MODERN DISEASES AND SAFETY ISSUES IN THE TREATMENT OF ONCOLOGICAL APLASIAS

Аннотация

Nowadays, cases of aplasia in oncology are gaining increasing importance. Aplasia is a pathological condition characterized by the absence or underdevelopment of cells or tissues, and it is often directly or indirectly associated with malignant tumors. Particularly relevant are hematological forms such as aplastic anemia, bone marrow cell aplasia, and lymphoid tissue deficiency. Modern treatment approaches include immunosuppressive therapy, antitumor drugs, transplantation, and genetic matching. This article discusses current therapeutic strategies for oncological aplasias, evaluates their effectiveness, and highlights the urgent need for further scientific research. Keywords: Oncological aplasia, aplastic anemia, immunosuppressive therapy, transplantation, genetic compatibility, pressing issues. Introduction: Aplasia cutis congenita is a rare, congenital disorder. In its severe phenotype, it is potentially life threatening. Its management and the timing of surgery remain controversial because of the risks involved with both conservative and surgical approaches. Most literature is based on case reports and very small case series because of the rarity of the disorder. The authors present their experience treating newborns with aplasia cutis congenita and its progressive development. Aplasia Cutis Congenita (ACC), congenital absence of the skin, is an uncommon anomaly. It most commonly presents as a solitary defect of the scalp but may also involve the trunk and extremities. The lesions are non inflammatory, well demarcated and have variable extents, ranging birth. The cause is not clear but genetic factors, compromised vasculature to the skin, infection, teratogens, fetus papyraceous and trauma are all implicated. Truncal aplasia cutis congenita has been reported with biliary atresia, distal duodenal atresia, intestine infarction and multiple hepatic hematomas. Syndromes such as Adams Oliver syndrome, SCALP syndrome (nevus sebaceus, CNS malformations, aplasia cutis congenita, limbal dermoid, pigmented nevus). [1] Histological details are available in very few reports. Histological features vary depending on the depth and duration of aplasia. Ulcers are seen at birth. After healing, the epidermis appears flattened with proliferation of fibroblasts within a connective tissue stroma. The total absence of the epidermal appendages remains a characteristic. https://scientific-jl.com 2 5 4 48-son_2-to’plam_Iyul -2025 ISSN:3030-3621 Ta'lim innovatsiyasi va integratsiyasi Aplasia cutis congenita histology The diagnosis of ACC can typically be made solely from clinical examination. Many providers withhold performing a lesional biopsy given the patient's age demographics and typical scalp involvement. When a biopsy is necessary to aid in the diagnosis, proper workup, including imaging of the lesion with ultrasound (US) or MRI, is important to ensure there are no underlying malformations that can be damaged during the biopsy procedure. Histopathologic findings of non-healed lesions include an absent epidermis and/or dermis with a proliferation of blood vessels. A subtype known as membranous-type ACC will have a thin translucent membrane covering. Lesions that have already healed with a scar will have a thin or flattened epidermis, absent adnexal structures, and dense, dermal fibrosis noted on pathology. A classification for ACC was proposed in 1986, which is still accepted today, and presented below. [2] Group 1: Scalp ACC without multiple anomalies Group 2: Scalp ACC with limb abnormalities Group 3: Scalp ACC with epidermal and organoid nevi Group 4: ACC overlying congenital malformations Group 5: ACC with associated fetus papyraceus or placental infarct Group 6: ACC with epidermolysis bullosa Group 7: ACC localized to extremities without blistering Group 8: ACC due to specific teratogens Group 9: ACC associated with malformation syndromes ACC is a rare congenital condition with an incidence of approximately 1 to 3 out of 10,000 births.[3] There is no significant gender or cultural predilection that has been reported in the literature. [4] Lesions will typically be noticed at birth, although patients may not present to be evaluated for several months as lesions are often asymptomatic. ACC can be associated with underlying morphologic abnormalities in approximately 37% of cases, according to Mesrati et al. including underlying bony defects, vascular anomalies, or neurologic malformations, so it is prudent for clinicians to evaluate the disease involvement with imaging. A midline vertex scalp lesion, hair collar sign, and vascular stains have all been shown to be strong indicators for cranial or central nervous system (CNS) involvement. Small, scalp lesions are less likely https://scientific-jl.com 2 5 5 48-son_2-to’plam_Iyul -2025 ISSN:3030-3621 Ta'lim innovatsiyasi va integratsiyasi associated with underlying defects and typically heal on their own within a couple of months; therefore, monitoring these lesions without