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Anaplastic large cell lymphoma (ALCL) expressing the anaplastic lymphoma kinase (ALK) (ALK+ ALCL) is a rare type of lymphoma which comprises 10-15% of all non-Hodgkin lymphomas in children and 2–3% in young adults. Relapsed/refractory disease occurs even more rarely (25–40% of all cases). There is as yet no standard treatment for relapsed/refractory ALK+ ALCL. Patients with ALK+ ALCL usually present at advanced stages of the disease with extranodal involvement (skin, soft tissues, bones, lungs, liver, spleen and bone marrow) and B symptoms. ALK-positive ALCL affects males more often than females. There are two morphological variants: the common type (65% of cases) and the non-common type which is associated with a poorer prognosis. ALK+ ALCLs are often associated with t(2;5) and t(1;2), resulting in the formation of the NPM-ALK and the TPM3-ALK fusion proteins, respectively. Data about the treatment of relapsed/refractory ALK+ ALCL are limited. Earlier, targeted therapies (brentuximab vedotin (BV), ALK inhibitors) and risk-adapted chemotherapy followed by hematopoietic stem cell transplantation (HSCT) for remission consolidation were shown to be highly effective. A total of 15 patients with relapsed/refractory ALK+ ALCL were treated at the R.M. Gorbacheva Research Institute starting from 2002. Fourteen (93%) patients had ALK-positive ALCL of common morphology and one (7%) patient had the non-common variant (histiocytic). The study was approved by the Independent Ethics Committee and the Scientific Council of the Pavlov University. The expression of CD3 on tumor cells was assessed (CD3 positive: n = 4 (27%), CD3 negative: n = 8 (53%), no data: n = 3 (20%). The median age at the diagnosis was 26 years (11 months– 37 years). The median follow-up from the diagnosis was 9 years (1–19 years). Nine (60%) patients were aged > 18 years and six (40%) patients were aged < 18 years. There were 10 (67%) males and 5 (33%) females. At onset, 2 (13%) patients were diagnosed with early-stage disease (stage II), while the others were diagnosed with advanced-stage disease: 2 (13%) patients had stage III disease and 11 (74%) had stage IV disease. Staging was performed according to the St. Jude staging system (in children) and the Ann Arbour staging classification (in adults). Thirteen (86%) patients had extranodal involvement. Four (27%) patients had refractory disease (progression within the first three months or the absence of complete remission after the first-line treatment) and the rest 11 (73%) patients had recurrent ALK-positive ALCL. Six patients developed early relapse (< 12 months after remission was achieved); 5 patients had late relapse (after > 12 months of remission); local (1 site) and systemic relapses were diagnosed in 7 and 4 patients, respectively. Our patients received from 2 to 7 lines of treatment (the median is 4). In the first line of therapy, the patients were treated according to NHL-BFM based regimens (n = 9; 60%), the CHOP (n = 5; 33%), and the HyperCVAD (n = 1; 7%) protocols. In the second line of therapy, 8 (53%) patients were treated according to NHL-BFM based regimens; 2 (13%) patients were treated with GDP; 1 (7%) patient received DHAP chemotherapy; 1 (7%) patient received a combination of methotrexate and vinblastine (MTX + V); 1 (7%) patient received bendamustine as a single agent. Two (13%) patients were treated with chemotherapy in combination with targeted drugs (GDP + BV, n = 1; NHL-BFM + crizotinib, n = 1). As a third or subsequent line of treatment, the patients received a variety of chemotherapy regimens (n = 5; 33%) and chemotherapy in combination with targeted drugs (n = 10; 67%). Five (33%) patients underwent ALK-inhibitor therapy (crizotinib (n = 4) and ceritinib (n = 1)). Seven (46%) patients were treated with BV (BV as a single agent (n = 4) and BV + chemotherapy (n = 3)). The median number of treatment lines before autologous HSCT (auto-HSCT) and allogeneic HSCT (allo-HSCT) was 2 (2–3) and 3 (3–4), respectively. Auto-HSCT was carried out in 11 (73%) cases. Nine (60%) patients underwent allo-HSCT (from a matched unrelated donor (n = 6), from a matched related donor (n = 2), and from a haploidentical donor (n = 1)). One patient received NK cells from a haploidentical donor as maintenance. In 5 (33%) cases, alloHSCT was carried out following auto-HSCT. The conditioning regimens (CR) used for auto-HSCT included BEAM (carmustine – 300 mg/m2, etoposide – 800 mg/m2, Cytosar – 1600 mg/m2, melphalan – 140 mg/m2) – in 5 (45%) patients; BeEAM (bendamustine – 320 mg/m2, etoposide – 800 mg/m2, Cytosar – 1600 mg/m2, melphalan – 140 mg/m2) – in 5 (45%) patients; and BuCy (Cyclophosphan – 100 mg/kg, busulfan – 14 mg/kg) – in 1 (10%) case. Seven (78%) patients undergoing allo-HSCT received the FluBenda conditioning regimen (fludarabine – 90–150 mg/m2, bendamustine – 390 mg/m2) and post-transplant Cyclophosphan and calcineurin inhibitors for the prevention of graft-versus-host disease (GVHD) (n = 7; 78%); one (11%) patient received the FluMel regimen (fludarabine – 150 mg/m2, melphalan – 140 mg/m2) and CsA/MTX (Cyclosporin А, methotrexate) for GVHD prevention; and in 1 case (11%) data on the RC and GVHD prophylaxis were missing. Overall response to the second line of treatment was achieved in 10 (67%) patients, with complete response observed in 7 (47%) cases, and partial response –in 3 (20%) cases. Five out of the 7 patients treated with BV during different lines of therapy managed to achieve complete response. Four out of the 5 patients who had undergone treatment with ALK inhibitors, demonstrated complete response. The 10-year overall survival (OS) rate of the study patients reached 90% (95% confidence interval (CI) 47–99). The 10-year progression-free survival (PFS) rate after the second line of treatment was 39% (95% CI 13–64). The 10-year OS and PFS rates after auto-HSCT were 100% and 35% (95% CI 8–64) respectively. The 5-year OS following allo-HSCT was 85% (95% CI 33–98), while PFS was 60% (95% CI 19–85). Four out of the 11 patients who had undergone auto-HSCT relapsed, and 2 patients progressed. Median time to relapse/progression was 8 (6–27) months. Three out of the 9 patients who had been treated with allo-HSCT ended up relapsing (median time: 8 (6–17) months). Two patients achieved repeated remission (in one case, it was the result of treatment with ceritinib, while in the other case it became possible after the resection of the lesion, radiotherapy and prescription of crizotinib), and 1 study patient died as a result of disease progression 17 months after allo-HSCT. The 6 patients who had achieved complete remission before undergoing allo-HSCT, are still in CR. Five out of the 9 patients developed grade I–II acute GVHD with skin involvement but did not show any signs of chronic GVHD. The observed complications of chemotherapy and auto-HSCT were standard and manageable and were not the focus of attention in this study. Taking into account the high probability of developing resistance to ALK inhibitors and the high risk of relapse after treatment with BV, targeted therapy should be used to prepare patients for HSCT. The use of ALK inhibitors and BV in our study led to repeated remission in 80% and 71% patients respectively. It was demonstrated that in the majority of cases even heavily pretreated patients with ALK+ ALCL can be cured (which is not the case with other non-Hodgkin lymphomas), especially if allogenic HSCT (allo-HSCT) is carried out. Still, we think that auto-HSCT can also be considered for remission consolidation since OS rates following auto-HSCT and allo-HSCT are comparable (100% and 85%). Moreover, auto-HSCT can also be a valid option in the absence of a fully matched donor, i.e. when only an alternative (haploidentical or partially matched) donor is available, since the use of haploidentical HSCT in ALCL patients has not been studied well enough yet. Further research on the matter is warranted. It was demonstrated that a non-myeloablative conditioning regimen before allo-HSCT (FluBenda) could be opted for in patients with relapsed/refractory ALK+ ALCL and that it was similarly effective as myeloablative RC when compared with a historical control group. Disease status before HSCT was proven to have a statistically significant influence on PFS (the best prognosis was associated with complete remission). At the same time, other factors did not impact the prognosis. This may be explained by the relatively small number of patients included in the study. Relapsed/refractory ALK+ ALCL is a disease with a relatively good prognosis even in heavily pretreated patients. Targeted therapy is a very important and effective step in preparation for HSCT. Allo-HSCT is more effective than auto-HSCT but the latter can also be considered a valid therapeutic option.

Aim of the study is to present a clinical case of abdominal morcellomas.Methods: The technique of morcellation involves not only incisions, but also a significant crushing of tumor cells, which can eventually lead to the spread of the disease. Fibroids left in the abdominal cavity during morcellation continue their development and can reach tumors of considerable size. An observation of the detected parasitic uterine fibroids several years after laparoscopic myomectomy is presented.Result: Histological examination of the removed preparation shows a microscopic picture of the uterine leiomyoma node of a typical structure in a thin fibrous capsule. It was received a normal postoperative course and a patient was discharged from hospital on the 4th day.Conclusion: Abdominal morcellomas after laparoscopic interventions on the uterus is a rare complication associated with the parasitic persistence of myomatous tissue on the abdominal organs. The risks of such complications of endosurgery indicate the need for strict compliance with all technical aspects of using a devices for the evacuation of removed tissues, careful intraoperative monitoring and sanitation of the abdominal cavity.

Subject of research: technique for determining residual stresses of the first kind, in samples that are cut from the spar after vibration shock hardening. Purpose of research: to increase the accuracy, as well as to improve the methodology for determining residual stresses. Methods and objects of research: the object of the study is residual stresses and the algorithm of their processing. The study used a modified order of approximation of data obtained from sensors. Main results of research: a new algorithm for processing experimental data is presented, which allows us to obtain more advanced results of studies of residual stresses in samples. A mathematical model of data processing has been developed to implement the algorithm. This mathematical model for determining residual stresses in the structure has a modified order of approximation of data obtained from sensors. Approximation by a polynomial of the sixth degree occurs before the plot is calculated and constructed, and not after its construction and subsequent smoothing, as was implemented earlier. This technical solution contributes to improving the accuracy and correctness of studies for determining residual stresses.

Background. Allergic rhinitis is caused by grass pollen is a common problem in the world. The symptoms of this disease can varied on the age of the patient. Aim: to identify the etiology and analyze the clinic of allergic rhinitis in adolescents. Methods. An allergic examination was carried out in 96 patients with allergic rhinitis signs who were treated at MEGI MC, which included the study of an allergic history and setting of scarification tests, determination of IgE, comparison of clinical manifestations and detection of sensitization to pollen of various plants in adolescents with allergic rhinitis. Results. The prevailing share of girls was 65.4%. The etiological factors were tree pollen in 28.6% of cases (in 27 patients), weeds — 12.4% (12 people), meadow grasses — 10.6% (10 people), meadow and weeds — 8.3 % (8 people), a combination of trees, meadow and weeds — 6.4% (6 people) and trees and meadow grasses — 4.7% (4 people). Conclusion. Typical clinical manifestations consist of light and middle rhinitis — 71 people (94%), conjunctivitis — 45 people (58.8%), rhinosinusitis — 22 people (28.6%), bronchial asthma — 10 people (10.4%).

Background. Cytokine homeostasis is an important factor characterizing the general condition and adaptive capabilities of the body of patients with malignant neoplasms. However, the role of various growth factors and their significance in the development and enhancement of malignant growth in breast cancer remain poorly understood. Aim. To evaluate the levels of cytokines - tumor necrosis factor , interleukins-4, -6, -8 and -10 in the blood serum of patients with different stages of breast cancer in comparison with healthy volunteers. Material and methods. The study was conducted in 65 patients aged 25 to 67 years (mean age 44.5 [40.056.5] years). Two groups were distinguished: the first with stage 12, the second with stage 34 of breast cancer. The comparison group consisted of 15 apparently healthy women without cancer, aged 29 to 66 years (mean age 51.0 [39.061.0] years). Blood levels of tumor necrosis factor , interleukins-4, -6, -8 and -10 were studied by enzyme immunoassay. The obtained data were processed using the methods of variation statistics, the Statistica 10.0 software package. The significance of differences was assessed by calculating the median and interquartile interval, analysis of variance was performed using the KruskalWallis H-test, and Dan's Q-test was used for multiple comparisons. The critical significance level p for statistical tests was taken equal to 0.05. Results. In the group of patients with stage 12 breast cancer, an increase in the blood levels of all studied cytokines was revealed in comparison with the group of healthy women: interleukin-6 (p=0.00719), interleukin-8 (p=0.00259), tumor necrosis factor (p=0.00014), interleukin-4 (p1=0.0133), interleukin-10 (p1 0.00001). In the group of patients with stage 34 breast cancer, an increase in blood levels was characteristic of all studied cytokines: interleukin-8 (p=0.00009), tumor necrosis factor (p=0.000004), interleukin-4 (p 0.00001), interleukin-10 (p 0.00001), except for interleukin-6 (p=0.15608). The established patterns in changes in the content of cytokines in the blood of patients with breast cancer at different stages of development can serve as the basis for developing approaches to the diagnosis and treatment of the disease. Conclusion. In patients with breast cancer, the levels of tumor necrosis factor , interleukins-4, -6, -8, -10 (p 0.05) are higher than in healthy women.

Fecalitis are one of the key factors of inflammation of the diverticular mucosa and the complications in diverticular disease of the colon. AIM. To study the results of endoscopic treatment with removal of fecalitis in diverticular disease complicated by chronic diverticulitis. Materials and methods. Between 2015 and 2019, the study included 87 patients with chronic recurrent diverticulitis. All patients received the same conservative treatment, and the main group (42 patients) underwent endoscopic rehabilitation of diverticulae. Evaluation of results of endoscopic scale (Mayo), histological scale (Reilly) and laboratory tests (fecal calprotectin) activity of the severity of inflammation of the mucous membrane of the colon showed significantly relief of inflammatory activity in the mucosa of diverticula, which contributed to a more rapid recovery of patients and reducing the frequency of relapses.

Aim was to study the prevalence of gastrointestinal tract pathology and the state of intestinal biocenosis among bronchial asthma patients. Materials and methods: 93 patients with asthma in the exacerbation stage who had diseases of the gastrointestinal tract were examined. Instrumental, immunological, bacterial studies of the respiratory and digestive organs were carried out. The results of our study indicate a relationship between the development of bronchial asthma and gastrointestinal pathology due to negative environmental effects, stress, glucocorticosteroid therapy, changes in general and local protective reactions against a background of a chronic disease involving organ barriers with an autoimmune pathogenesis mechanism in the pathological process.

The optical characteristics of vertical cylindrical micropillars with AlGaAs distributed Bragg reflectors and InAs/GaAs quantum dots, which are designed for the fabrication of single-photon sources, have been studied. The effect of parameters such as the inclination angle of sidewalls, partial oxidation of AlGaAs layers, and deviation of quantum dots from the central axis of a micropillar on the Purcell factor and the radiation extraction efficiency has been numerically simulated by the finite-difference time-domain method. The allowable ranges of the listed parameters have been determined for cylindrical vertical 920-nm micropillars. The comparison of the calculations performed with the refined refractive indices of the used materials at cryogenic temperatures with the measured characteristics of the fabricated micropillar structures has confirmed the adequacy of the used models.