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The aim – based on the analysis of the scientific literature focused on understanding the role of exosomes in the mechanisms of inflammation development and application of stem cells for cellular therapy in different pathological conditions, to identify and substantiate the prospects of using the exosomes as prognostic markers of a disease progression and application of their therapeutic potential in cardiovascular pathology. Global trends in the study of stem cells of different origins from the perspective of morphofunctional, molecular-genetic, cytogenetic, immunogenetic and cytological characteristics contribute significantly the development of regenerative medicine in the context of developing new methodological solutions for the use of stem cells and their components, particularly exosomes, for cell therapy of various pathological conditions. Studies show the indirect effect of exosomes on the immune response activation, coordination of cellular senescence processes and antigen presentation. There are also evidence of their impact on the structural and functional restoration of affected organs and blood vessels. The application potential of exosomes in practical medicine, particularly in the area of new approaches development to synthesize the newer biopharmaceuticals and as markers of multifactorial pathology course in conjunction with studies on the mechanisms of exosome involvement into immune processes is discussed. The study on the exosome-mediated mechanisms of inflammation in atherosclerosis is relevant, given the fact that their main physiological role is to implement the link between immunocompetent cells. Conclusions. Improving knowledge of the molecular biological mechanisms of the exosome influence on immunological processes in patients with cardiovascular pathology allows to expand the range of diagnostic and prognostic criteria for the formation of immuno-inflammatory reactions and endothelial dysfunction and to outline ways to personify the choice of therapeutic programs, which, in turn, can open approaches to develop fundamentally newer pharmaceuticals.

to provide a comparative characterization of the prevalence of polymorphic variants of cytokine genes in plasma cell myeloma (PCM) patients suffered after the Chornobyl disaster and patients who were in contact with ionizing radiation within the natural radiation background, based on comparison with population controls to determine their contribution as genetic markers of disease risk.Molecular genetic studies of polymorphism of cytokine genes (TNF-α, TGF-β1, IL-6, IL-10, IFN-γ) and complex frequency analysis of occurrence in three-, four-, and five-locus combinations of their allelic variants as prognostic markers of the risks of plasma cell myeloma was carried out in 102 patients - 56 victims of the Chornobyl nuclear power plant accident and 46 patients irradiated within the limits of the natural radiation background, in comparison with the control group (364 practically healthy people, residents of the Central geno-geographical region of Ukraine).The same probable increase in the prevalence of the TGF-β genotype codon10 T/T of the TGF-β1 gene was established in the groups of patients irradiated after the Chornobyl NPP accident and non-irradiated patients. In patients with plasma cell myeloma a protective effect for IL-10 -1082 A/G and an association with the risk of disease occurrence for IL-10 -1082 G/G were determined.Probable difference in the frequency of the TGF-β1 genotype codon10 T/T of the TGF-β1 gene in the observed groups relative to the control group provides grounds for considering this single-nucleotide polymorphism of the TGF-β1 gene as an immunogenetic factor of predisposition to the development of PCM independent of exogenous factors. The study of the contribution of multigene combinations of «gene-gene» interaction indicates their role in the mechanisms of plasma cell myeloma occurrence and confirms the presence of an additive interaction.Meta: nadaty porivnial'nu kharakterystyku poshyrenosti polimorfnykh variantiv geniv tsytokiniv u khvorykh na plazmoklitynnu miielomu (PKM), postrazhdalykh vnaslidok Chornobyl's'koï katastrofy, ta patsiientiv, iaki kontaktuvaly z ionizuiuchym vyprominiuvanniam v mezhakh pryrodnogo radiatsiĭnogo fonu, na pidstavi zistavlennia z populiatsiĭnym kontrolem dlia vyznachennia ïkh vnesku iak genetychnykh markeriv ryzyku zakhvoriuvannia.Materialy i metody. Molekuliarno-genetychni doslidzhennia polimorfizmu geniv tsytokiniv (TNF-α, TGF-β1, IL-6, IL-10, IFN-γ) ta kompleksnogo analizu chastot zustrichal'nosti v try-, chotyry-, p’iatylokusnykh kombinatsiiakh ïkh alel'nykh variantiv iak prognostychnykh markeriv ryzykiv plazmoklitynnoï miielomy provedeno u 102 patsiientiv – 56 postrazhdalykh vnaslidok avariï na Chornobyl's'kiĭ AES ta 46 khvorykh, oprominenykh u mezhakh pryrodnogo radiatsiĭnogo fonu, u zistavlenni z grupoiu kontroliu (364 praktychno zdorovykh osib, zhyteliv Tsentral'nogo geno-geografichnogo regionu Ukraïny). Rezul'taty. Vstanovleno totozhnie virogidne pidvyshchennia poshyrenosti genotypu TGF-β codon 10 T/T gena TGF-β1 v grupakh oprominenykh vnaslidok avariï na Chornobyl's'kiĭ AES i neoprominenykh khvorykh. U khvorykh na plazmoklitynnu miielomu vyznacheno protektyvnyĭ efekt dlia IL-10 -1082 A/G i asotsiatsiia z ryzykom vynyknennia zakhvoriuvannia dlia IL-10 -1082 G/G.Vysnovok. Virogidna vidminnist' chastoty genotypu TGF-β codon 10 T/T v grupakh sposterezhennia shchodo kontrol'noï grupy nadaie pidstavu rozgliadaty tseĭ odnonukleotydnyĭ polimorfizm gena TGF-β1 iak nezalezhnyĭ vid ekzogennykh chynnykiv imunogenetychnyĭ faktor skhyl'nosti do rozvytku PKM. Doslidzhennia vnesku mul'tygennykh kombinatsiĭ vzaiemodiï «gen–gen» svidchyt' pro ïkh rol' v mekhanizmakh vynyknennia plazmoklitynnoï miielomy i pidtverdzhuie naiavnist' adytyvnoï vzaiemodiï.

To study the associative relation of polymorphic HLA gene variants and BCR/ABL1 transcript types in patients with chronic myeloid leukemia (CML) 87 CML patients were examined. 42 patients had e13a2 BCR/ABL1 transcript and 45 patients had e14a2 BCR/ABL1 transcript. The prevalence of the genes allelic variants of major histocompatibility complex was analyzed and the association coefficients for the disease risk depending on the presence of certain types of BCR/ABL1 transcripts were calculated. Unconditional markers of increased risk of CML (HLA-DRB1*11) and markers of resistance to CML (HLA-A*03) were highlighted. The allele frequencies of HLA-A*03, HLA-A*68, HLA-B*08, HLA-B*15, HLA-B*40, HLA-DRB1*04, DQB1*06 were significantly reduced and allele frequencies of HLA-DRB1*12 and DRB1*11 were increased in patients with the e13a2 transcript compared to healthy people. The allele frequencies of HLA-A*03, HLA-A*11, HLA-B*08, HLA-B*14, HLA-B*40, HLA-DRB1*04 and DQB1* 03 were significantly reduced and the allele frequency of HLA-DRB1*11 was significantly increased in patients with e14a2 transcript compared to healthy persons. Thus, the individual analysis of the complex of fusion proteins e13a2 and e14a2 and HLA alleles in CML patients could indicate the additive effect of both molecular structures joint carrier for CML developing risk.

Background. There is limited information about impact of additional chromosome aberrations (ACA) on the efficacy of the 2nd line nilotinib therapy. Objective. The aim of the study was to analyze significance of ACAs for the outcome after second line tyrosine kinase inhibitors (TKI) therapy with nilotinib in the chronic myeloid leukemia (CML) patients, who experienced previous imatinib therapy failure. Methods. The CML patients in chronic phase treated with nilotinib after imatinib failure were analyzed for outcomes. Results. Among a total of 114 patients, 18 patients (15.8%) had ACAs at the beginning of the 2nd line therapy with nilotinib. Seven patients (38.9%) of 18 had variant translocations and 11 patients (61.1%) had other chromosomal abnormalities in addition to t(9;22), known as clonal evolution. Complete cytogenetic response (CCR) at 12 months was achieved in 37.5%, 42.8% and 45.5% (p=0.842) of patients with classic t(9;22) translocation, variant translocations and ACAs respectively. In the patients with variant translocations t(9;V;22) or clonal evolution treated with nilotinib after the imatinib failure, the CCR and major molecular response (MMR), event free survival (EFS), progression free survival (PFS) and overall survival (OS) rates did not differ from those in the CML patients with t(9;22) only. At the same time quantitative characteristics of leukemic and ACA clones had prognostic value for CCR. The increased number of Ph-positive cells and the number of cells with the ACA at the start of nilotinib therapy reduced the probability of CCR. Conclusions. Higher nilotinib inhibitory activity compare with imatinib allows us to overcome imatinib resistance in the CML patients regardless of the ACA presence at the beginning of nilotinib therapy.

Peptidylboronic acids have recently become widespread as effective drugs for cancer treatment. Howe­ver, the use of these drugs is often accompanied by negative side effects associated with the phenotypic affiliation to the ABO system. Therefore, it is important to determine the role of pharmaco-chemical charac­teristics of antigens of ABO system and therapeutic agents (for example, bortezomib) in the selection of individualized therapies for patients with chronic lymphoproliferative neoplasms. The expediency and efficiency of bortezomib use for patients with plasma cell myeloma depen­ding on the phenotype affiliation to the ABO system were evaluated. Efficiency of plasma cell myeloma therapy was analyzed in 104 patients who received treatment according to clinical protocols. Dependence of the duration of remission in performance of standard polychemotherapy was researched. Calculation of energy parameters and geomet­ry of probable supramolecular structures of peptidylboronic (bortezomib) and boric acids with antigens of the ABO blood system was performed in the HyperChem 8.07 software package. It was demonstrated that the ability of antigens to form supramolecular complexes with bortezomib varies in the series: B1 >> 01 > A1, which is in line with the results of clinical researches. It was assumed that in case of patients with В blood group secondary process (interaction of bortezomib with carbohydrate antigen) is energetically more beneficial than the main process (inhibition of proteasome), while for patients with O and A groups, equilibrium is shifted toward the main reaction, which results in the therapeutic effect of the drug.

Describe and characterize the peculiarities of the chronic myeloid leukemia (CML) course and responseto treatment in patients irradiated as a result of the Chornobyl nuclear power plant (ChNPP) accident based on theassessment of clinical-laboratory and clinical parameters.The CML patients (n = 33) exposed to ionizing radiation as a result of the ChNPP accidentwere enrolled. The comparison group consisted of CML patients (n = 725) with no history of radiation exposure. Allpatients were in the chronic phase of the disease. Clinical, hematological and molecular genetic research methodswere applied.Patients exposed to ionizing radiation as a result of the ChNPP accident had no differences in CML manifestation, as well as in classical genetic markers at the onset of the disease compared with patients with no historyof radiation exposure. Reduction of tumor clone on imatinib therapy was significantly less effective in the patientsexposed to ionizing radiation than in cases of no history of radiation exposure. Cases of primary resistance were statistically significantly prevalent in the ChNPP accident consequences clean-up workers while in the residents ofradiologically contaminated areas a statistically significant increase in probability of loss of complete cytogeneticresponse (development of secondary resistance) to imatinib therapy was found. An association was found betweenthe radiation exposure and probability of loss of complete cytogenetic response to imatinib therapy in this group ofpatients.The radiation exposure in the history even many years before the onset of CML is an unfavorable exogenous factor responsible for the development of resistance to imatinib therapy.Meta: nadaty kharakterystyku osoblyvostiam perebigu khronichnoï miieloïdnoï leĭkemiï (KhML) ta vidpovidi na likuvannia sered oprominenykh vnaslidok avariï na Chornobyl's'kiĭ atomniĭ elektrostantsiï (ChAES) patsiientiv na osnovi otsinky kliniko-laboratornykh ta klinichnykh parametriv.Materialy i metody. Obstezheno 33 osoby iz KhML, iaki zaznaly diï ionizuiuchogo vyprominiuvannia vnaslidok avariïna ChAES. Grupu porivniannia sklaly 725 patsiientiv iz KhML bez radiatsiĭnogo anamnezu. Usi patsiienty znakhodylysia vkhronichniĭ fazi zakhvoriuvannia. Vykorystovuvaly kliniko-gematologichni ta molekuliarno-genetychni metody doslidzhennia.Rezul'taty. Patsiienty, iaki zaznaly vplyvu radiatsiĭnogo vyprominiuvannia, ne vidriznialys' osoblyvostiamymanifestatsiï KhML, porivniano z patsiientamy bez radiatsiĭnogo anamnezu, prote dlia nykh vyznachalasia nyz'ka efektyvnist' do terapiï imatynibom. U grupi uchasnykiv likvidatsiï naslidkiv avariï na ChAES statystychno znachushche perevazhaly vypadky rozvytku pervynnoï rezystentnosti, porivniano z grupoiu zhyteliv radiatsiĭno zabrudnenykh terytoriĭ ta grupoiu porivniannia. Vyiavleno statystychno znachushche pidvyshchennia chastoty vtraty dosiagnutoï povnoï tsytogenetychnoï vidpovidi na terapiiu imatynibom u patsiientiv, iaki buly evakuĭovani abo prozhyvaly na radiatsiĭno kontaminovanykh terytoriiakh, porivniano z patsiientamy bez radiatsiĭnogo anamnezu. Vyznacheno asotsiatyvnyĭ zv’iazokmizh vplyvom radiatsiĭnogo faktoru ta virogidnistiu vtraty dosiagnutoï povnoï tsytogenetychnoï vidpovidi na terapiiu imatynibom v tsiĭ grupi patsiientiv.Vysnovky. Naiavnist' radiatsiĭnogo oprominennia v anamnezi navit' za bagato rokiv do debiutu KhML, ie nespryiatlyvym seredovyshchnym faktorom, iakyĭ obumovliuie rozvytok rezystentnosti do terapiï imatynibom.

Assessment of role of the bone marrow colony-forming efficiency in plasma cell myeloma patients at different stages of treatment as a prognostic criterion for the disease course.The colony forming efficiency (CFE) was assayed in stage I-II plasma cell myeloma (PCM)patients (n = 37) aged 42-73, namely in patients survived after the Chornobyl NPP accident (n = 21) and persons notexposed to ionizing radiation (n = 16). There were 11 males exposed to ionizing radiation and having got stage I PCM,9 males and 3 females exposed and having got stage II PCM, 3 males and 3 females not exposed and having got stageI PCM, 6 males and 2 females not exposed and having got stage II PCM. Healthy persons (n = 20) were included in thecontrol group.Number of the bone marrow (BM) granulocyte-macrophage colony-forming units (CFU-GM) in both exposedand not exposed PCM patients depended on a disease stage. CFU-GM was (16.7 ± 1.2) in the stage I PCM patients vs.(11.1 ± 1.1) in the stage II PCM ones both being lower (p0.05) compared to control (64.5 ± 2.2). Changes in cluster formation were similar, i.e. (37.7 ± 1.6) and (19.4 ± 1.3) correspondingly in the stage I and stage II PCM patients.Respective values in control were (89.8 ± 3.6). The CFE in stage I and stage II PCM patients at the time of diagnosiswas lower (5.7 ± 1.5 and 2.4 ± 1.1 respectively) vs. control (39.5 ± 1.51, p0.05), but has increased in remission upto (29. 6 ± 1.8) and (13.8 ± 1.2) respectively. There was no difference at that between the irradiated and non-irradiated patients. Number of the fibroblast colony-forming units (CFU-F) in the stage I and stage II PCM patients duringdiagnosis, namely (43.9 ± 5.4) and (22.5 ± 3.7), was lower (p0.05) vs. control (110.5 ± 4.9). Upon reaching remission the CFU-F value increased significantly (p0.05), reaching (87.4 ± 4.2) and (55.6 ± 2.7) correspondingly in thestage I and stage II PCM patients.Dependence of the BM cell CFE on the stage of PCM and presence or absence of remission was established. Prognostic value of the CFE of BM CFU-GM in terms of life span of patients was shown (Ro Spearm = 0.39,p0.02), namely in case of CFE20 before the polychemotherapy administration the life span of PCM patients wassignificantly longer vs. cases of CFE20.Meta roboty: na osnovi doslidzhennia efektyvnosti koloniieutvorennia klityn kistkovogo mozku khvorykh na plazmoklitynnu miielomu na riznykh etapakh likuvannia otsinyty ïï znachennia iak prognostychnogo kryteriiu perebigu zakhvoriuvannia.Materialy i metody. Efektyvnist' koloniieutvorennia (EKU) otsineno u 37 patsiientiv vikom 42–73 rokiv z plazmoklitynnoiu miielomoiu (PKM) I–II ct.: 21 patsiienta, postrazhdalogo vnaslidok avariï na Chornobyl's'kiĭ AES, ta16 neoprominenykh khvorykh. Sered oprominenykh z I st. obstezheno 11 cholovikiv, sered khvorykh z II st. – 9 cholovikivta 3 zhinok, sered neoprominenykh z I st. – 3 cholovikiv, 3 zhinok, sered patsiientiv z II st. – 6 cholovikiv ta 2 zhinok.Kontrol'nu grupa sklaly 20 zdorovykh osib.Rezul'taty. Kil'kist' koloniieutvoriuiuchykh granulotsytarno-makrofagal'nykh odynyts' (KUO-GM) kistkovogo mozku (KM) khvorykh na PKM ob’iednanoï grupy (opromineni, neopromineni) zalezhala vid stadiï zakhvoriuvannia. U khvorykh z I st. KUO-GM stanovyla 16,7 ± 1,2 proty 11,1 ± 1,1 pry II st. i bula nyzhchoiu (p0,05), porivniano z kontrolem (64,5 ± 2,2). Podibnymy buly zminy pry utvorenni klasteriv (I st. – 37,7 ± 1,6; II st. – 19,4 ± 1,3; kontrol' –89,8 ± 3,6). U khvorykh z I ta II st. na moment diagnostyky EKU bula nyzhchoiu (5,7 ± 1,5 ta 2,4 ± 1,1 vidpovidno),porivniano z kontrolem (39,5 ± 1,51, p0,05), pry remisiï EKU zrostala (29,6 ± 1,8 ta 13,8 ± 1,2 vidpovidno). Pokaznyky oprominenykh i neoprominenykh patsiientiv ne vidriznialys'. Na etapi diagnostyky kil'kist' koloniieutvoriuiuchykh odynyts' fibroblastiv (KUO-F) bula nyzhchoiu (p0,05), porivniano z kontrolem (110,5 ± 4,9) – 43,9 ± 5,4 ta22,5 ± 3,7 u patsiientiv z I ta II st. PKM vidpovidno. Pry dosiagnenni remisiï KUO-F zrostala (p0,05): u khvorykh zI st. PKM KUO-F siagala 87,4 ± 4,2; u patsiientiv z II st. – 55,6 ± 2,7.Vysnovky. Vstanovlena zalezhnist' EKU klityn KM vid stadiï PKM ta naiavnosti/vidsutnosti remisiï. Pokazanoprognostychne znachennia pokaznyka EKU KUO-GM KM shchodo tryvalosti zhyttia patsiientiv (Ro Spearm = 0,39, p0,02):za naiavnosti EKU20 do provedennia polikhimioterapiï tryvalist' zhyttia khvorykh na PKM bula suttievo dovshoiuporivniano z patsiientamy, u iakykh pokaznyk EKU20.

Experimental study of the effect profile of bortezomib in the plasma cell myeloma (PCM) patients depend- ing on a specific phenotype carrier state and a pharmacochemical characteristics of ABO system glycoproteins.The research was conducted on the 104 PCM patients, including the Chornobyl NPP acci- dent survivors (n = 49) and 65 study subjects in the comparison group. Immunogenetic criteria for positive response to the applied treatment protocols were issued according to the duration of remission, absence of infectious com- plications, and evidence of chronic renal failure as a disease complication.Possibility of glycoproteins A and B participation in the formation of human biological individuality at a level of protein-protein interaction with antineoplastic drug bortezomib, which is widely used in cancer management prac- tice, in particular in the PCM treatment is considered. The glycoprotein B was shown being a selective target for borte- zomib, slowing down the recognition and interaction of antigen B with monoclonal anti-B antibody, while the agglu- tination period lengthens at that by 66 %. Assumption that the formation of bortezomib complex with glycoprotein B provides a background for interaction with the key reaction of proteasome 26S inhibition, which to some extent con- tributes to the drug effect retardation was confirmed through the quantum-chemical calculations. Equilibrium is shift- ed toward the main reaction leading to a higher drug efficacy in patients with blood groups O (I) and A (II).Since the complexation occurs predominantly in alkaline medium the administration of drugs with alkaline reaction should be restricted for at least round the clock after administration of bortezomib according to its half-life in plasma in patients with B (III) blood group and chronic renal failure.Meta roboty – eksperymental'ne doslidzhennia osoblyvostey̆ diï preparatu bortezomib u khvorykh na plazmokli- tynnu miielomu (PKM) zalezhno vid nosiy̆stva konkretnogo fenotypu i farmakokhimichnoï kharakterystyky glikopro- teïniv systemy AVO.Materialy i metody. Doslidzhennia provedeni u 104 khvorykh na PKM, sered nykh – 49 osib, postrazhdalykh vnaslidok avariï na ChAES, ta 65 patsiientiv grupy porivniannia. Imunogenetychni kryteriï pozytyvnoï vidpovidi na likuval'ni programy vyznachaly na osnovi tryvalosti remisiï, vidsutnosti infektsiy̆nykh uskladnen' i stupenia naiavnosti khronichnoï nyrkovoï nedostatnosti iak uskladnennia zakhvoriuvannia.Rezul'taty. Rozglianuta mozhlyvist' uchasti glikoproteïniv A i V u formuvanni biologichnoï indyvidual'nosti liudy- ny na rivni bilok-bilkovoï vzaiemodiï z likars'kym protypukhlynnym preparatom bortezomibom, iakyy̆ shyroko za- stosovuiet'sia v onkologichniy̆ praktytsi, zokrema pry likuvanni PKM. Dovedeno, shcho selektyvnoiu mishenniu dlia bor- tezomibu ie glikoproteïn V, shcho upovil'niuie rozpiznavannia i vzaiemodiiu antygena V z monoklonal'nym anty-V an- tytilom, pry ts'omu termin agliutynatsiï podovzhuiet'sia na 66 %. Kvantovo-khimichni rozrakhunky pidtverdyly prypu- shchennia, shcho reaktsiia utvorennia kompleksu bortezomibu z glikoproteïnom V skladaie pidgruntia formuvannia vzaie- modiï z osnovnoiu reaktsiieiu ingibuvannia proteasomy 26S, shcho, pevnoiu miroiu, spryiaie upovil'nenniu diï preparatu. Dlia patsiientiv z grupamy krovi O (I) i A (II) rivnovaga zmishchuiet'sia v bik osnovnoï reaktsiï, shcho zumovliuie vyshchu efek- tyvnist' preparatu.Vysnovky. Oskil'ky kompleksoutvorennia vidbuvaiet'sia perevazhno v luzhnomu seredovyshchi, patsiientam z grupoiu krovi V (III) ta naiavnoiu khronichnoiu nyrkovoiu nedostatnistiu rekomendovano obmezhuvaty vvedennia preparativ z luzhnoiu reaktsiieiu shchonay̆menshe protiagom doby pislia vvedennia bortezomibu, vidpovidno do periodu y̆ogo napiv- rozpadu v plazmi.

In this paper, a clinical case of combination of chronic myeloid leukemia and T-lymphoblastic lymphoma is present-ed, which is currently a rather rare finding for a clinician. The diagnosis of T-lymphoblastic lymphoma is establishedafter 2 years from the verification of chronic myeloid leukemia. The course of diseases and approaches to treatmentare described.The pathogenetic relationship between myeloid and lymphoid diseases remains unclear and is likely to be the resultof several factors - radiation, chemical and, consequently, genetic disorders.U daniĭ roboti predstavlenyĭ klinichnyĭ vypadok poiednannia khronichnoï miieloïdnoï leĭkemiï ta T-limfoblastnoïlimfomy, shcho narazi ie dovoli ridkisnoiu znakhidkoiu dlia klinitsysta. Diagnoz T-limfoblastnoï limfomy vstanovle-no cherez 2 roky vid veryfikatsiï khronichnoï miieloïdnoï leĭkemiï. Opysano perebig zakhvoriuvan' i pidkhody do liku-vannia.Patogenetychnyĭ zv’iazok mizh zakhvoriuvanniamy miieloïdnoï ta limfoïdnoï pryrody zalyshaiet'sia nez’iasovanym ta,naĭvirogidnishe, ie rezul'tatom diï dekil'kokh faktoriv – radiatsiĭnogo, khimichnogo i vnaslidok ts'ogo – genetychnykhporushen'.

Objective to study the peculiarities of clinical characteristics and polymorphism of ABO and Rh blood group systemsin relation to the natural history of plasma cell myeloma in the ChNPP accident survivors.Peculiarities of the disease natural history were reviewed in the 111 plasma cell myeloma(PCM) patients receiving medical management at the Department of Radiation Oncohematology of the NRCRM dur-ing 2010-2017. Principal clinical and laboratory characteristics of PCM, namely the values/levels of LDH, β2-mic-roglobulin, albumin, serum calcium, urea, creatinine and hemoglobin were assessed, taking into account the gender,radiation history (ChNPP accident clean-up workers, evacuees from areas of obligatory resettlement, inhabitants ofcontaminated territories, and the comparison group) and the PCM stage codenamed by Durie-Salmon et al. (1975)and the ISS (1985) classifications. Distribution of polymorphic variants on ABO and Rh blood systems was studiedin the 106 PCM patients.It was found that the level of β2-micro-globulin and calcium was increased significantly in male (p = 0.02and p = 0.04, respectively), whereas serum urea content was elevated in female (p = 0.04) PCM patients featuring acompromised radiation anamnesis in comparison to non-irradiated patients. Some probable differences were foundfor urea level (F = 3.58, p = 0.05) and serum albumin (F = 4.00, p = 0.05) in the examined group of PCM patients.Probable (p0.05) incidence increase of the B phenotype was established as a predictor of complicated natural his-tory of PCM with abnormal genetic equilibrium resulted from the increased incidence of IB allele in chronic renal fail-ure (CRF) patients. Significant (p0.05) prolongation of the remission period upon a standard PCT application wasfound in PCM patients being the A phenotype carriers having a preserved gene and phenotypic equilibrium comparedwith carriers of O and B phenotypes.Clinical and hematological parameters are different in PCM patients survived after the ChNPP accidentand those with favorable radiation history. Distribution of polymorphic variants of ABO antigenic structures inpatients with complicated natural history of the disease is also different, that can be a background for predictingthe effectiveness of treatment. Further research is required in this field.Meta: vyvchyty osoblyvosti klinichnykh kharakterystyk ta polimorfizm system grup krovi AVO, Rh shchodo perebiguplazmoklitynnoï miielomy u patsiientiv, postrazhdalykh vnaslidok avariï na ChAES.Materialy i metody. Proanalizovano osoblyvosti perebigu zakhvoriuvannia u 111 patsiientiv z plazmoklitynnoiumiielomoiu (PKM), iaki znakhodylys' na obstezhenni ta likuvanni u viddilenni radiatsiĭnoï onkogematologiï NNTsRMprotiagom 2010–2017 rr. Otsineno osnovni kliniko-laboratorni kharakterystyky PKM (riven' laktatdegidrogena-zy, β2-mikroglobulinu, al'buminu, kal'tsiiu syrovatky krovi, sechovyny, kreatyninu ta rivnia gemoglobinu) z urakhu-vanniam stati, radiatsiĭnogo anamnezu (uchasnyky likvidatsiï naslidkiv avariï na ChAES, evakuĭovani z zon bezumov-nogo vidselennia, zhyteli kontaminovanykh terytoriĭ ta grupa porivniannia), stadiï PKM za klasyfikatsiieiu Durie-Salmon et al. (1975) ta ISS (1985). Provedeno doslidzhennia rozpodilu polimorfnykh variantiv za systemamy kroviAVO ta Rh u 106 patsiientiv z PKM.Rezul'taty. Vstanovleno, shcho u khvorykh na PKM z obtiazhenym radiatsiĭnym anamnezom porivniano z neopromineny-my patsiientamy virogidno zrostaly: u cholovikiv – riven' β2-mikro-globulinu (r = 0,02) ta kal'tsiiu (r = 0,04),u zhinok - riven' sechovyny syrovatky krovi (r = 0,04). Pidtverdzheno, shcho dlia obstezhenoï grupy patsiientiv zPKM virogidni vidminnosti vstanovleni shchodo rivnia sechovyny (F = 3,58; r = 0,05) ta al'buminu syrovatky krovi(F = 4,00; r = 0,05). Vstanovleno virogidne (r -#060; 0,05) pidvyshchennia chastoty zustrichal'nosti fenotypu V iak predyk-tora uskladnenogo perebigu PKM z porushenniam gennoï rivnovagy vnaslidok zrostannia chastoty aleliu IB upatsiientiv z khronichnoiu nyrkovoiu nedostatnistiu. U khvorykh na PKM pry nosiĭstvi fenotypu A na tli zberezhenniagennoï i fenotypovoï rivnovagy vstanovleno suttieve (r -#060; 0,05) podovzhennia periodu remisiï pry provedenni stan-dartnoï polikhimioterapiï u porivnianni z nosiiamy fenotypiv O i V.Vysnovky. Vyiavleni vidminnosti kliniko-gematologichnykh pokaznykiv u patsiientiv z PKM, postrazhdalykh vnaslidokavariï na ChAES, i osib bez obtiazhenogo radiatsiĭnogo anamnezu ta rozpodilu polimorfnykh variantiv antygennykhstruktur AVO u khvorykh z uskladnenym perebigom zakhvoriuvannia, shcho mozhe sklasty pidґruntia dlia prognozuvanniaefektyvnosti likuvannia i potrebuie podal'shykh doslidzhen' v danomu napriamku.

Prognostic significance of additional chromosomal abnormalities (ACAs) for tyrosinekinase inhibitors therapy (TKI) response in chronic myeloid leukemia (CML) patients is discussed. In many ways, this uncertainty is dueto the low frequency as well as the high variability of ACAs in patients with chronic phase CML. In this study, rate of this phenomenon and its impact on the resistance to TKI therapy in CML patients was evaluated. Overall, 502 (91.8%) patients had only the classic translocation t(9;22)(q34;q11) without ACAs at diagnosis. 45 (8.2%) patients presented with additional cytogenetic findings at diagnosis: 29 (5.3%) patients had variant translocations t(9;V;22), which were formed by three chromosomes, and in 16 patients (2.9%) had ACAs. One patient had both and was included in the group of patients with ACAs. The analysis of the tumor clone reduction dynamics by the Kaplan-Meier method did not reveal statistically significant differences in the cumulative complete cytogenetic and major molecular response rates (p = 0.712 and p = 0.111 respectively) between the patients with classical translocation t(9;22), patients with variant translocations and patients with ACAs. Analysis of long-term outcomes demonstrated inferior event-free (EFS), progression-free (PFS) and overall survival (OS) in CML patients with ACA at diagnosis. At 3 years, for patients with a classic translocation, patients with ACAs, and patients with a variant translocation t(9;V;22), the probability of EFS was 84,9% (95% ÑI, 81,2% 88,6%), 93,8% (95% CI, 81,8% 100,0%) and 43,9% (95% CI, 17,4% 70,4%), respectively. The probability of PFS was 92,0% (95% Ѳ, 89,3% 94,7%), 93,3% (95% Ѳ, 80,8% 100,0%) and 60,6% (95% Ѳ, 35,9% 85,3%), respectively. The probability of OS was 93,8% (95% C², 91,3% 96,4%), 93,8% (95% C², 82,1% 100,0%) and 76,2% (95% C², 65,2% 87,2%), respectively. No statistical difference was observed between the patients with classic translocation t(9;22) and those with variant translocations in terms of EFS, PFS and OS. Chromosomal abnormalities that appeared in CML patients at diagnosis and are not classic CML-specific translocation t(9;22)(q34;q11) may impair the prognosis of disease outcome. The presence of variant transactions in diagnosis does not impact the TKI therapy effectiveness. Additional chromosomal abnormalities in Ph+ cells lead to loss of the achieved cytogenetic and/or molecular response, disease progression, and the overall survival reduction in CML patients, treated with TKI.