283. Different schemes of B-cell chronic lymphocytic leukemia (B-CLL) treatment in population affected by the Chernobyl accident consequences

Abstract

The aim of the study was to evaluate different schemes of B-CLL therapy in population affected by the Chernobyl nuclear power station accident consequences. The 32 patients with B-CLL were treated in Hematological Department of Research Centre for Radiation Medicine in postaccidental period from 1990 to 2003. 16 men aged 42–74 years with B-CLL were studied. The absorbed dose of ionizing radiation varied from 2.8 to 12 cSv but was defined not for all persons. The treatment was started from 1 to 10 months after B-CLL diagnosis. Before B-CLL treatment the most patients had total increase of lymphatic nodes, splenomegaly, hepatomegaly, toxicopaty syndroms, high frequency of infections complications, severe anemia, thrombocytopenia, hemolytic syndrome, leukocytosis. The monoclonal population of B – lymphocytic was present in bone marrow (BM) in the typical variant of B-CLL. Diffused lymphoid infiltration, forming spots of BM necrosis with moderate resorbtion, fragmentation, lysis was found on hystology of BM threpanobioptat in all patients. B-CLL in clean-up workers of the Chernobyl accident consequences is characterized by rapid progression of the disease, and diffusion defeat of BM. It has been established that the most effective programe of treatment is the combination of fludarabine with cyclophosphamide. The complete and partial remission was achieved in 11 out of 14 cases. The treatment scheme (COP, CHOP, leukerane with prednisolone) did not led to complete remission. Our results of B-CLL treatment showed the high effectiveness of fludarabine-based therapy.