engleski

Discrimination analysis of some immunological parapeters in prediction of final outcome of disease in children with solid malignant tumors

Despit continous progress in suportive therapy a large proportion of the morbidity in children with solid tumors ia related to treatment. using statistical approach, we have examined the possibility of impying immunological parameters to predict further course of illness or to possibly divide the patients into the group with favourable or unfavourable outcome. To this end, we have analysed by discrimination analysis the number of T and b lymphocytes, the reactivity of lymphocytes to mitogens and immunoglobulin level in the blood of 91 children with solid malignant tumors. All testings have been done before starting the therapy, during the therapy, after ending the therapy, and one year since the end of the therapy. It was shown that it is not possible to predict further course of final issue of the disease based on immunological parametrs before starting the therapy. However, already at the begining of the therapy it is possible in more than 70% of cases, based on immunologica parameters, to divede the patients into the group of predictably living or dying. In the period of recovalescence, 3 to 6 months and one year after the end of therapy, the certainty of predicting the final outcome of the disease is 96% or 98% respectively. This results have shown thatthe number of T and B lymphocytes, the reactivity of lymphocytes to mitogens and the immunogliobulin level in thechildren with solid malignant tumors before starting the therapy has no prognostic value. However, during the therapy it is possible to predict further course of the disease and its final issue based on these parametrs. our data point out the need to modified therapeutic protocols during the therapy in these severely immunocompromised patients. Utilization of immunomodulatory agents might improve their ability to mount an adequate immunological response.

imunološki parametri; djeca; solidni tumori

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