Afanasieva O. The state of central hemodinamics, oxidant and antioxidant system in children with acute leukemia.

The new methods of early diagnostics, prophylaxis and prognostication of cardiotoxic complications in children with acute leukemia (AL) jointly with polychemotherapy have been represented in the disser-tation. It has been determined that 53,9 % of examined children during polychemotherapy had the devel-opment of cardiomyopathy, which was manifested in changing bioelectric activity of myocardium, disor-ders of contractive, pumping and diastolic function. It has been shown that forming both cardiomyopathy occurred before beginning treatment under the influence of basic disease (AL), however, the main role in pathogene-sis of cardiac complications was the toxic influence of polychemotherapy. It has been confirmed by the morphological data of myocardium of the dead children. We have found the modest parts of blast infiltra-tion with the massive apoptosis of cardiomyocytes and necrosis of tissue in myocardium. The changes in metabolism of the oxidant and antioxidant system were considered as the main link in the mechanisms of development of toxic cardiomyopathy in children with AL. It has been determined that activity of oxidative mechanisms was several times more than activity of antioxidants systems as before treatment as during all stages of polychemoterapy. The diseased children with cardiomyopathy had more distinct manifestations of oxidative stress and the deficiency of nitric oxide than diseased children without cardiomyopathy. We have discovered the prognostic criteria of forming toxic cardiomyopathy in children with AL and the signs which were important for their therapeutic correction in the process of chemotherapy.