In our dissertation we proposed a new solution of the hematology current problem. Based on clinical, laboratory, instrumental, functional, immunological and mathematical methods of research the dissertation has expanded the data on the actual problem of hematology: the features of the clinical picture have been described, and the frequency of occurrence and the course of intoxication syndrome in patients with acute leukemias have been studied.
In the first stage of the work, more than 195 cases of hospitalizations of patients with different variants of acute leukemias for the period 2013-2016 were analyzed. As a result of the study, 195 patients with acute leukemia (87 women and 108 men) were included and comprehensively examined in the clinical and functional monitoring group, 128 of whom were patients with acute myeloblastic leukemia (60 women and 68 men) and 67 patients with acute lymphoblastic leukemia (27 women and 40 men), it is before and after induction treatment. The age of the examined patients is from 18 to 75 years.
The following research methods were conducted: general clinical: collecting anamnesis, objective status, instrumental research, general blood test, a biochemical study of blood serum; clinical and hematological: bone marrow examination with myelogram count, histological examination of hematopoiesis and its microenvironment, cytochemical studies of peripheral blood and bone marrow, lumbar puncture with a biochemical examination of cerebrospinal fluid and morphological study of its centrifugal preparation; cytogenetic: a study of karyotype in patients with acute myeloblastic leukemia, evaluation of clone with nonrandom chromosomal abnormalities in the dynamics of carrying out chemotherapeutic protocols by the method of differential staining of chromosomes of blast cells of bone marrow; instrumental: abdominal ultrasound, ECG; CT or MRI (if necessary).
It is advisable to intensify therapy to prevent a recurrencу when the initial plasma medium weight molecules content, free histamine, serotonin, heparin, lactic and pyruvic acid fractions in patients with acute leukemia increases or in the event of an increase during the remission.
It was found that an additional risk factor for the recurrence of acute leukemia disease is an increase in the initial plasma medium weight molecules content, free histamine, serotonin, heparin, lactic and pyruvic acid fractions at the beginning of the disease.
On the basis of studying the features of examining the clinical picture of different variants of acute leukemias and determining the features of intoxication syndrome according to the indicators of the content of free serotonin, free histamine in the blood plasma and medium weight molecules in the serum of patients with acute leukemia we pathogenetically substantiated and supplemented ways to optimize the treatment of patients with acute leukemia, by identifying molecules of medium mass, free fractions of histamine, serotonin, heparin, lactic and pyruvic acids and new approaches to treatment using antihypoxant and membrane-stabilizing agents.
