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Aim. To determine the type and rate of secondary chromosomal aberrations and role in pathogenesis of mantle cell lymphoma (MCL). Material and methods. Standard cytogenetic examination (SCE) and fluorescent in situ hybridization (FISH) with tests for Uq22/ATM, 13ql4, 17pl3/p53, 9p 21/p 16 and chromosome 12 centromere were made in 28 patients. Results. Secondary chromosomal aberrations were detected in 22 patients. Chromosomal abnormalities occurring in more than 2 cases include deletions 6ql5-q23 (53% cases); 1Ц22/АТМ (50%); 9p21 (36%, in half the cases deletion 9p21 was biallele); 13ql4 (32%); trisomy 3/3q, monosomy 20 and deletions/translocations Iq and Ip (27% and 20%) and deletion 17pl3/p53 (18%). Trisomies 12/12q, 6 and 18/18q, monosomies 2 and 16, deletions/translocations 2p and 16p were found in 2 cases each. The FISH technique identified 9 chromosomal anomalies missed at SCE. Deletions 6ql5q23 were seen in patients with privalent lesions of lymph nodes. Deletions llq, 13ql4, 9p21 and 17pl3 occur more frequently in transformation and the blastoid variant. Monosomy 20 was found only in patients with large cell transformations. This was the only cytogenetic defect characteristic for transformed cases, in contrast to denovoblastoid ones. Thus, deletions 6q, Uq23, 13ql4 and 9p21 are typical for MCL. Deletions 9p2I and 17pl3 are more characteristic for large cell variants of the tumor. Deletion 17pl3 occurs at the terminal stage of the disease in rapidly growing tumor mass and resistance to chemotherapy. FISH technique is effective in detection of submicroscopic rearrangements especially small deletions. No significant differences were found between transformed and de novo blastoid cases. This shows that the blastoid variant is not a specific biological form, it is rather a less typical manifestation of the disease due to some preclinical cytogenetic disorders. Conclusion. Progression and transformation of MCL are related to mutation of proapoptotic genes and genes proteins of which are inhibitors of active complexes of Dl cycline. Specification of these mechanisms requires further investigations in patients with different clinicomorphological forms of the disease at various stages of the disease.

Aim. To investigate factors determining prognosis and efficacy of induction therapy including interferon-alpha-2b (intron-A, Schehng Plough) in patients at an early chronic stage of Ph-positive chronic myeloid leukemia (CML) as shown by histomorphological examination. Material and methods. The analysis covered 52 CML patients treated at an early chronic phase with intron-A in a standard daily dose 5 IU/m2 in combination with low-dose cytosinearabinoside (10 mg/m2, s.c. , daily for 10 days of each month). The treatment efficacy was assessed by the international criteria of complete and partial hematological remission and cytogenetic response. The cytogenetic study employed the direct method, even and G-differential staining, fluorescent hybridization in situ (FISH). The sections were stained with hematoxilin-eosine by Gomori, van Gieson. Histological samples were examined with histomorphometry. Immunohistochemical examination was made on paraffin sections using a panel of monoclonal antibodies CD3, CD4, CDS, CD20, NK, PCNA, Ki-67 (Dako, Denmark). Results. Repeated assessment of histomorphological parameters such as erythroid lineage, degree of myelofibrosis and reduction of leukemic population indicate the treatment efficacy. Estimation of the level of leukemic population proliferation in trephine biopsies from CML patients with monoclonal antibodies PCNA and Ki-67 before the treatment is prognostically significant as it further correlates with the cytogenetic response (r = 0.821, p = 0.000000). Conclusion. It is valid to study histomorphological picture of CML to prognosticate and assess treatment efficacy with standard doses of interferon-alpha with high probability.

Aim. To study prognostic implications of a focal mature cell lesion of the bone marrow (BM) in patients with diffuse large В cell lymphosarcoma (DBLCL). Material and methods. 54 patients with histologically confirmed DBLCL were given first-line CHOP and CHOP-like courses from 1996 to 2003. B-cell nature of the tumor was confirmed immunohistochemically, immunophenotypically and with flow fluorimetry. Results. In debute of the disease 16 patients had local involvement of the lymph organs (stage I-II by Enn-Arbor), 21 patients - generalized disease (stage III-IV) and 17 patients - involvement of nonlymphatic organs. Overall 3-year survival in first-line therapy in mature cell lesion of BM was 23%, without it - 0%. One-year event-free survival was 34 and 0%, respectively. Conclusion. The presence of a focal mature cell lesion of BM in DBLCL patients influences the prognosis. Regarding high frequency of transformation of mature cell lymphoproliferative diseases in DBLCL . focal lesion of BM is an indirect sign of a secondary nature of the disease.

Aim. To ascertain the role of lung biopsy in diagnosis of lung lesions in hemoblastosis (HB) patients. Material and methods. The results of diagnostic biopsies of the lungs obtained from 22 HВ patients are presented. Ten patients had no respiratory insufficiency (RI), twelve patients had RI. The biopsy was transbronchial in 1 case, thoracoscopic in 10 and open in 11 cases. Results. In Rl-free patients lung biopsy was informative in all the cases. The biopsy provided information which allowed therapy modification resulting in improvement of the patient condition. In RI patients biopsy was informative in 8 of 12 patients. Nonspecific changes in the lungs were identified histologically in 2 of 12 patients. In 2 RI patients lung biopsy confirmed the diagnosis made after examination of the bronchoalveolar lavage. Modification of therapy after the biopsy was conducted in 58.3% HB patients with RI. Improvement was seen in 2 of them. 10 of 12 patients with RI died within 1-2 weeks after biopsy. Conclusion. Lung biopsy in HB patients should be obtained only after examination with noninvasive methods and before development of RI as prognosis after lung biopsy in the presence of RI is unfa- vourable. The histological material should be examined for all expected pathogens.

Aim. To assess the potential of biopsies with the thick cutting needle of anterior mediastinum tumor. Material and methods. Biopsy with the use of the thick cutting needle (Baxter Healthcare Corporation, length 150 mm, thickness 2.5 mm, length of the cutting channel 20 mm) of a primary mediastinal tumor was made in 12 patients. Results. The findings were the following: 8 cases of primary mediastinal B-cell lymphosarcoma, 1 case of T-cell lymphosarcoma with involvement of the mediastinum, 2 cases of thymic carcinoma, 1 case of pituitary tumor. Mediastinal puncture was controlled by ultrasound which secured accurate position of the needle and safe conduction of the puncture. Conclusion. Puncture biopsy with the thick cutting needle of anterior mediastinum tumor provides short duration of the diagnostic process and correction of the treatment policy.