Ponochevna E. Pathogenetic character and correction of hemostasis disoders in children with acute leukemia during intensive chemotherapy

Thesis is devoted to the investigations of regularities and pathogenetic mechanism of hemostasis system in children with acute leukemia during intensive chemotherapy. Improvement of therapeutical results and achivement of continuous complete remissions were reached by modern protocols of chemotherapy. Considerable complications develop during chemotherapy and thrombohemorragic one is the most life threatening. Investigation tovards this problem are current and similar study was not carried out in Ukraine. 100 children with diagnose acute leukemia were examined for this study: 40 children had AML, 40 - ALL, 20 - relapse ALL. 50 children were investigated on the all stages of intensive chemotherapy On the background of systemic approaches, diagnostic algorithm for hemostasis was grounded by us and it included volume of investigation, timepoints of control, interpretation of data, it was made pathogenetic character of hemostasis system condition in children with acute leukemia, discribed clinical syndroms and pathogenetic versions of thrombohemorragic complications and disorders, and determined the demage of the links of hemostasis. There are analysed the data and conducted the theoretical generalisations of genesis , regularitics and mechanism of hemostatic disturbances in children with AL during intensive chemotherapy and took into account of leukemic effects, toxicity of chemotherapy and influence of correcting means. Methods of hemostasis correction were systematized and improved (controled hemodilution, platlate concentrate, fresh frosen plasma, pharmacological means). The obtained results, grounds and summeries make the basis for theoretical generalise and elaboration of programm of supprotive care during the intensive chemotherapy.