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The aim of the investigation was to estimate Vero-Fludarabine in chronic lymphocytic leukemia and non-Hodgkin’s lymphoma patients. We report the activity of three combinations of Vero-Fludarabine, one with cyclophosphamide (Vero-FluCy), the second with cyclophosphamide plus rubida (Vero-FLUCYr) and 3rd with rituximab (VeroFCR). For patients with chronic lymphocytic leukemia who received Vero-FluCy the overall response rate was 66.6%. Of the 9 patients, who received Vero-FluCy, 33.3% achieved complete remission and 33.3% partial remission. For patients with follicular lymphoma grades 1 and 2 who received Vero-FLUCYr or VeroFCR the overall response rate was 100%. The treatment was well tolerated. Hematologic toxicity included neutropenia and thrombocytopenia. 24% patients who received Vero-FluCy were complicated by infections. Nonhematologic toxicity was mild.We conclude that Vero-Fludarabine is an effective treatment in previously untreated or in pretreated patients with chronic lymphocytic leukemia and follicular lymphomas.

The authors have described the world’s first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.

The paper presents an assessment of treatment efficacy in chronic lymphocytic leukemia CLL patients according to chemotherapy type and initial renal function. The high efficacy of chemotherapy with fludarabine in CLL patients with or without renal failure at diagnosis was revealed. However, regardless of chemotherapy type initial treatment response was worse in patients with renal failure.

In present study the immediate and long-term therapy results of 14 patients with refractory chronic lymphocytic leukemia (CLL) are analyzed. Treatment program included alemtuzumab alone or in combination with fludarabine.

Aim. to analyze the efficacy of RFC (rituximab, fludarabine, and cyclophosphan), FCM (fludarabine, cyclophosphan, and mitoxantrone), and FC (fludarabine and cyclophosphan) treatment programs in patients with chronic lymphocytic leukemia (CLL) in an open-labeled comparative controlled investigation. Materials and methods. The paper presents the authors' results of treatment in patients with progressive CLL in 2002 to 2007. The study included 229 patients, of them 78 patients received the RFC program, 72 had the FCM program, and 79 had the FC one. Results. With the use of RFC, a clinically significant therapeutic effect was obtained in 96% of the patients, a complete remission (CR) was in 80% of the primary patients and in 53% of the pretreated patients. When the FCM program was applied, a positive response was noted in 93% of the patients, CR was seen in 75 and 42% of the primary and pretreated patients, respectively. In the treatment of FC, the total effect was 80%, CR was in 41 and 14% of the primary and pretreated patients, respectively. Conclusion. Comparative analysis of an objective response to therapy has indicated that the effectiveness of the RFC significantly exceeds that of the FCM and FC programs, without enhancing toxicity, which allows he RFC regimen to be regarded as the program of choice in therapy for CLL.

The authors have described the world's first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.