The research results of the interrelation between the indices of metabolic intoxication and individual time perception (individual minute) in 112 patients with hemophilia with haemorrhages of various localization have been presented. It has been ascertained, that the indices of lipid peroxidation and permeability of erythrocytic membranes are criteria that make it possible to assess the ability of an organism for adaption. The index of individual time perception may serve as a marker for metabolism changes in hemophilia patients` organism, which allow of considering it as an additional assessment criterion for the clinical course and cure rate.

The levels of the laboratory markers for antiphospholipid syndrome, i.e. cardiolipin autoantibodies and antibodies to β2-glycoprotein 1 IgG and IgM in systemic lupus erythematosus have been studied. It has been established that the increase of the marker level of antiphospholipid syndrome is observed in 67 % systemic lupus erythematosus cases. The IgG autoantibodies are mоre often detected in the development of secondary antiphospholipid syndrome.

The group of patients with hereditary microthrombocyte thrombocytopaty has been studied. The diagnostic criteria for this form of thrombocyte pathology have been determined, the effective methods of the treatment have been shown.

The assessment of antitumor activity of cytotoxic lymphocytes is an important indicator of their functional status in cellular immunotherapy. Testing of CD107a marker expression by the method of flow cytofluorimetry has been widely lately used for these purposes. The research that we carried out to determine the antitumor activity of mononuclear lymphocytes in peripheral blood including those stimulated by interleukine-2 showed that incubation of mononuclear lymphocytes in peripheral blood in the presence of К-562 tumor line was conducive to the reliable increase in rates of natural killer and killer-like cells expressing CD107a. A straight correlation between CD107a+killer cells percentage and the number of the dead targets in the test with the use of CFSE fluorescent label was detected. The assessment method of CD107a expression makes it possible to measure the cytotoxic activity in a cell in a concrete population of effectory cells and may be used alongside with standard methods for target-cell lysis.

The article presents the data on the treatment for chronic myeloleukemia with the application of allogenic transplantation of hemopoietic stem cells. The analysis of the received results testifies to the fact that the allogenic transplantation of hemopoietic stem cells is a highly effective method of the treatment of patients with chronic myeloleukemia.

The sensitivity of procalcitonin (PCT) as a diagnostic test of 68 per cent to detect systemic inflammatory response syndrome (SIRS) was lower than that of C-reactive protein (CRP) (c² = 6,2; р = 0,01). The specificity of both tests to detect and identify SIRS did not substantially differ, which was indicated by the area under curve for CRP - 0,84 and PCT - 0,84. The parallel detection of CRP and PCT in patients with the sings of febrile neutropenia made it possible to identify the patients, who were able to develop the clinic of SIRS within 24-48 hours with probability of 78 per cent and to identify the patients, who did not develop the SIRS clinic within 24-48 hours with probability of 56 per cent.

The changes of the functional state of blood coagulation, registered in the process of the treatment of oncological patients are caused in the majority of cases by the combined defect of a plasmic component in consequence of thrombocytopenia. The reaching of a diagnostic threshold for the thrombocyte level less than 28 × 10⁹/l and factor activity of prothrombin complex less than 40 per cent as a result of the clinic of systemic inflammatory response allows of making a supposition that a bleeding develops within a few days at the early stage of the treatment of the patient with malignant neoplasm or hemoblastosis. If the number of thrombocytes is more than 28,5 × 10⁹/l /l in the combination with the level of factor activity of the prothrombin complex no less than 40 per cent or there is no systemic inflammatory response syndrome, the changes of blood coagulation cannot be an independent cause for a bleeding and the correction is not needed.

The efficacy of the treatment of 15 patients with chronic myeloleukemia (CML) of different severity in the Hematology Department of the Gomel Regional Clinical Hospital has been studied. The therapy efficacy was assessed by qualitative parameters, which include dynamics of spleen size, data on clinical and biochemical blood tests, morphological analysis of marrow for clinical efficacy and long-term results and safety of imatinib in patients with chronic myeloid leukemia, tolerant to traditional cytostatic therapy in the chronic phase and acceleration phase in multiple use. The treatment 1st included the dose of 400 mg/day. The full hematological response was received in 86 % patients with CML in its chronic or advanced phases by the end of three months from the beginning of the treatment with imatinib, which was a good result for wide clinical practice. The performed research showed that the preparation was highly effective, possessed good tolerance and relatively seldom caused hematological and non-hematological complications in comparison with the traditionally performed chemotherapy. The treatment with imatinib considerably improved the results of the therapy of the patients with the progressing stage of the disease and made it possible to receive clinical and hematological remission.

High-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (auto-HSCT) can achieve remission in 90 % patients with multiple myeloma. Unfortunately, the duration of this remission is less than 3 years. The development of the methods to maintain the remission and to control minimal residual disease in patients with multiple myeloma is a pressing task for hematologists. In the group of the patients treated with α-interferon, after HDC with autologous HSCT the dual response rate was significantly higher (p < 0,05) and relapse rates were significantly lower (p < 0,05) in comparison with the group of patients treated that α-interferon.

To increase the efficacy of the therapy of trophic skin lesions (erosions, sores), we have developed a new treatment method with the application of autofibronektin-thrombocyte concentrate (AFTC). The method lies in the fact that a patient's thrombocyte-enriched autoplasma is cold incubated with non-fractional heparin. AFTC is used for local treatment for trophic skin erosions and sores. AFTC-efficacy of skin erosions healing makes up 100 % in acute vascular purpura and atrophic arthritis, the healing of skin sores is observed in 93 % cases.

The immunophenotyping method makes it possible to detect and delimit specific cellular antigenic determinants, which enables to establish the criteria for the identification ofmorphlogically non-differetiable normal and pathologic cells. A leukemic cell clone has homogenous morphcytochemical characteristics in myelodysplastic syndromes. It is heterogenic in its antigenic structure of blastic elements which determines the prospects for its immunophenotypic investigation. The immunophenotype of marrow cells displays a high diagnostic value by the heterogeneity of the cellular population in the patients with myelodysplastic syndromes. The given method may serve as a tool for differentiative diagnosis for different myelodysplastic syndromes and can be used in the elaboration of the prognostic criteria for this pathology.

At the present stage of the development of pediatric hematology along with the success of the therapy there is s problem of late treatment effects which reveal itself in functioning disturbances of the main systems of the organism vital activity. The article presents the substantiation of the creation of special rehabilitation programs which take into consideration the complex character of the disturbances and ensure their effective correction. A qualitatively new organization of rehabilitation activities with the wide use of treatment-and-psychological methods has been proposed. The authors analyzed the structure of the concomitant diseases in the children suffering from myeloid neoplasms, which made it possible to outline the approaches to the creation of a medical rehabilitation system for this group of children. The description of different types of the rehabilitation therapy and their efficacy was given.

The problem of hemostasis disturbances in neonatology gains currency due to its physiological instability aggravated by various pathologic processes. Based on literary data, the article systematizes the causes that lead to the disturbance of hemostasis functioning in the neonatal period and characterizes the risk factors for hemorrhagic complications from the neonate and the mother. It has been shown that the state of microcircular hemostasis in the neonates demands its detailed investigation, as the received knowledge about the functioning of primary hemostasis will make it possible to decide a lot of important issues that relate to the disturbance correction in hemorrhagic syndrome in the neonates.

The decreased level of the chemotactical receptor CXCR2 expression is accompanied by the emergence of soluble CXCR2 (рCXCR2) in cellular supernatant in neutrophil activation. The content of рCXCR2, interleukin-6 (IL-6) and α-defenzins (human neutrophil peptides, HNP) has been studied in the peritoneal fluid of patients with acute peritonitis and lavages from abdominal cavity in diagnostic lapascopy for the diseases that are not related to the abdominal organ inflammation (control group). It was shown that the levels of рCXCR2, HNP and IL-6 in the peritoneal fluid were reliably higher in the comparison with the level of the control group in the acute postoperative period of the disease. The positive correlation between рCXCR2 and HNP (r = 0,72, р < 0,001) and IL-6 (r = 0,64, р < 0,05) was detected in the peritoneal fluid of the patients and the lavages from the abdominal cavity of the patients of the control group. We assume that the detection of рCXCR2 in the peritoneal fluid alongside with IL-6 and HNP can serve as an additional diagnostic tool for the early recognition of intra-abdominal peritonitis complications.

Interleukin-8 (IL-8) is the main chemotactical factor for polymorphonuclear neutrophils (PMN) in inflammation. We have already shown that PMN stimulation in vitro causes a sharp decrease of IL-8 receptor expression of second type CXCR2 on the PMN membrane and an emergence of soluble glykopeptid CXCR2 (рCXCR2) in the supernatant. In this work we have studied the effect of рCXCR2 on IL-8 synthesis in the monocyte culture of the blood and bronchoepitheial human cells A549. It was shown that рCXCR2 reliably stimulated IL-8 synthesis in the monocyte culture with the evident doze-dependent effect. рCXCR2 did not cause IL-8 synthesis in the culture of the bronchoepitheial human cells A549. The influence of рCXCR2 on the monocytes was not related to the lypopolysaccharide contamination of the preparation and was caused by the protein and carbohydrade parts, included in рCXCR2 molecule.

Tandem transplantation of hemopoeitic and mesenchymal stem cells is a perspective and now widely used direction of cell therapy of oncohematological diseases and multiple sclerosis in the clinical practice of the Republic of Belarus. Mesenchymal stem cells are also effectively used as concomitant immunosuppressive therapy of acute and chronic reaction Transplant Against Host (RTAH). The protocols of the application of mesenchymal stem cells for the therapy of oncohematological patients and patients with multiple sclerosis are approved by the Ministry of Public Health Care of the Republic of Belarus. The efficacy of the cell therapy with the use of mesenchymal stem cells is studied in the clinical research in the treatment for various diseases: genetic degenerative diseases of skeleton, ischemic disease, liver cirrhosis, neurodegenerative diseases (parkinsonism, Alzheimer's disease). The experimental work and clinical trials have shown the positive effect of the transplantation of mesenchymal stem cells in myocardial infarction and in the substitutive therapy of liver impairment.

The work determines the standard conditions for the obtainment of a transplant of mesenchymal stem cells from adipose tissue for the clinical application as co-transplant in allogenic transplantation of hemopoietic stem cells. To ensure the safety of the transplant besides its quality control, including morphologic and immunophenotypic tests, the results of microbiological tests and viability test were necessary in the categorization of mesenchymal stem cells. The registration certificate, devised earlier for the systematization of data on the transplant was drawn, when the mesenchymal stem cells from adipose tissue were distributed for the therapy. Nineteen transplants of the mesenchymal stem cells from the adipose tissue were prepared by this protocol for the clinical application. They were successfully used as co-transplants in the allogenic transplantation of hemopoietic stem cells and in the therapy of reaction Transplant Against Host in patients with oncohematological pathology in Minsk Municipal Clinical Hospital No.9.

The restoration of hemopeisis indices after high dose chemotherapy with autologic and allogenic transplantation of stem hemopoeitic cells with the combined use of hemopoietic growth factors - erythropoietin and granulocytic colony-stimulating factor at the early post-trasplantation period has been studied. 268 patients were included into the investigation. The shortening of restoration terms of hemoglobin, leucocytes and neutrophils in the group of patients, undergoing the combined therapy of hemopoietic growth factors after autologic transplantation of stem hemopoeitic cells. The shortening of restoration terms of hemoglobin, leucocytes and neutrophils in the group of patients, undergoing the combined therapy of hemopoietic growth factors after allogenic marrow transplantation. In whole, the application of erythropoietin in the combination of with granulocyte colony-stimulating factor led to the decreased hematologic toxicity.

The present-day approaches to the treatment for chronic lymphatic leukemia have been considered, the application of rituximab, monoclonal antibody to СD20-receptors has been grounded. The results of the retrospective analysis and randomized clinical research, dedicated to the assessment of efficacy of rituximab in the combination with chemotherapy in CLL, have been presented. Based on these results, the conclusion about the advantage of immunochemotherapy with rituximab over the chemotherapy in the treatment of CLL patients has been made. It is emphasized, that R-FC mode can be considered as a new first-line therapy standard in CLL patients.

176 oncohematologic patients, their sibs and 200 blood donors were examined to determine the possibility for related and unrelated donor for hemapoietic stem cell transplantation. HLA antigens I and II were indentified and frequency of occurrence of certain parameters of this system was calculated. It was shown that the compatible sibling was most often selected in anplastic anemia (57,5 % cases) for the patients with anplastic anemia, chronic myeloleukemia (CML), acute myeloblastic leukemia (AML) and lymphogranulomatosis (LGM). The matching of a donor-sibling for the patients with three other nosologies varied from 34,4 % for LGM, up to 39,9 % cases for AML and CML took an intermediate position - 38,3%. Meanwhile the found values for the 3 later groups were not statistically different, but were reliably lower than for the patients with anplastic anemia. The revealed features in the distribution and their siblings of the HLA system parameters in comparison with the control group were the reason for more often finding a donor-sibling for the patients with anplastic anemia. The above mentioned values were identical among themselves (for the patients and siblings). On the contrary, the HLA-parameter distribution for the patients of the three other groups as in their siblings did not differ from the control groups. It has been established, that the citizens of Minsk have the Caucasian type of HLA-gene distribution. Consequently, the search for an unrelated donor for the transplantation is possible not only in the data register of the Republic of Belarus, but also in the analogous registers of other countries.

The number of the supposed leukemic stem cells in marrow samples of 54 patients with primary B-linear acute lymphoblastic leukemia was detected by the method of multiparametric flow cytofluorimetry in leukemia diagnosis (zero day). The level of minimal residual disease was estimated on zero and on the fifteenth days of induction therapy. In the course of the research it was found out that leukemic B-cell precursors with СD34+СD38-CD19+ phenotype prevailed among the cells with СD34+СD38-phenotype. The high percentage of both СD34+СD38-, СD34+СD38-, and СD34+СD38-CD19+ among the general population leukemic cells was associated with a worse response to the therapy. Therefore, the initial number of such cells can be considered as a prognostic marker in acute lymphoblastic leukemia in children.

The article elucidates the results of the international clinical research into the application of alemtuzumab in patients with chronic lymphatic leukemia (CLL) and presents the results of the application of alemtuzumab both in monotherapy and in the combination with chemomedicines (fludarabin, cyklofosfan). The received results testify that the application of alemtuzumab in CLL patients is an effective up-to-date method of therapy.

The experiment that had been carried out on rats showed that acute exposure of ionizing radiation at a dose of 1 Gy led to a significant decrease of the level of energetic metabolism and change of such morphological parameters of thymocytes as a cell size, dimension index and density of structural elements on it surface. On the tenth day a partial restoration of the morphological features was observed but mitochondrial respiration stays in a depressed state.

The participation of aquaporin-1 (AQP-1) in the regulation of erythrocyte structural metabolic features in anemias of various genesis has been studied. It has been ascertained that the patients with asiderotic anemia (n = 6) have a 36 per cent decrease in the erythrocyte aggregation speed in comparison with the control group (n = 12). AQP-1 inhibition and AQP-1 combined suppression and phospholipase-dependent membrane mechanisms lead the increase in the erythrocyte aggregation speed till the level of the control group. The received results are evidence of AQP-1 participation in the regulation of erythrocyte structural metabolic features in the patients with anemias.

The analysis of myeloproliferative characteristics of 55 patients with radiation-associated myelofibrosis and 47 patients - with spontaneous myelofibrosis with myeloid metaplasia has been presented. Taking into account individual radiation doses, absorbed after the Chernobyl Disaster, disease stages, expected living median in 14-year observation interval, myeloproliferation-depression index, subgroups of good, interim and bad prognosis for the disease course were singled out, the radiation affect on myelopoiesis in the dynamics of the disease course was assessed.

The article presents 8 cases of secondary acute myeloblastic leukemia in patients, undergoing the treatment for a malignant neoplasm or anplastic anemia acquired in childhood and 40 cases of de novo acute myeloblastic leukemia of the high risk group. The clinical laboratory characteristics, therapy and survival rate of secondary acute myeloblastic leukemia and de novo acute myeloblastic leukemia have been discussed in the article with the account of the literary up-to-date data.

We have studied H- and L-subunits of ferritin in acute leukemia. Our data makes it possible to suggest that the appearance of considerable numbers of ferritin in the serum of patients with clonal blood diseases is connected with its secretion with lymphocytes. As it is impossible to establish the reliable correlation between the dimension of the tumor in leukemia and the level of ferritin, then the ferritin secretion is hypothetically relating to its regulatory functions. We have shown that the separate testing of H- and L-forms of ferritin makes it possible to determine the content of serum ferritin. It has been established that the content of serum ferritin differs in acute leukemia at attacks and remission but it is necessary to accumulate the data for the comprehension of true diagnostic H-ferritin value. It is possible that in the nearest future hematologic syndromes in malignant tumors, i.e. clonal processes from the inflammation-associated syndromes, can be differentiated according to the content of serum ferritin.

In cases when there is no HLA-compatible related donor, an unrelated donor is searched for in the data bases of international and national registers of donors for hemopoietic stem cells. The Minsk Municipal Registе of donors for marrow and hemopoietic stem cells was founded in 2009. At present it contains the data on more than 3,5 thousand donors described by HLA-phenotype. The HLA-typing Laboratory was organized in 2010 in Municipal Clinical Hospital № 9. Its main tasks are donor typing for Minsk Municipal register of donors for marrow and hemopoietic stem cells and to select pairs of donor-recipient for allogenic transplantation. Accreditation of HLA-typing Laboratory by European Federation of Immunogenetics and including of the national register into the IBMTR data base are a prospective goal.

The article presents the results of our own fludarabin-containing FLAG protocol-based treatment of 54 patients with both first detected and resistant forms of acute myeloid leukemia. It has been shown that, the application of the indicated chemiotherapy scheme is highly effective and makes it possible to assure remission in most patients.

The article presents the results in the analysis of the quality of specialized medical assistance to patients with hemopoietic diseases in the Republic of Belarus. The structure of the hematological service, availability with bed fund, specialists, laboratory equipment have been described. The results of the analysis revealed the necessity to perform the restructuring of the service. To improve quality and accessibility of the medical assistance to the patients with hemopoietic pathology and to introduce up-to-date treatment technologies, the prospects for the development have been determined, concrete suggestions to optimize the structure of the service have been given.

The causative agents of infective inflammatory complications in 42 patients with acute myeloid leukemia have been detected. Their sensitivity to antibiotics and antimicotics was studied, and according to which the etiotropic infectious treatment was carried out. The individually selected antibiotic therapy made it possible to arrest in proper time the inflammation nidi, which did not impede the subsequent treatment of the patients.

Nineteen children, of them 11 boys (57,9%) and 8 girls (42,1%) aged from 1,3 to 16 were diagnosed with verified Fanconi`s anemia in the Republic of Belarus in the period from 1992 to 2010. Pathologic skin pigmentation, bone and eye anomalies were the most widespread anomalies in the children`s development. To perform the mutagenic analysis of FANCA gene, DNA from the peripheric blood and marrow mononuclears of 9 patients was extracted. The fragmentary analysis of FANCA gene revealed DNA abnormalities in 2 patients (1-6 exone deletion and 6 exone deletion). The mutation screening of 43 exones of FANCA gene detected mutation in three more patients (exone 19, exone 27, exone 28). Two mutations of 5 detected ones were new. The mutation screening in this group in the combination with FANCA gene mutations in five patients revealed also numerous one-nucleotide polymorphism (SNP), 3 patients revealed only SNP, and one patient had neither mutations nor SNP.

Six boys aged from 4 months to 15 years old were diagnosed with Wiskott-Aldrich syndrome in the Republican Research Centre for Pediatric Oncology and Hematology. All the patients revealed WAS gene mutations. The missence-mutations in exones 2 and 3, detected in 4 patients prevailed in the spectrum of the mutations. WASP was fully absent in lymphocytes and rather a severe course of the disease was observed in all the patients. Only one child with WAS gene mutation in second exone had a mild course of the disease. The mutations were localized in tenth exone in two patients, which is a nonsense of the mutation. The WASP expression was partially preserved in one patient with such mutation.

339 patients with cardiovascular pathology and 260 persons of the control group have been examined. The level of homocystein in plasma was measured by means of liquid chromatography under high pressure with fluorescent detection. The indicators of plasmic and thrombocyte hemostasis in the patients with normal or heightened level of plasma homocystein were compared. According to the obtained data, the increase of the homocystein level plays an important role in the formation of hypercoagulation syndrome. The presence of hyperhomocysteinemia leads to the development of endothelial dysfunction, activation of coagulation and thrombocyte parts of hemostasis, decrease of natural anticoagulants and fibrinolysis activity

IDA clinical picture consists of common symptoms of anemia caused by hemic hypoxia, and signs of tissue iron deficiency (sideropenic syndrome). Biochemical criteria for diagnosis of IDA and LID (latent iron deficiency) are recommended by WHO. Optimal tactics of patients with IDA involves saturating and maintenance therapy with iron. The main iron-containing products are iron sulfate, gluconate, chloride, fumarate, glycine sulfate. The integrated medicine Tot'hema contains ferrous iron with its stimulant absorption of organic gluconic acid. When choosing a iron-containing medication divisional therapists focused on the patient's chances to get the drug for a course of treatment, tolerability of the drug and on their own experience.