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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nodgo</journal-id><journal-title-group><journal-title xml:lang="ru">Российский журнал детской гематологии и онкологии (РЖДГиО)</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Pediatric Hematology and Oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2311-1267</issn><issn pub-type="epub">2413-5496</issn><publisher><publisher-name>LTD “Graphica”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21682/2311-1267-2023-10-1-57-67</article-id><article-id custom-type="elpub" pub-id-type="custom">nodgo-922</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEWS</subject></subj-group></article-categories><title-group><article-title>Применение современных методик терапии при развитии жизнеугрожающих осложнений у пациента после повторной аллогенной трансплантации гемопоэтических стволовых клеток: обзор литературы и клинический случай</article-title><trans-title-group xml:lang="en"><trans-title>Modern methods of therapy in the development of life-threatening complications in a patient after repeated allogeneic hematopoietic stem cell transplantation: review of the literature and clinical case</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3225-8412</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сергеенко</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sergeenko</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-детский онколог отделения детской трансплантации костного мозга и гемопоэтических стволовых клеток НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Pediatric Oncologist Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">karina_s19@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2395-4045</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мачнева</surname><given-names>Е. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Machneva</surname><given-names>E. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., врач-гематолог отделения детской трансплантации костного мозга и гемопоэтических стволовых клеток НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова, врач-гематолог отделения трансплантации костного мозга</p><p>115522, Москва, Каширское шоссе, 23</p><p>119571, Москва, Ленинский просп., 117</p></bio><bio xml:lang="en"><p>Cand. of Sci. (Med.), Hematologist Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov, Hematologist Department of Bone Marrow Transplantation</p><p>23 Kashirskoe Shosse, Moscow, 115522</p><p>117 Leninskiy Prosp., Moscow, 117997</p></bio><email xlink:type="simple">lena.machneva@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1091-1521</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алиев</surname><given-names>Т. З.</given-names></name><name name-style="western" xml:lang="en"><surname>Aliev</surname><given-names>T. Z.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-детский онколог отделения детской трансплантации костного мозга и гемопоэтических стволовых клеток НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Pediatric Oncologist Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">timaliev118@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0179-2479</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Костарева</surname><given-names>И. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Kostareva</surname><given-names>I. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-детский онколог отделения детской трансплантации костного мозга и гемопоэтических стволовых клеток НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Pediatric Oncologist Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">kostareva_92@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1469-2365</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Валиев</surname><given-names>Т. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Valiev</surname><given-names>T. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., заведующий отделением детской онкологии и гематологии (химиотерапия гемобластозов) № 1 НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Dr. of Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1 of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">timurvaliev@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0132-167X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Киселевский</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kiselevskiy</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, заведующий лабораторией клеточного иммунитета НИИ экспериментальной диагностики и терапии опухолей</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Dr. of Sci. (Med.), Professor, Head of the Laboratory of Cellular Immunity of the Research Institute of Experimental Diagnostics and Tumor Therapy</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">kisele@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3560-001X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Власенко</surname><given-names>Р. Я.</given-names></name><name name-style="western" xml:lang="en"><surname>Vlasenko</surname><given-names>R. Ya.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., старший научный сотрудник лаборатории клеточного иммунитета НИИ экспериментальной диагностики и терапии опухолей</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Cand. of Sci. (Med.), Senior Researcher of the Laboratory of Cellular Immunity of the Research Institute of Experimental Diagnostics and Tumor Therapy</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">vlasenko2002@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2945-284X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Киргизов</surname><given-names>К. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirgizov</surname><given-names>K. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., заместитель директора по научной и образовательной работе НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Cand. of Sci. (Med.), Deputy Director for Scientific and Educational Work of Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">k.kirgizov@ronc.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6131-1783</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Варфоломеева</surname><given-names>С. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Varfolomeeva</surname><given-names>S. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, директор НИИ детской онкологии и гематологии им. акад. РАМН Л.А. Дурнова</p><p>115522, Москва, Каширское шоссе, 23</p></bio><bio xml:lang="en"><p>Dr. of Sci. (Med.), Professor, Director of Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov</p><p>23 Kashirskoe Shosse, Moscow, 115522</p></bio><email xlink:type="simple">s.varfolomeeva@ronc.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава России; РДКБ ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia; Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>04</month><year>2023</year></pub-date><volume>10</volume><issue>1</issue><fpage>57</fpage><lpage>67</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сергеенко К.А., Мачнева Е.Б., Алиев Т.З., Костарева И.О., Валиев Т.Т., Киселевский М.В., Власенко Р.Я., Киргизов К.И., Варфоломеева С.Р., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Сергеенко К.А., Мачнева Е.Б., Алиев Т.З., Костарева И.О., Валиев Т.Т., Киселевский М.В., Власенко Р.Я., Киргизов К.И., Варфоломеева С.Р.</copyright-holder><copyright-holder xml:lang="en">Sergeenko K.A., Machneva E.B., Aliev T.Z., Kostareva I.O., Valiev T.T., Kiselevskiy M.V., Vlasenko R.Y., Kirgizov K.I., Varfolomeeva S.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.nodgo.org/jour/article/view/922">https://journal.nodgo.org/jour/article/view/922</self-uri><abstract><p>Не вызывает сомнения, что аллогенная трансплантация гемопоэтических стволовых клеток (алло-ТГСК) – один из наиболее эффективных методов лечения для многих тяжелых заболеваний. Однако, несмотря на значительный прогресс, алло-ТГСК по-прежнему ассоциирована с высокой частотой осложнений и летальности в посттрансплантационном периоде в связи с токсичностью режимов кондиционирования, инфекционными и иммунными состояниями. Острые осложнения, такие как эндотелиальные повреждения, острая и хроническая реакции «трансплантат против хозяина» (РТПХ), остаются основными причинами летальности после алло-ТГСК. В своем клиническом случае мы продемонстрировали пример развития таких жизнеугрожаемых осложнений, как ассоциированная с трансплантацией тромботическая микроангиопатия и РТПХ, у пациента после повторной алло-ТГСК, а также их успешное купирование современными методиками терапии, включающими введение близкородственных донорских мезенхимальных стволовых клеток и блокатора комплемента экулизумаба.</p></abstract><trans-abstract xml:lang="en"><p>There is no doubt that allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the most effective treatments for many serious diseases. However, despite significant progress, allo-HSCT is still associated with a high rate of complications and mortality in the posttransplant period due to the toxicity of conditioning regimens, infectious and immune conditions. Acute complications such as endothelial injury, acute and chronic graft-versus-host disease (GVHD) remain the main causes of mortality after allo-HSCT. In our clinical case, we demonstrated an example of the development of such life-threatening complications as transplant-associated thrombotic microangiopathy and GVHD in a patient after repeated allo-HSCT, as well as the successful relief of these complications by modern therapeutic methods, including the introduction of closely related donor mesenchymal stem cells and the complement blocker eculizumab.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>острый лимфобластный лейкоз</kwd><kwd>трансплантат-ассоциированная тромботическая микроангиопатия</kwd><kwd>экулизумаб</kwd><kwd>мезенхимальные стволовые клетки</kwd><kwd>Элизария</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute lymphoblastic leukemia</kwd><kwd>transplant-associated thrombotic microangiopathy</kwd><kwd>eculizumab</kwd><kwd>mesenchymal stem cells</kwd><kwd>Elizaria</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ditschkowski M., Elmaagacli A., Trenschel R., Gromke T., Steckel N., Koldehoff M., Beelen D. 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