CONFERENCE REVIEW
16–17 июня 2023 г. в Коломне состоялась II научно-практическая конференция «Достижения, проблемы и перспективы в гематологии», организованная Ассоциацией гематологов Московской области. В ходе конференции ведущими отечественными гематологами были представлены самые актуальные сведения о современных достижениях в области диагностики и терапии широкого спектра болезней и новообразований системы крови, а также о проведении научных исследований и правовых аспектах при лечении данных заболеваний. Особенностью докладов была их практическая направленность и обмен опытом с участниками конференции.
RARE AND COMPLEX CLINICAL SITUATIONS: DIAGNOSIS AND SELECTION OF TREATMENT TACTICS
Arteriovenous malformation (AVM) of the head and neck is a rare disease developing during embryo- and vasculogenesis due to RASA1 mutation which is inherited in accordance with autosomal dominant pattern and is associated with CMC1 locus on the long arm of the 5th chromosome 5q13.3. Statistically, AVMs are rarer than other congenital vascular abnormalities such as lymphatic or venous malformations. While AVMs are non-malignant neoplasms, among all vascular abnormalities they are the most aggressive, destructive and complex in their structure. In international literature, a small number of articles describing cases of this pathology exists (for example, I.T. Jackson et al. analyzed 16 cases of this pathology, M.T. Chen et al. reported on 14 cases, M.P. Kohaut et al. analyzed 81 cases of extracranial AVMs).
In Russin literature, the number of articles describing clinical cases of AVM is in the single digits, and this topic remains quite relevant. The article presents a rare clinical observ
Intravenous leiomyomatosis is a smooth muscle tumor of unclear malignant potential capable of intravascular growth with varying levels of intravascular advancement. The only radical treatment method is surgical intervention requiring quality preoperative preparation and determination of optimal surgical tactics taking into account the level of damage. A description of a clinical case of intravenous leiomyomatosis with intracardial growth is presented
NEW DIRECTIONS AND ADVANCEMENTS IN TREATMENT OF ONCOLOGICAL DISEASES IN THE CURRENT AGE
Multiple myeloma (MM) is a B cell lymphoproliferative disease characterized by clonal proliferation of plasma cells and heterogenous progression. Successes in MM therapy are in large part based on the study of molecular and genetic features of disease pathogenesis and identification of high-risk chromosomal abnormalities determining prognosis and antitumor response. Elderly patients with newly diagnosed MM with high-risk cytogenetics who are not candidates for autologous stem cell transplantation should receive programs of antitumor therapy which increase progression-free survival and overall survival with satisfactory tolerability and minimal toxicity. Use of monoclonal antibodies in triplets at early stages allow to achieve deeper antitumor response, the absence of minimal residual disease in a greater number of observations, and improve survival in all patient subgroups.
A clinical observation of a 75-year-old female patient with newly diagnosed MM with high-risk cytogenetics and multiple bone plasmacytomas with massive extraosseous components is presented. During D-Rd regimen therapy, after 8 daratumumab administrations very good partial remission was achieved which has been maintained for 20 months. Significant improvement in quality of life with satisfactory treatment tolerability and absence of adverse events are observed
SUPPORTING THERAPY ASPECTS
Study of the problem of multiple primary malignant neoplasms (MPMNs) becomes more important and significant in modern clinical oncology. MPMN is a varied group of independent tumors of varying origin located in one or several organs. Due to introduction of single-use elastomeric microinfusion pumps into the clinical practice, continuous cyclical drug outpatient and in-hospital treatment of oncological patients with MPMNs can be performed. Significant successes of specific therapy led to increased lifespan of patients with MPMNs. Prolonged administration of drugs using infusion pump with set velocity allows to deliver cytostatics into the patient’s body in strictly controlled amounts. The article presents 2 clinical cases of effective antitumor treatment of patients with MPMNs using infusion pum
Therapy of chronic pain syndrome and adequate perioperative pain management during treatment of malignant neoplasms are important problems at the current stage of clinical medicine development. Currently, multimodal pain management is effectively applied through drugs of various pharmacological groups prescribed depending on pain intensity in accordance with a digital rating scale. Associated adverse events as well as impossibility of using peroral or transdermal forms in some cases, limit the use of opioid analgesics. High bioavailability and fast absorption of μ1-opioid receptor agonist tafalgin shown during preclinical studies, relatively favorable safety profile allowed to use this drug in oncological clinic.
An experience of using tafalgin in treatment of pain syndrome in patients with malignant tumors at the “Lapino” clinical hospital since 2022 is presented. The effectiveness of the drug is evaluated, and its niche in multimodal pain management is determined.
ISSN 2782-6171 (Online)