ОПЫТ ИММУНОЛОГИЧЕСКОЙ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ОСТРОГО МИЕЛОБЛАСТНОГО ЛЕЙКОЗА, РЕЗИСТЕНТНОГО К ПРОГРАММНОЙ ПОЛИХИМИОТЕРАПИИ, У БОЛЬНОГО МОЛОДОГО ВОЗРАСТА

Aim: to analyze the case of immunological detection and treatment of young male with resistant acute myeloid leukemia in Sverdlovsk Regional Hematological Centre. Bone marrow and peripheral blood samples obtained from male, aged 38, treated using intensive chemotherapy programs and then obtained supportive care and palliative chemotherapy in municipal hospital. Immunohistochemical characterization of AML blast cells: medium and small cells with one or several nucleoli, MPO, CD34, CD117, CD68 positive. In cytochemistry lipids were positive in 29.0% of blasts, glycogen – 81.0%. Immunophenotype of blast cells was CD45, CD13, CD33, CD34, CD38, CD117, MPO-cyt (+). Karyotype was 47, XY, +13 and changed during AML clonal progression. In case, two non-synonymous substitution were co-existed in samples: NRAS gene с. 182 A>C and TP53 gene с. 215 С>G. The number of NRAS gene point mutations changed during AML clonal progression (additional c. 35 G>С substitution was found). Immunophenotype of blast cells not changed during progression. Overall time of patient observation was 42 week.