorphosis after neoadjuvant chemoradiotherapy.Materials and methods. An estimate of the informative value of carcinoerembryonic antigen (CEA) indices in 179 patients with colorectal cancer determined before and after preoperative chemoradiotherapy (CRT) in SOD 50 Gy.Results. Analysis of the results presented in the study showed that in all patients, CRT caused a significant decrease in the level of CEA (–71%) 10 weeks after its end (p < 0.001). In the course of the pathomorphological study, after the neoadjuvant treatment, the first degree of tumor pathomorphism was recorded in 4.5% of patients, II – 38.5%, III – 45%, IV – 12% (the degree of pathomorphosis is not related to the clinical stage and the degree of differentiation of colorectal cancer). It was revealed that patients with III and IV degrees of therapeutic pathomorphosis initially had a CEA level lower, in comparison with patients with grade I-II. Clinical progression of the disease is diagnosed in 24% of cases (43/179). It was noted that in patients with the IV degree of therapeutic pathomorphism of the tumor, no recurrence of the rectal cancer was detected in either case.Conclusion. The results of the study showed that the problem of individual prediction of the effectiveness of combined treatment of the rectal cancer remains very relevant, rather complicated and yet not completely solved. However, it can be assumed that the use of such an indicator as CEA in monitoring patients after the treatment, can serve as a criterion for the sensitivity of colorectal cancer to CRT. Initially low antigen level can be considered as a positive factor of tumor response to ongoing treatment and disease-free survival of patients with locally advanced rectal cancer.

The strategy and tactics of antibacterial therapy for acute respiratory tract diseases in children in the practice of neighbourhood paediatricians are discussed on the basis of the current Russian clinical guidelines. The article presents the diagnostic criteria and the choice of antibacterial drugs for acute bacterial rhinosinusitis, acute streptococcal tonsillitis, acute otitis media.

The aim of this study was to analyze the basic epidemiological parameters of MM in the Kirov region based on own regional population register data. Materials and methods . Five hundred and sixty-seven patients with newly diagnosed MM between 1994 and 2016 were included. The median age was 64 years (range, 29–90). The age-standardized incidence of MM in Kirov region was 1.8 cases per 100.000/year. Results. During research period (23 years) we have the positive trend of the incidence and prevalence of MM and negative tendency of mortality every year. Our prognosis of the intensive incidence in Kirov region is 2.2–2.3 cases per 100.000 in 2017–2019 years. The 5-year overall survival rate (5y-OS) was 18 % (1994–1999); 24 % (2000–2005) and 36 % (2006–2011) respectively. The median OS was 28; 26 and 38 month respectively. The median OS for patients who diagnosed in the period 2012–2016 was not achieved. The reason for the increase in the prevalence of the disease and the reduction in mortality is the greater effectiveness of new bortezomib-containing chemotherapy regimens. Conclusion . Аmong the Kirov region population standardized incidence of MM is 1.8 cases per 100.000/year. The prevalence of MM in the Kirov region has a linear growth trend from 3 to 11 patients per 100.000 peoples within the analyzed period of observation 1994–2016. OS increased from 18 to 36 % in the period from 1994 to 2011. OS of MM patients has been increasing since 2006, due to using bortezomib-containing treatment options and autologous stem cell transplantation. In general, the 5-year OS increased from 18 to 36% in the period from 1994 to 2011.

The article considers a clinical case of the grave course of the flu А(Н1N1)pdm09 with development of the viral and bacterial pneumonia and acute respiratory distress-syndrome (ARDS) in the baby. A description of the respiratory support is provided, the data on catamnesis in a year are given.

Objective: Our aim was to evaluate the efficacy of an ectoine nasal spray in treating children with seasonal allergic rhinitis. Methods: An open randomized study of children aged 3–17 with the aggravation of early spring hay fever. All participants received oral antihistamine, and the children of the treatment group — oral antihistamine plus ectoine nasal spray. The symptoms of the disease and the amount of additional drug therapy were analyzed on the 1st, 10th and 21st day of treatment. Results: The group with patients who received an ectoine nasal spray (n = 24) showed a significant, if compared to the control group (n = 18), decrease in the severity of all symptoms of rhinitis — nasal congestion from the 14th day of treatment (p = 0.010), nasal discharge — from the 15th day of treatment (p = 0.036), nasal irritation and sneezing — from the 17th day of treatment (p = 0.020), as well as the symptoms of allergic conjunctivitis such as itchy eyes — from the 18th day of treatment (p = 0.020) and conjunctival hyperemia — from the 19th day of treatment (p = 0.040). The use of an ectoine nasal spray was accompanied by a decrease in the frequency of the assignment of drugs for the additional rhinitis treatment. Conclusion: An ectoine nasal spray in combination with antihistamines induces a more rapid relief of major symptoms of seasonal allergic rhinitis and allergic conjunctivitis in children, as well as reduces the need for additional medical treatment of the disease, if compared to the antihistamine monotherapy.

To analyze the efficiency of the ALL-2009 protocol (ClinicalTrials.gov NCT01 193933) in patients with T-cell leukemias, particularly the role of autologous hematopoietic stem cell transplantation (auto-HSCT) after non-myeloablative BEAM conditioning, followed by maintenance therapy.Since 2009, the ALL-2009 study has enrolled 90 patients with T-cell acute lymphoblastic leukemia (T-ALL), the treatment results were assessed in 86 patients: 6 and 28 patients underwent allogeneic HSCT and auto-HSCT, respectively. A landmark analysis was used to compare survival rates in patients who had undergone auto-HSCT and in those who had not. For this, the median time from complete remission to the date of auto-HSCT was determined (the median was 6 months). Then to compare with the auto-HSCT group, only 27 patients who had been in complete remission for 6 months or more were included in a chemotherapy group.The achievement of complete remission in patients with thymic T-ALL (100%) was significantly higher than in those with early (85.7%) or mature (70%) variants. The patients with early and mature T-ALL as compared to those with thymic T-ALL showed high death rates in the remission induction (7.4 and 10% versus 0) and the patients with mature T-ALL had a.higher proportion of refractory forms (20% versus 0). The 5-year overall and relapse-free survival rates in all the T-ALL patients were 66 and 76%, respectively. After auto-HSCT, the risk of recurrence was 0% versus 21% after chemotherapy (p=0.03). The relapse-free survival rates significantly differed in the auto-HSCT and non-auto-HSCT groups: 100 and 66%, respectively (p=0.047).The long-term survival rates obtained during this multicenter study in the T-ALL patients treated according to the ALL-2009 protocol, the basis for which is the principle of continuity of cytostatic effects, are exclusively optimistic. Late consolidation with auto-HSCT following non-myeloablative BEAM conditioning, followed by maintenance therapy, considerably reduces the risk of recurrence.Цель исследования. Анализ эффективности протокола ОЛЛ-2009 (ClinicalTrials.gov NCT01193933) у больных Т-клеточными лейкозами, особенно роли трансплантации аутологичных гемопоэтических стволовых клеток (ауто-ТГСК) после немиелоаблативного режима кондиционирования ВЕАМ с последующей поддерживающей терапией. Материалы и методы. В исследование ОЛЛ-2009 с 2009 г. включили 90 больных острым Т-лимфобластным лейкозом (Т-ОЛЛ), результаты лечения оценены у 86 больных: 6 выполнена аллогенная ТГСК, 28 - ауто-ТГСК. Для сравнения выживаемости больных, которым выполнили или не выполнили ауто-ТГСК, использовали landmark-анализ. Для этого определяли медиану времени от достижения ПР до даты ауто-ТГСК (медиана составила 6 мес). Затем для сравнения с группой ауто-ТГСК в группу химиотерапии включили 27 больных, которые пережили в полной ремиссии 6 мес и более. Результаты. Достижение полной ремиссии у больных с тимическим Т-ОЛЛ (100%) существенно выше, чем у больных с ранним (85,7%) или зрелым (70%) вариантами. Для раннего и зрелого по сравнению с тимическим Т-ОЛЛ характерна высокая частота летальных исходов в период индукции ремиссии (7,4 и 10% по сравнению с 0), а для зрелого Т-ОЛЛ - и большая доля рефрактерных форм (20% по сравнению с 0). Общая и безрецидивная 5-летняя выживаемость всех больных Т-ОЛЛ составили 66 и 76% соответственно. При выполнении ауто-ТГСК вероятность развития рецидива составила 0 по сравнению с 21% при применении химиотерапии (р=0,03). Достоверно (р=0,047) различалась безрецидивная выживаемость больных, которым выполняли ауто-ТГСК или нет: 100 и 66% соответственно. Заключение. Полученная в рамках многоцентрового исследования долгосрочная выживаемость больных Т-ОЛЛ, лечившихся по протоколу ОЛЛ-2009, в основе которого лежит принцип непрерывности цитостатического воздействия, является исключительно оптимистичной. Поздняя консолидация с помощью ауто-ТГСК после немиелоаблативного кондиционирования ВЕАМ и последующая поддерживающая терапия значительно снижают вероятность развития рецидивов.