Head of the department- hematologist — Zalina T. Fidarova, Candidate of Medical Sciences
The main focus of the department is the study of the biological phenomena underlying leukemia, myelodysplastic syndromes, aplastic anemia, and a scientifically based approach to the treatment of these diseases, the creation of new treatment programs, and their introduction into wide hematological practice.
The Department of Hemoblastosis and Hematopoietic Depression Chemotherapy with Bone Marrow and Hematopoietic Stem Cell Transplantation Unit was originally called the Hematology Clinic of the Institute of Blood Transfusion (Hematological Research Center of the Ministry of Health of the Russian Federation), established in 1927 on the initiative of professors M.P. Konchalovsky and H.H. Vlados.
The first head of the department, from 1927 to 1953, was Corresponding Member of the USSR Academy of Medical Sciences, Professor H.H. Vlados.
The Clinic studied issues related to the etiology, pathogenesis and treatment of Addison-Birmer anemia ,Werlhof's disease, erythremia, leukemia; developed the main indications for the transfusion of blood and its components in diseases of the blood system and internal diseases.
H.H. Vlados contributed to the development of a unitary theory of hematopoiesis and the classification and nomenclature of cells of the hematopoietic system.
In 1927, H.H. Vlados, together with N.M. Shustrov, published the country's first guide to clinical hematology.
From 1953 to the 1960s, the Clinic was headed by Professor, Corresponding Member of the USSR Academy of Medical Sciences, M.S. Dultsin. Work continued on the study of leukemia, anemia, and lymphomas. In 1965, M.S. Dultsin, together with Professors I.A. Kassirsky and M.O. Raushenbakh, published the manual "Leukemia, etiology, pathogenesis, clinic, treatment."
From 1953 to 1965, one of the leading hematologists of the country, Doctor of Medical Sciences, Professor Y.I. Lorie, who was ctively engaged in the problems of hemolytic anemia and immunohematology, worked in the department.
From 1969 to1988, the head of the department was an Honored Scientist of the RSFSR, a participant in the Great Patriotic War, Professor F.E. Feinshtein. Under his leadership, work continued on the study of leukemia, lymphomas, aplastic anemia, hemolytic anemia; protocols for the treatment of these diseases were improved; programs for the treatment of leukemia, aplastic anemia, including bone marrow transplantation were developed. F.E. Feinshtein is one of the authors of the monographs- “Diseases of the blood system” (1980.1987), “Hematopoietic depressions” (1987).
From 1988 to 2011 The department was headed by Academician of the Russian Academy of Medical Sciences, Professor V.G. Savchenko, and from 2011 to 2021 – Doctor of Medical Sciences, E.N. Parovichnikova.
For more than 20 years, work has been carried out to create a risk-adapted strategy for the treatment of hemoblastosis based on the modification of therapy depending on the detection of patient-specific molecular markers of the disease at different stages of the antitumor program. The result of this work has been long-term treatment results comparable to those in the world's leading clinics. The five-year survival rate for different types of leukemia ranges from 15% to 90%, for aplastic anemia - 80-85%, myelodysplastic syndromes - 20-40%. Molecular methods for detecting and monitoring minimal residual disease are being developed and introduced into clinical practice as a mandatory element of the program treatment of acute leukemia. Also, early (before treatment or after achieving complete remission) genotyping of potential bone marrow donors and addressing the issue of including allogeneic hematopoietic stem cell transplantation in the treatment program has also become key in the treatment program of leukemia and MDS. Close cooperation with the Department of High-Dose Chemotherapy and Bone Marrow Transplantation makes it possible to implement this highly effective method in a third of patients with hemoblastosis.
For the first time in the country, multicenter collaborative research on the treatment of acute leukemia was initiated with the participation of the hematology departments of Russia.
Since 1992, the department has been the focal point of all Russian multicenter studies on the treatment of acute adult leukemia. During this time, 20 multicenter clinical trials for the treatment of acute myeloid, promyelocytic and lymphoblastic leukemias were initiated and conducted, bringing together several thousand patients from more than 30 hematology centers in Russia. One of the principles underlying these studies is the preservation of high efficiency of therapy with the possibility of "replication" in the regions of the Russian Federation of a risk-adapted strategy for the treatment of patients with acute leukemia. As a result of this work, in a number of regional centers, the results of the treatment of these most serious diseases of the blood system have become comparable to the results of the federal center.
One of the scientific activities of the department is the creation of differentiated programs for the treatment of patients with myelodysplastic syndrome, depending on the genetic characteristics of the disease. Changes in the stromal microenvironment supporting hematopoiesis in patients with myelodysplastic syndrome and acute leukemia are being studied.
An optimal algorithm for programmatic therapy of severe and refractory forms of aplastic anemia has been developed, including sequential step-by-step immunosuppression and allogeneic bone marrow transplantation as the first stage in the treatment of young patients with HLA-compatible siblings.
Modern information technologies and analytical apparatus are being introduced into the structure of controlled studies on the treatment of patients with hemoblastosis and hematopoietic depressions. The Russian Register of Patients with Acute Leukemia was created. An internet database was also created for statistical processing of treatment results according to research protocols.
The use of methods of extracorporeal blood surgery (leuko-, plasmapheresis) as an important component of complex antitumor therapy and its complications in hemoblastosis and hematopoietic depressions is being studied.
Programs for rational precision and empirical antimicrobial therapy of infections in neutropenia based on the study of the spectrum and antibiotic sensitivity of pathogens isolated from patients with acute leukemia and aplastic anemia have been developed and are continuously being improved upon.
The department has developed a strategy for the treatment of acute leukemia, aplastic anemia and MDS in pregnant women. Since 1990, the treatment of hemoblastosis in pregnant women has been improved and individualized, depending on gestation time and the molecular genetic characteristics of the disease. More than 70 children have been born in the department, the eldest of whom turned 32 in 2022.
In 1991, the International School of Hematology was created, whose activities continue to the present day. Leading domestic and foreign experts take part in the work of the school. Meetings are held at least twice a year.
Pedagogical work is constantly carried out in the department. Annually, 2-3 clinical residents and 1-2 graduate students are admitted to the department for training. The research activity of postgraduate students consists not only of clinical work, but also of work in the scientific laboratories of the NMRC for Hematology (Laboratories of Molecular Hematology, Cytogenetics, Pathological Anatomy). During the year, about 30-50 printed works are published on the topics of scientific and clinical works. Every year 1-2 dissertations are submitted for defense.
The staff of the department participate in all conferences “Leukemias and Lymphomas. Therapy and Basic Research,” held by the NMRC for Hematology, send abstracts, and take part in annual international and domestic conferences on hematology. They are organizers, experts and participants of Russian congresses on hematology and present the results of their scientific and clinical developments at many regional conferences across Russia.
The department employs a young, close-knit, friendly, responsible and motivated team.
