The value of adding rituximab to chemotherapy in children with aggressive B-cell non-Hodgkin lymphoma (B-NHL) is still insufficiently studied. We enrolled 231 patients [mean age 9 years old (range 2-17); male:female ratio 3Á4:1] with Burkitt (BL, 179 patients, 76Á7%), diffuse large B-cell (32 patients, 14%), primary mediastinal B-cell (14 patients, 6%), and other (6 patients, 2Á6%) B-cell lymphomas in a prospective study of immunochemotherapy. Stages were I-II in 32% and III-IV in 68% of the patients. Four doses of 375 mg/m 2 rituximab were added to the Berlin-Frankfurt-Munster-NHL-90-like chemotherapy, with methotrexate being reduced or omitted in the first 2 induction blocks. The complete remission rate was 100% in limited-stage and 91Á4% in advanced-stage patients. Five advanced-stage patients (2Á2%) died in induction and 1 patient with stage 2 B-NHL died in remission; 11 patients in the high-risk group progressed on therapy (3 non-BL are alive after salvage) and 5 relapsed. Sixteen patients (9Á7%) with advanced stage disease proceeded to transplant. With a median follow-up of 46 months, 98Á5 AE 1% of patients with limited disease and 88Á1 AE 2% (88Á1% in Risk Group 3; 82Á6% in Risk Group 4) in advanced stages are alive. This study confirmed that combined immunochemotherapy for B-lymphomas is highly effective in children, despite reducing the intensity of the induction blocks.

This cooperation demonstrates the proof of principle to obtain second opinions in short time over far distances for seldom diseases on a scientific level.

/24 ч в целях уменьшения токсичности. Впервые в лечении детей и подрост-ков со зрелоклеточными В-НХЛ использовано противоопухолевое действие ритуксимаба (Мабтера в дозе 375 мг/м 2 внутривенно). Из 83 больных, включенных в анализ с 2004 по 2009 г., клинико-гематологическая ремиссия достигнута у 77 (92,8 %); при меди-ане наблюдения 51,6 мес ремиссия продолжалась у 23 (85,2 %) больных В-ОЛ, у 32 (88,9 %) (Мабтера)

Aim. To study the clinical problems and develop the symptomatology of the foreign bodies (FB) of the gastrointestinal tract (GIT). Materials and methods. Ninety patients with GIT foreign bodies were observed over the period from 1997 to 2017. To diagnose, a complex of endoscopic and radial methods was used. Localization, size and type of the detected foreign bodies were compared with the symptoms revealed. Results. Fifty patients intentionally swallowed foreign bodies, 40 – accidentally. Altogether, 90 patients swallowed 193 items (nails, needles, pieces of wire etc.). On the basis of the study, three forms of clinical course regarding the swallowed GIT FB were singled out: latent, manifest and complicated. The pathognomonic symptoms of GIT FB are “migrant” abdominal pains associated with migration of FB along the GIT lumen, intensification of pains while moving, exercise stress and palpation, feeling of “heaviness” in epigastric region. Multiple gastric FB cause the auscultative symptom of “ringing”. Pains, available with GIT FB, are not connected with taking food and are not ceased after taking antacids. Conclusions. Introduction of the developed GIT FB symptomatology into healthcare practice and training of physicians will contribute to earlier and more accurate diagnosis.

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