COVID-19 is an infectious disease caused by the beta-coronavirus SARS-CoV-2 that in 2020 has spread worldwide. In most severe patients, the clinical picture begins with respiratory failure further deteriorating up to multiple organ failure. Development of coagulopathy is the most adverse prognostic. Analyzing currently available clinical data revealed that 71.4 % and 0.6 % of survivors and fatal cases, respectively, demonstrated signs of overt disseminated intravascular coagulation (DIC). Monitoring D-dimer level, prothrombin time, platelet count and fibrinogen content is important for determining indications for treatment and hospitalization in COVID-19 patients. In case such parameters deteriorate, a more pro-active “aggressive” intensive care should be applied. Low molecular weight heparin (LMWH) should be administered to all patients with diagnosed COVID-19 infection (including non-critical patients) requiring hospitalization, but having no contraindications to LMWH.

Background. Diffuse large B-cell lymphoma (DLBCL) is a potentially curable biologically heterogeneous lymphatic tumor. Standard R-CHOP therapy shows disappointing results, both immediate and longterm. To improve efficacy without additional toxicity, it is worth considering the possibility of using biologically oriented therapy.Aim. To evaluate the clinical efficacy and toxicity of the genotypedirected R-CHOP-X in patients with newly diagnosed DLBCL in real clinical practice.Materials and methods. A single-center prospective interventional clinical study included 30 patients with newly diagnosed DLBCL between September 2023 and September 2024. The median age was 60 (38–78) years. According to the international prognostic index, 23 (77 %) patients were classified as having a high risk of progression. Genotype incidence in the study cohort: MCD – 7 %, N1 – 20 %, BN2 – 7 %, EZB– 16 %, ST2 – 7 %, NOS – 43 %.Results. 30 patients received personalized genotype-directed therapy. Of these, 21 (70 %) patients completed treatment: the overall response rate was 100 % (complete metabolic response – 100 %). 9 (30 %) patients continue therapy: the overall response rate is 100 %. At 12 months, overall survival and progression-free survival were 100 % (95 % confidence interval 100 %). Hematological toxicity was assessed depending on the number of cycles (n = 144): grade III–I neutropenia was detected in 7 % of cycles, grade III–I anemia and grade III–I thrombocytopenia in 1.4 and 3.5 % of cycles, respectively. Non-hematological toxicity was generally grade ≤I–II.Conclusion. The results of this clinical trial are promising and provide preliminary evidence for the benefit of personalized genotype-directed antitumor therapy in newly diagnosed DLBCL. This therapeutic strategy demonstrates high clinical efficacy, particularly in the main target group – DLBCL with a high risk of progression with low toxicity. Further randomized studies are needed to confirm the effectiveness and implement the new approach in routine clinical practice.

Background. Multiple myeloma (MM) is the second most common oncohematological disease among malignant tumors of the hematopoietic and lymphoid tissues. According to epidemiological data, MM accounts for approximately 10–12 % of all hematological malignancies. An analysis of the main clinical parameters and treatment outcomes was conducted in patients with MM included in the registry of the Moscow Clinical Research Center “Hospital 52” in 2022–2025. Aim. To evaluate the clinical and hematological profile of MM patients, as well as to analyze the effectiveness of first-line antitumor therapy, including standard treatment regimens and high-dose chemotherapy programs followed by autologous hematopoietic stem cell transplantation. Materials and methods. The observational retrospective study included 325 patients with newly diagnosed MM: 147 (45.2 %) men, 178 (54.8 %) women. The median age at diagnosis was 67 (22–92) years. The number of patients aged 65 years and older was 194 (59.7 %). Antitumor therapy was carried out according to current clinical guidelines. In the first line of therapy, bortezomib was most often used, in the second – lenalidomide and monoclonal antibodies, in the third – monoclonal antibodies. Results. According to the International Staging System, 62.2 % of patients had stage III disease. Myeloma nephropathy was detected in 28.9 % of patients, with 20.3 % requiring programmed dialysis. Autologous hematopoietic stem cell transplantation was performed in 30.8 % of patients. Response to induction therapy: complete remission – 8.0 %; very good partial remission – 27.7 %; partial remission – 24.6 %. The best response rates were achieved with the use of monoclonal antibodies (66.6 % – complete remission + very good partial remission). With a median follow-up of 12.6 months, 1-year overall survival was 83.9 % (95 % confidence interval 82.3–85.4), 1-year progression-free survival was 75.8 % (95 % confidence interval 73.9–77.6). Conclusion. Using registry data allows us to characterize the MM patient population, evaluate the effectiveness of patient treatment, plan the work of the hematology center, forecast the funds required for the purchase of medications, and improve the organizational aspects of the hematology service in a multidisciplinary institution.

The term “Diffuse Large B-Cell Lymphoma” (DLBCL) covers an extremely heterogeneous range of aggressive hematological tumors of lymphoid origin. The recommended standard first-line treatment R-CHOP is still the leading therapy for newly diagnosed DLBCL. However, the outcomes of the unified approach to chemotherapy disregarding a high clinical and molecular genetic heterogeneity of this variant of non-Hodgkin lymphoma are evaluated as unsatisfactory. This paper is the first in the Russian Federation to report the personal experience with the use of the combination of R-CHOP regimen as basic therapy and chemotherapeutic agent acalabrutinib, one of Bruton tyrosine kinase inhibitors, with respect to Sanger sequencing results.

Background. At the end of 2019, a new coronavirus infection caused by the SARS-CoV-2 virus was registered. In March 2020, the first cases of COVID-19 were detected in Moscow. Patients with chronic lymphocytic leukemia, characterized by profound immune dysfunction, have risk factors for severe viral disease.Aim. To identify risk factors for hospital mortality and severe course of COVID-19, as well as to optimize therapeutic and preventive measures.Materials and methods. The analysis included 238 patients (142 (59 %) men and 96 (41 %) women) with chronic lymphocytic leukemia and COVID-19 with a median age of 66 (37-90) years, who were hospitalized at City Clinical Hospital No. 52 (Moscow) between April 2020 and April 2023. To compare hospital mortality and severity of COVID-19, patients were divided into 2 groups depending on the hospitalization period: 2020-2021 and 2022-2023, which correlates with the prevalence of some SARS-CoV-2 variants from December 2021 and changes in Moscow epidemiological situation.Results. Overall hospital mortality rate in 2020-2021 was 25 % (n = 45). Age over 73 years was a significant unfavorable factor in men. Cardiovascular diseases increase the risk of death by 2.3 times. Patients with a Charlson Comorbidity Index of 6 or more have a 2.2 times greater risk of death. A history of 1 or more lines of immunochemotherapy increased the risk of hospital mortality by 1.5 times. Relapse/progression of the disease were factors of unfavorable prognosis for patient survival. Binet stage C also showed a significant unfavorable prognosis. When studying all cases of death (n = 51), complications such as myelotoxic agranulocytosis, secondary bacterial complications and severe interstitial pulmonary damage 75 % were identified.Conclusion. Coronavirus infection caused by SARS-CoV-2 represents an infectious threat among patients with chronic lymphocytic leukemia and may affect the regimen and tactics of antitumor therapy. The use of a full range of preventive measures, vaccination and pre-exposure prophylaxis in this cohort of patients is of great importance.