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The development of various analitic techniques like classical cytogenetics, molecular cytogenetics and molecular methods has greatly improved our ability to understand the basis of cancer development, that can be helpful in hematological diagnostics and treatment. Thus, improving these methods and raising the diagnostic standards remain of key importance in haematooncology. The influence of cytogenetic and biomolecular analysies on clinical decisions has increased considerably recently, but laboratory techniques have to be optimized to provide reliable results for the best patient care. The aim of this study is to present the basis of genetic diagnostic methods used in hematooncology and their role in clinical practice.

Malignancies may be associated with a variety of renal complications. These include: acute kidney injury, chronic tubulointerstitial and vascular pathologies as well as paraneoplastic glomerulonephritis. Membranous nephropathy consists a main paraneoplastic glomerulopathy in solid tumors, and minimal change disease is the most common in haematologic malignancies, especially in Hodgkin lymphoma. Epidemiology, pathogenesis, clinical manifestations and management of these conditions are described in the paper.

A cancer diagnosis provides significantly level of emotional distress and discomfort both for patient and his family. They must confront themselves with the new, difficult reality. A cancer-related distress may promote the serious psychic disturbances and influenced negatively the therapeutic process. The good interpersonal relationship between physician and patient clearly decreased the level of fear and depression, improved patient's physical and psychical state. Patients who have good communication with their physician are more prone to good adherence and compliance which are essential for the effective therapeutic process. This article discusses the role of relationship between physician and patient regarding its influence on compliance and provides a review of different types of therapeutic contact and the principles of building the physician-patient relationship.

Central venous catheters (CVC) are frequently used in patients with a hematological disorders in order to administer drugs, stem cell infusions, blood products, parenteral alimentation as well as for blood sampling. There are known mechanical, infectious and thrombotic complications of central venous catheters in hematological patients. Infectious and thrombotic complications have been considered as separate entities so far, but there are theory and accumulating evidence that they are interrelated. Since data on central venous catheters-related thrombosis in hematological patients have been obtained mainly from retrospective studies of small size, prospective randomized studies are warranted. In this review we present current opinions about epidemiology, pathogenesis, diagnosis of CVC-related thrombosis and also its correlations with infectious CVC-related complications.

Osteonecrosis (avascular necrosis, AVN, aseptic necrosis) is the consequence of the disturbance of blood supply to specific bone area. AVN occurs as a result of many different conditions such as fracture, thrombosis, mechanical vessel injury, fat embolism and many others. The most frequent location is the femoral head, but aseptic necrosis can also affect epiphysis of long bones and small bones of upper and lower limb. Avascular necrosis is also one of the serious long-term complications of antineoplastic treatment, including high dose steroids, specific cytostatics and radiotherapy. Children and adolescents treated for hemato-oncologic diseases during the intensive bone growth are at special risk for osteonecrosis. Adequate management is based on early and proper diagnosis and treatment - conservative, pharmacological or surgical. MRI technique has been shown to have the best sensitivity and specificity in the moment of the diagnosis of AVN, as well as during the disease proccess.

Hematopoietic stem cells (HSC) transplantations are usually performed 24-48 hours after the end od high-dose chemotherapy (HDC). It is possible, however, that at that time the transplanted HSC can be affected by the administered drugs. We report the results obtained in 30 patients (pts) with hematological malignancies (multiple myeloma - 14, Hodgkin's disease -6, non-Hodgkin's lymphomas -4, chronic myeloid leukemia -6) treated with HDC with peripheral blood stem cell transplantation (PBSCT). The following HDC regimens were applied: melphalan - 14, Dexa-BEAM (dexamethasone, BCNU, etoposide, cytarabine, melphalan) - 10 and BuCy2 (busulfan, cyclophosphamide) - 6. To evaluate the impact of HDC on the growth ability of less /14/ and more /7/ mature CFU-GM, sera were taken directly before cytoreductive chemotherapy, on the last day of HDC (0 day) and on days 1, 2, 3, 4 and 5 after the end of HDC. After melphalan, for CFU-GM/14/ the following results were received: days 0 - 54 +/- 9, 1 - 55 +/- 9, 2 - 68 +/- 12, 3 - 82 +/- 10, 4 - 95 +/- 8,5 - 100 +/- 8% and for CFU-GM/7/: days 0 - 60 +/- 11, 1 - 59 +/- 8, 2 - 72 +/- 11, 3 - 80 +/- 7, 4 - 90 +/- 9, 5 - 105 +/- 7%, determined as a percentage of those obtained before HDC (100%). After Dexa-BEAM, for CFU-GM/14/: days 0 - 45 +/- 13, 1 - 49 +/- 8, 2 - 59 +/- 12, 3 - 85 +/- 15, 4 - 96 +/- 9, 5 - 106 +/- 11%, and for CFU-GM/7/: 0 - 43 +/- 15, 1 - 50 +/- 9, 2 - 63 +/- 11, 3 - 89 +/- 11, 4 - 98 +/- 11, 5 - 110 +/- 8%. In case of BuCy2, for CFU-GM/14/: days 0 - 55 +/- 13, 1 - 67 +/- 7, 2 - 69 +/- 15, 3 - 85 +/- 10, 4 - 103 +/- 12, 5 - 108 +/- 7% and for CFU-GM/7/: days 0 - 50 +/- 12, 1 - 71 +/- 6, 2 - 76 +/- 16, 3 - 98 +/- 9, 4 - 105 +/- 11, 5 - 101 +/- 8%. In all pts PBSCT were infused 72 hours after HDC. The median time to reach granulocytes > 0.5 G/l and >1.0 G/l was 12 (8-17) and 13 (9-18) days, respectively. The recovery of platelets >20.0 G/l and >50. 0 G/l occured after 17 (9-48) and 25 (11-54) days, respectively. We conclude that the suppressive effect of the sera taken on days 0-2 on the CFU-GM growth depends on the HDC-regimen. We have also shown that third day after completion of HDC is the optimal time for the infusion of HSC. The time of hematological reconstituton is related in all investigated pts and independently on the HDC-program (p>0.05).

Background: Haematological treatment is associated with excessive distress due to side effects of cytostatics and due to severe life consequences of the illness. It could be a cause of anxiety or depressive states in vulnerable persons., Aim: The purpose of the study was to assess prevalence of depression, anxiety disorders, and distress among patients treated due to haematologic malignancies., Methods: 45 patients with leukaemia or lymphoma, 29 treated due to other internal diseases and 28 healthy persons were assessed. The following research instruments were used: the Present State Examination (PSE), the General Health Questionnaire (GHQ-30), criteria scales (ICD-10) for depression and anxiety., Results: Depression was diagnosed in 29% of the patients with hematological illnesses and in 11% of patients with other internal illnesses. Prevalence of GAD was appropriately 11% and 9%. Generally, psychiatric disorders were present in a half of the patients in every group. About 1/4 th of the haematologic patients had much more severe depressive symptoms than others., Conclusion: The groups of patients have much higher, depressive and distress scores than controls. Psychiatric or psychotherapeutic treatment could be considered as part of the treatment of malignant haematologic cancers.

The results are presented of MRI studies of the brain and spinal cord in patients with neurological symptoms in the course of certain diseases of the haemopoietic system (leukaemias, lymphomas). The analysis showed that MR images, although not specific, can be very useful for the evaluation of the intensity and topography of haematological lesions in the central nervous system. However, the diagnosis of these processes is not easy. In the differential diagnosis focal lesions of vasogenic origin, infections and radiation-induced lesions should be considered, and in cases of lymphoma--metastases are a possibility.

Indications for autologous and allogeneic bone marrow transplantation in hematological malignancies and solid tumours are summarised. AML treatment protocol including induction and consolidation chemotherapy followed by conventional maintenance chemotherapy or high dose chemotherapy with subsequent autologous or allogeneic stem cell transplant are presented. We compared elements and targets of autologous and allogeneic procedures pointing out the major differences regarding transplant related mortality, disease free survival and relapse rates.

Over the last three decades, there have been a number of advances made in the treatment of haematological malignancies including an increasingly defined role in curative therapy programmes for high dose chemotherapy (HDC) with stem cell support. This has provided an impetus for similar approaches to be tested in solid tumours. Drug resistance is one of the most important reasons for treatment failure in these diseases, and therefore attempting to overcome it with HDC is an obvious strategy to investigate. This rationale is supported by laboratory data demonstrating that dose correlates with number of cells killed, and that increasing drug doses by 5-10 fold can overcome resistance. Clear evidence of a dose-response effect in patients is provided by numerous clinical trials of chemotherapy in solid tumours. A large number of studies have investigated HDC in solid tumours, particularly in those malignancies which demonstrate initial chemo-sensitivity, but later relapse. Except for breast cancer, for other solid tumours there are no randomised trials defining the role of HDC. Many of the trials are small pilot studies in heavily pretreated patients with large volume disease and therefore any conclusions must be guarded.

The qualitative and quantitative methods of transplant material (hematopoietic stem and progenitor cells) evaluation in the Hematology Department of Jagiellonian University in Cracow are performed. Our experience in the first 26 patients suffered from hematological malignancies and solid tumors subjected to high-dose chemotherapy supported with autologous hematopoietic cells transplantation are presented.