Aim. To comprehensively assess the degree of infiltration of the bone marrow, liver, spleen, and lymph nodes by pathological lymphocytes, as well as the functional state of the kidneys in patients with chronic lymphocytic leukemia using scintigraphic methods.

Materials and methods. 40 patients with a verified diagnosis of В-CLL aged 36 to 75 years (mean age 58.3±8.7 years) were examined from 2018 to 2024. Radionuclide studies were conducted in the radionuclide department of Kyiv City Clinical Hospital No. 18, which is located on the basis of the Department of Radiology and Radiation Medicine of the O.O. Bogomolets National Medical University in cooperation with the hematology department of the state institution “Institute of Hematology and Transfusiology of the National Academy of Medical Sciences of Ukraine”.The following were performed: multi-target osteoscintigraphy with the radiopharmaceutical (RPP) 99mTc-MDP (methylenediphosphonic acid) with an activity of 370-740 MBq to assess the degree of bone marrow infiltration by lymphocytes and parallel determination of kidney function; as well as hepato-spleno-scintigraphy with RFP 99ᵐTc-sulfur colloid to determine the functional state of these organs a week later.Radionuclide studies were performed on a scintillation gamma camera SPECT-1 “AMCRIS-H Limited” (Ukrainian-American Enterprise), with computer software “Spect Work” (Ukraine). The methods did not require special preparation of patients.

Results. The use of 99mTc-MDP radiotracer with osteo- and nephrotropic kinetics allowed us to sequentially perform dynamic renoscintigraphy first, followed by osteoscintigraphy (OSG) 3 hours later. This made it possible to assess the degree of impairment of the filtration and excretory capacity of the kidneys and to determine secondary bone marrow involvement in В-CLL. In 82.5 % of patients, bone marrow infiltration by lymphocytes of varying severity was detected: moderate was observed in 37.5 %, and severe – in 45 % of patients. A decrease in the filtration and excretory capacity of the kidneys was observed in 35.5 % of patients. Functional disorders of the liver were recorded in 67.5 % of the examined, and changes in spleen function – in 75% of patients.A direct correlation was established between the degree of bone marrow infiltration and functional changes in the liver and spleen (r = 0.73, p < 0.001).

Conclusions. The use of 2 scintigraphic methods allows to assess the functional state of 4 target organs in B-CLL: bone marrow, kidneys, liver and spleen. Multi-target scintigraphy using phosphate compounds labeled with ⁹⁹ᵐTc provides simultaneous examination of the skeleton to detect secondary bone lesions and kidney function. This reduces the radiation exposure of the patient and provides a certain economic benefit. Strong correlations between the degree of bone marrow infiltration by pathological lymphocytes and functional changes in the liver and spleen confirm the systemic nature of the pathological process. Scintigraphic studies can be used to monitor the results of therapy, predict the course of the disease, and optimize treatment tactics in patients with B-CLL.

Keywords: chronic lymphocytic leukemia, multi-target osteoscintigraphy, hepato-splenoscintigraphy, dynamic renoscintigraphy, target organs.