The dynamics of cellular and humoral immunity during the treatment of pneumonia in patients on a background of acute leukemia

Abstract

Pneumonia is often life threatening infectious complication on a back ground of software treatment in patients with acute lymphoblastic leukemia (ALL). The existing consensus documents on the treatment of pneumonia in patients with impaired immunity focuses on antibac terial therapy, at the same time, questions about the need for correc tion of the immune status of patients remain poorly understood. A promising direction is the use of glutamyl cysteinyl glycine sodium in the treatment of pneumonia in patients with OL to enhance the activ ity of the immune system and improve the anti infective protection. The aim of the study : was the analysis of indicators of cellular and humoral immunity in the process of applying immunocorrigirutee drug glutamyl cysteinyl glycine sodium (Glutoxim) in patients with pneu monia, which arise on the background of ALL optimization approach es in the treatment of pneumonia in patients with impaired immunity. Materials and methods . Study group of 87 patients with pneumonia on the background of ALL that took place a software based treatment of hematological centre «SE City Multidisciplinary Clinical Hospital No. 4» (str) for 2014 2015, the average age of patients was from 28 to 39 years old. ALL diagnoses of pneumonia was verified in accordance with generally accepted clinical and morphological criteria. Patients from the main study group (n=57) was additionally appointed glu tamyl cysteinyl glycine sodium to 2 ml of 3% (60 mg), N 10, in the morning, intravenous, total dose of 600 mg. All patients investigated indicators immunogram: T lymphocytes, b lymphocytes and indicators subpopulation composition (CD3+, CD4+, CD8+, CD19+, CD19 , CD16+, CD56+). The study was conducted using flow through laser cytofluometry (BeckmanCoulter, USA) and calculated the derived indices. Indicators of immunogram in patients of study groups were evaluated in the dynamics of treatment. Statistical processing was per formed using packages of applied programs «Excel» and «Statistic 10». Results . The analysis of indicators of cellular and humoral immunity of patients with pneumonia accompanied by АLL in the process of applying glutamyl cysteinyl glycin sodium showed significant activation of phagocytosis and anti infective protection of the results of increasing the relative amount of T helpers (CD4 +), PC cells, increased immunoregu latory index, FA and FC. The results of the dynamics of humoral immu nity also confirm the positive influence of the use of glutamyl cysteinyl glycine sodium on the immune reactivity of patients with reliable change indices of IgA and IgM, which are responsible for neutralizing infectious agents, bacterial toxins and indirectly activate phagocytosis. Conclusion . The use of immunomodulatory therapy with the drug glu tamyl cysteinyl glycine sodium (Glutoxim) in patients with pneumo nia on the background of ALL leads to improved clinical manifesta tions of the disease, reduces the duration of ABT improves the quality of life and leads to earlier return (average 3 4 days) to the program treatment АLL. The results of the research prove the possibility of optimizing the treatment of pneumonia by the using of immunomodu latory therapy glutamyl cysteinyl glycine sodium (Glutoxim) patients with pneumonia on a background of АLL.