Over the past 10 years, the rate of childhood disability in Ukraine has increased 2 times due to malignant neoplasms (MN) of lymphatic and hematopoietic tissue. In the structure of the overall incidence of children, the cancer increase is observed by 20%. Moreover, the prevalence of cancer among adolescents increased by 26% during the last 5 years. The purpose of the study is to evaluate the children immune state in the period of cancer remission after basic anticarcinogenic treatment. Materials and methods. To evaluate the immunological reactivity of the organism, we determined the integral hematological parameters: LI (lymphocytic index); RLESR – the ratio of leukocytes and erythrocyte sedimentation rate (ESR); INLR – index of neutrophils and lymphocytes ratio; INMR – index of neutrophils and monocytes ratio; ISLM – index of lymphocytes and monocytes ratio; IA – index of allergy; LII – leukocyte index of intoxication. Results and discussion. The immunity state was evaluated in 152 children in the period of remission of oncohematological diseases (OHD) and MN after basic treatment (operative treatment (OT), chemotherapy (CT), radiotherapy (RT) upon admission to hospital treatment. There appeared the afferent and efferent immunity ratio violation in children in the period of OHD remission after receiving combined treatment courses when admitted to hospital. This indicator was increased in 19.6% of children after basic treatment with CT after combined therapy with HT + PT in 35.1% of the subjects. Chronic moderate changes in the macrophage-microphage system are also determined by the increase of ISMM. The ISMM increased in 54% of children to (17.3 ± 2.6) units after CT + RT. In children undergoing OHD remission after CT, these shifts were determined with less deviations (13.5 ± 2.2) units with a lower frequency of 35.3%. Violation of the ratio of activity of the cellular and humoral units with inhibition of the cellular level of immunity (a decrease in the level of lymphocytes of the Harkavy Index, LI) was found in 25.5% of children after CT and in 16.2% of children after receiving CT + RT, with a rise in the neutrophilic ratio index and lymphocytes (NRIL) in these groups of children, indicating a decrease in cells of specific body protection. Increased index of allergy in children after CT and combined CT + RT was found, but more pronounced in the first case. However, with CT more often (in 25.5% of patients), when entering to hospital treatment, the leukocyte index of intoxication (LII) was reduced, indicating the viral load of the organism. One third of the children on admission to hospital after MN treatment had the oppression to production of effector immunocompetent monocytes cells according to the increase of ISL. The greater deviations of this index in the average in 38% of the surveyed were determined after the protocols OT + CT, OT + CT + RT, the smallest deviations and were less common in 21.6% of those examined after OT. Chronic moderate changes in the macrophage-microphage system were determined at an average frequency (45.6%) after all types of radical treatment, but higher rates of ICNM were determined in cases after the combination of radical treatment OT+ CT + RT and OT + CT. On average, 46.7% of children who were treated in hospital after all types of radical MN treatment had a violation of the ratio of cells activity of nonspecific and specific immune defense with inhibition of a specific component, with the increase of the INMR coefficient. Conclusions. Children in OHD remission had violations according to the calculated integrative indicators of immunological reactivity. This is most often manifested after receiving a combined CT + RT. Violation of the ratio of activity of the cellular and humoral units with inhibition of the cellular level of immunity (decrease in LI) was found to be approximately the same frequency after various protocols of basic treatment. Violations of immunological reactivity in children who were treated in hospital after radical MN treatment were more often manifested by violations of the activity of cells of nonspecific and specific immune defense with oppression to a specific component and did not depend on the types of radical treatment.

Keywords: children, oncological diseases, anti-carcinogenic treatment, state of immunity

Full text: PDF (Ukr) 199K

1. Lazorishinets VV, Moiseenko RO, Poberskaya VO, et al. Basic principles of organization and methodology of rehabilitation of children with oncological and oncohematological diseases in Ukraine. Medical rehabilitation, health resort, physiotherapy. 2010; 2: 3-7. [Ukrainian]
2. Каladze NN. Features of rehabilitation of the children with oncolohematological pathology. Herald for Physiotherapy and Balneology. 2011; 4: 47-57 [Russian]
3. Goryachkovsky AM. Clinical biochemistry in laboratory diagnostics: reference manual. 2nd ed. Odessa: Ecology, 2005. – 616 p. [Ukrainian]
4. Speransky VV, Dmitrieva II, Zaripova RM. Immunological informativeness of leukocytogram. Klin lab diagnostics. 1999; 12: 6–7. [Ukrainian]
5. Poberska VO, Yanchenko TS, Yevsyeyeva SV, ta in. Porivnyalna otsinka vidnovlyuvalnogo likuvannya ditey z onkologichnimi zakhvoryuvannyami na ambulatornomu ta sanatorno-kurortnomu etapakh reabilitatsiyi. Medichna reabilitatsiya, kurortologiya, fizioterapiya. 2010; 1: 3–7. [Ukrainian]