Liubarets T. Regularities of radiation-associated chronic myeloproliferative diseases and myelodysplastic syndrome formation in exposed persons during the remote period upon the Cheernobyl NPP accident: diagnostics and management perfection

The dissertation provides theoretic generalization and new solution of the actual problem regarding regularities of chronic myeloproloferative diseases (ChMPD) and myelodysplastic syndrome (MDS) formation in persons exposed in a dose range of 0.51-67.86 cSv. The contributing role of ionizing radiation was defined regarding the variability of clinical-laboratory characteristics in ChMPD and MDS patients. It was found that exacerbation of extent of apoptose abnormalities indicates to different ways of this process with possibility of its occurring through Fas-mediated pathway in Chernobyl accident survivors. Serum level increase of VEGF in exposed chronic myelomonocytic leukemia (CMML), IMF, and MDS patients testifies the increased angiogenesis intensity as an unfavorable factor of disease course, substantiating the necessity of angiogenic inhibitors (thalidomide and its analogues) administration. Survival dependence in the exposed patients upon leukemia (CML, IMF, CMML) type and MDS variant was established. Integral prognostic indices (IIleuk та IImds) were proposed making possible the survival prognosis with accuracy of 96.2% and 99.7% in patients having the diagnosed leukemia (CML, CMML) and MDS. Mathematical models have been elaborated providing the survival prognosis in leukemia and MDS patients taking into account the radiation status.