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В країнах Європейського Союзу, за даними Європейського директорату з контролю якості лікарських засобів і охорони здоров’я Ради Європи (EDQM), у 2016 р. медіана рівня поширеності маркерів ВІЛ ½, гепатиту В і С серед первинних донорів крові становила відповідно 3,9; 81,5 та 49,8 на 100 000 донорів. Серед повторних донорів спостерігалася медіана значно нижчого рівня поширеності (ВІЛ, гепатит В і С), а саме 1; 1,8 та 1,4 на 100 000 донорів. За даними Інституту патології крові та трансфузійної медицини НАМН України, рівень поширеності маркерів ВІЛ, гепатиту В і гепатиту С серед донорів у 2016 р. становив відповідно 83,3; 633,3; 866,6 та сифілісу 557,1 на 100 000 донацій. Навіть серед повторних донорів України у 2016 р. рівень поширеності маркерів ВІЛ, гепатиту В і С значно перевищував рівень країн ЄС – відповідно 14,4; 119,9; та 184,8 на 100 000 донацій. Зареєстрований рівень поширеності маркерів ВІЛ, гепатиту В і С серед донорів у 2020 р. має тенденцію до зниження, але лишається значно вищим за показник країн ЄС у 2016 р. – 54,4; 295,9 та 650,2 на 100 000 донацій. Високий рівень поширеності маркерів трансфузійно-трансмісивних інфекцій серед донорів України вимагає встановлення причин, які впливають на ситуацію, та перегляду Національної стратегії порядку скринінгу донорської крові.

The article deals with basic methods used by modern technology to obtain coagulation factor VIII (FVIII). The blood plasma fractionation remains the only biotechnological approach to make life-saving protein therapy to treat human diseases. The biological medicines from human plasma play a vital role in the treatment of patients with different diseases. These products include a range of coagulation factors (FVIII, FIX, the prothrombin complex, Von Willebrand factor, fibrinogen etc.), immunoglobulins, protease inhibitors, anticoagulants and albumin. Four plasma proteins are commercially important for production: albumin, IgG, factor VIII, and factor IX. VIII is a coagulation factor in the blood, which is missing or defective in patients with Hemophilia A. Replacement therapy with FVIII concentrates constitutes the basis for hemophilia care. Cryoprecipitate was described in the mid 60's of the XX century as a first concentrate of antihemophilic FVIII.The main indications for the clinical use of cryoprecipitate were hypofibrinogenemia or disfibrinogenemia. Previously, cryoprecipitate was used for treatment of hemophilia A and von Willebrand’s disease. Traditional FVIII production methods included deposition steps, which were aimed at elimination of protein impurities such as fibrinogen, fibronectin and immunoglobulins. These technologies could use the combination of methods at low temperatures or the addition of protein precipitating substances (PEG, polyvinylpyrrolidone, dextran, ficol, percol etc.). Using chromatographic methods in FVIII production technology allowed receiving high purity and specific activity concentrate of FVIII. Ion exchange chromatography techniques are often used in order to isolate coagulation FVIII. These techniques include methods of affinity chromatography as well as the use of monoclonal antibodies to bind of FVIII. Nowadays, production of plasma concentrate of FVIII is used in combination with different chromatographic techniques.

Aim To detect the frequency, diagnostic and prognostic significance of 11q23/MLL rearrangements and to determine the chromosomes that are most frequently involved in 11q23/MLL abnormalities in adult acute leukemia (AL). Materials and methods Cytogenetic investigations of bone marrow and/or peripheral blood cells from 140 patients with acute myeloid leukemia (AML) and 57 patients with acute lymphoblastic leukemia (ALL) were performed. The methods of conventional cytogenetics (GTG-banding) and fluorescence in situ hybridization were used. Results Chromosomal abnormalities in leukemia cells were found by conventional cytogenetic methods in 80 (57%) and 37 (65%) adult patients with AML and ALL, respectively. 11q23/MLL rearrangements were found in 7 (5%) and 8 (14%) patients with AML and ALL, respectively. Among them, 8 (53.4%) patients had translocations, 2 (13.3%) - had deletions and 5 (33.3%) patients had trisomies or tetrasomies of chromosome 11. With respect to the distribution of partner chromosomes involved in 11q23/MLL translocations chromosome 4 was found to participate in 3 (37.5%) cases of 11q23/MLL translocations, 9 - in 2 (25%) cases and chromosomes 10, 14 and non-identified chromosome were involved in 1 (12.5%) case each. Nine patients (60%), besides abnormal ones, had 9-86% normal metaphases in their karyotypes. Of 15 patients with 11q23/MLL rearrangements, 5 (33%) patients had only 11q23/MLL rearrangements, whereas other 10 (67%) - had additional cytogenetic abnormalities, besides 11q23/MLL rearrangements. Conclusions Chromosomal abnormalities of various kinds were found in 57% and 65% adult patients with AML and ALL, respectively. The frequency of 11q23/MLL rearrangements in patients with AML and ALL was 5% and 14%, respectively. Since AL patients with 11q23/MLL rearrangements are attributed to cytogenetic categories of AL with a poor or intermediate risk prognosis, cytogenetic methods should be included in the standard examination of AL patients for diagnosis, prognosis and selection of the optimal treatment strategy.

Objective. To present the immediate results of the splenectomy and preferable variants of transfusion therapy performance in patients with malignant non-Hodgkin’s lymphoma (MNHL). Materials and methods. 109 splenectomies were performed in patients with MNHL at the Department of General and Hematological Surgery of the institute from 1987 to 2020. The surgery was conducted by upper middle laparotomy under general anesthesia with intubation and, in particular cases, under spinal anesthesia. Results and discussion. The indications for splenectomy in patients with MNHL were as follows: massive splenomegaly, abdominal syndrome, associated hemocytopenia, inefficacy of cytostatic therapy, absence of diagnosis. All patients underwent vaccination against capsular bacteria for prevention of post-splenectomy infection in 10-14 days prior to the surgery. In case of anemia, which has been observed in 55 % of patients, the RBC concentrate was applied. All the patients, who received corticosteroid hormones prior to splenectomy, were administered prednisolone and hydrocortisone in the amount of 3 mg/kg of body mass at similar doses in an hour before the surgery for prevention of adrenal insufficiency during the surgery. The patients, who did not receive those medications, were also intramuscularly administered prednisolone at a dose of 0.5 mg/kg of body mass in an hour before the surgery for the same aim. The patients with PLT value 80.0×109/L) underwent two courses of leukapheresis. The patients with concomitant regional portal hypertension and in case of manipulations close to the pancreatic tail were administered somatostatin drugs in the course of the splenectomy. The splenectomy proved to be effective in 100 (92 %) of patients with MNHL: the great tumor mass was removed, the abdominal syndrome and concomitant hemocytopenia were neutralized, the signs of hypersplenism ceased, the hemolysis ceased, the cytostatic therapy became less necessary or unnecessary, the final diagnosis was established. The most serious postsurgical complications were acute adrenal failure (n=3), postsurgical intra-abdominal hemorrhage (n=2), pancreonecrosis (n=6). The postsurgical lethality was 2.7 %. Conclusions. The splenectomy proved to be effective in 92 % of patients with MNHL. The infusion therapy is individual for each patient and may include transfusion surgeries if indicated. The main objective of the infusion therapy in patients with MNHL is prevention and elimination of intra- and postsurgical complications.

Objective. To substantiate the safety of the infusion drug Hecoton in the early postoperative period in patients after cardiac surgery. Materials and methods. The study involved 60 patients receiving infusions of 200 ml colloid-hyperosmolar solution Gecotone. The solution contains: hydroxyethyl starch 130/0.42 – 5 %, polyatomic alcohol xylitol – 5 %, sodium lactate – 1.5 % and electrolytes Na+, K+, Ca++, Mg++, Cl-. The total amount of sodium in the solution is 270 mmol/l, which is 2 times higher than its concentration in blood plasma. The amount of lactate is 133 mmol/l, which is 4 times higher than in isotonic polyelectrolyte solutions. The total osmolarity of the drug is 890 mOsm/l. Vital signs, hemodynamics, glucose, arterial blood gas and acid-base status was evaluated before, during and infusion of medication. Results and discussion. Gecoton infusions had no adverse effect on hemodynamic parameters. All changes were not statistically significant. The mean values of the patient’s body temperature were within the normal range. There was no case of temperature increase above 36.9 °C in all patients after administration of the drug. There was a slight, statistically unreliable increase in the mean glucose level (from 8.57±0.42 to 9.53±0.48 mmol/l), which was most likely due to response to the surgical stress. Dynamics of arterial blood gas and acid-base state shows that pH and PaCO2 practically did not change, decrease of PaO2 from 115.69±5.52 mm Hg to 110,79±4,83 mm Hg after the infusion of Gecotone, was statistically unreliable, the base excess showed little dynamics to increase (from -1.84±0.35 to -1.29±0.23 mmol/l) after administration of Gecotone. Conclusions. The use of the complex colloid-hyperosmolar infusion solution Gecotone in patients after cardiac surgery in the early postoperative period is safe.

The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. Materials and methods Treatment response and survival of 83 patients with CLL complicated by immune cytopenia (IC) were analyzed. Treatment schedules in 58 medicated patients included corticosteroids; chemotherapy (COP, CHOP regimens), immunotherapy (rituximab alone), immunochemotherapy (rituximab-containing regimens - R-COP, R-CHOP). Twenty-five patients underwent splenectomy. Results The use of corticosteroids, as the first line of treatment, resulted in short-term remission in most patients. Chemotherapy was effective in a half of CLL patients, but duration of the remission did not exceed 32 months in CLL associated with autoimmune hemolytic anemia and immune thrombocytopenia. After rituximab monotherapy (10 patients) the stable remission was reached in 60% of the patients with median relapse-free survival of 40 months. Rituximab containing chemotherapy (22 patients) caused the long-term remission in 72% of the patients with median relapse-free survival of 76 months. Splenectomy performed in 25 patients with CLL complicated by IC was effective in 70% of the patients. The outcome of splenectomy depends on IC entity. The best response was registered in associated immune thrombocytopenia (median overall survival 118 months), the worst - in Fisher - Evans syndrome (15 months). Conclusions The treatment of patients with CLL complicated by ICs should be individualized. For CLL patients without significant enlargement of lymph nodes and spleen, low lymphocytosis, associated with autoimmune hemolytic anemia or immune thrombocytopenia, the monotherapy with rituximab is optimal. In case of occurrence of autoimmune hemolytic anemia, immune thrombocytopenia or Fisher - Evans syndrome in CLL patients with enlargement of lymph nodes, spleen, significant lymphocytosis, the use of R-COP or R-CHOP schemes, 4-6 courses, is the most effective. Splenectomy is indicated in patients with massive splenomegaly, the resistance to medication, recurrent relapses after adequate therapy.

A cytogenetic study of bone marrow aspirate from 32 patients with different types of myelodysplastic syndrome (MDS) has been carried out. The patients were from eight regions of Ukraine. Chromosome deletions prevailed in the spectrum of karyotype changes. The largest number of chromosome abnormalities was revealed in patients with a refractory anemia with an excess of blasts (66.6% of cases). Chromosomal changes that involved three or more chromosomes occurred among 27% of all karyotype changes examined by us. Transformation of myelodysplastic syndrome to acute myeloid leukemia (AML) was found in 5 patients (45.4% of the cases) among 11 patients with abnormal karyotypes. We propose that cytogenetic confirmation of increased apoptosis in the bone marrow from the myelodysplastic syndrome patients is a phenomenon of chromosome fragmentation. The risk of transformation of myelodysplastic syndrome to acute myeloid leukemia was measured with the use of a new international score system, IPSS.

The aim of the study was to improve cytogenetic diagnostics and monitoring of myelofibrosis and to reveal the spectrum of cytogenetic abnormalities in patients from Ukraine. Materials and Methods: A total of 42 patients (23 females and 19 males) with myelofibrosis was studied using different cytogenetic methods. Granulocyte colony-stimulating factor (G-CSF) was added by the new method during cultivation of peripheral blood (PB) cells from 31 patients for specific stimulation of mitotic divisions. Two patients underwent examination by fluorescent in situ hybridization method. Results: In cell cultures of PB stimulated in vitro with G-CSF and in non-stimulated bone marrow chromosome abnormalities were found in 19 (45.2%) of all the patients. The spectrum of cytogenetic abnormalities of bone marrow and PB was the same in all of the patients. Aspiration of bone marrow was unsuccessful due to significant fibrosis in 10 (29.4%) of 34 patients. The study by fluorescent in situ hybridization method confirmed cytogenetic abnormalities revealed by G-method and discovered additional possibly normal subclone. Conclusions: Cytogenetic study of PB using in vitro G-CSF as a specific stimulant of mitosis instead of phytohemagglutinin revealed significant variety of chromosomal abnormalities in Ukrainian patients with myelofibrosis. This method could be a less invasive alternative to cytogenetic examination of bone marrow in the subgroup of patients with considerable fibrosis and consecutive changes. The usage of fluorescent in situ hybridization method supplemented karyotyping by G-banding method.

There was estimated quality of the plasm indices; so in comparison with the fractioning methods, using two regimens of the donor's blood centifugating, harvested with the help of various conservants, the most secure and functionally adequate plasm preparation was determined such, which is obtained with the help of plasmapheresis procedures. The expediency of application and introduction of the differentiated centrifugation technology, providing rational usage of a donor's blood, was determined. After conduction of leukofiltration of the conserved blood and plasm the residual cells content is reducing significantly, while preserving activity of the blood coagulation factors.

We carried out the cytogenetic investigation of bone marrow aspirate from 32 patients with different types of MDS. The patients were from 8 regions of Ukraine. 11 patients had abnormal karyotype, and the transformation to AML were observed in 5 of them (45.5%). 27% of all patients had chromosomal changes with 3 or more chromosomes involved. The highest percentage of the patients with chromosomal anomalies (66.7%) was in cases of RAEB. Chromosome deletions were the most frequently detected karyotype abnormalities. We consider the phenomenon of chromosome fragmentation as the cytogenetic approval of the increased level of apoptosis in patients with MDS. The risk of the transformation to AML was measured using new international score system IPSS.

Safety of haemotransfusions remains a challenge in modern transfusion medicine. Methodological approaches toward eliminating risks for haemotransfusion complications include a wider employment of principles of haemocomponent therapy, prevention of a possibility of infections contamination of blood and its components, deleukocytation of blood components, categorizing of donors by phenotypes, registering those donors having been phenotyped, categorizing of potential recipients by phenotypes, screening of alloimmune antierythrocytic antibodies in donors, sick and pregnant women, introduction of autodonation on a wide scale.

The author has investigated the possibility of using as the reference agent in estimation of the resorption rate from vascular bed of fatty emulsions the very agent that is introduced or the oil, one of the ingredients of this agent. Fatty emulsions for parenteral nutrition intralipid (Sweden), lipofundin-C (Finland), venolipid (Japan), lipidin and lipidin-2 (USSR), and specially purified sunflower oil were used to plot the calibration curve.

Water leaks into the sodium in steam generators at power stations containing BN-350 and BN-600 reactors may be detected with IVA-I hydrogen-in-sodium indicators, where the sensor is a magnetic-discharge pump having a vacuum connection to a hydrogen-permeable membrane [i]. The performance is largely determined by steam generator design features and operating modes. The features in the BN-350 generators include evaporators with individual gas spaces, which enable one to detect evaporator leaks from the hydrogen levels in the protective gas. In most steam generator designs, the gas spaces are remote from the steam generators, and it is more effective to monitor leaks from hydrogen in sodium.

The adhesive properties of 215 cultures, including 215 Escherichia coli strains, 43 Klebsiella pneumoniae strains and 60 Pseudomonas aeruginosa strains isolated from the urine of 124 children with chronic obstructive pyelonephritis were studied in the direct hemagglutination test simultaneously with those of 30 E. coli strains and 20 K. pneumoniae strains isolated from the feces of 50 healthy children, as well as 60 P. aeruginosa strains isolated from children with parenteral infections of other localization. E. coli and K. pneumoniae strains isolated from the urine of children with chronic obstructive pyelonephritis were found to have D-mannose-resistant hemagglutinins (68% and 37.2%) and a combination of mannose-sensitive and mannose-resistant adhesins (44.6% and 13.3% respectively). P. aeruginosa strains isolated from the urine of urological patients in the postoperative period showed the presence of mannose-resistant hemagglutinins to a greater extent (76.6%) than those isolated from children with parenteral infections of other localization (45%).

The aim of the study was to improve cytogenetic diagnostics and monitoring of myelofibrosis and to reveal the spectrum of cytogenetic abnormalities in patients from Ukraine.A total of 42 patients (23 females and 19 males) with myelofibrosis was studied using different cytogenetic methods. Granulocyte colony-stimulating factor (G-CSF) was added by the new method during cultivation of peripheral blood (PB) cells from 31 patients for specific stimulation of mitotic divisions. Two patients underwent examination by fluorescent in situ hybridization method.In cell cultures of PB stimulated in vitro with G-CSF and in non-stimulated bone marrow chromosome abnormalities were found in 19 (45.2%) of all the patients. The spectrum of cytogenetic abnormalities of bone marrow and PB was the same in all of the patients. Aspiration of bone marrow was unsuccessful due to significant fibrosis in 10 (29.4%) of 34 patients. The study by fluorescent in situ hybridization method confirmed cytogenetic abnormalities revealed by G-method and discovered additional possibly normal subclone.Cytogenetic study of PB using in vitro G-CSF as a specific stimulant of mitosis instead of phytohemagglutinin revealed significant variety of chromosomal abnormalities in Ukrainian patients with myelofibrosis. This method could be a less invasive alternative to cytogenetic examination of bone marrow in the subgroup of patients with considerable fibrosis and consecutive changes. The usage of fluorescent in situ hybridization method supplemented karyotyping by G-banding method.