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BACKGROUND: Following the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multidisciplinary setting. It has confirmed recognition in well-known documented conditions such as graft-vs.-host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease. MATERIALS AND METHODS: In order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added. RESULTS AND CONCLUSION: These updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines were divided into two parts: PART I covers Cutaneous T-cell lymphoma, chronic graft-vs.-host disease and acute graft-vs.-host disease, while PART II will cover scleroderma, solid organ transplantation, Crohn's disease, use of ECP in paediatric patients, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.

Článek

Analysis of extracorporeal photopheresis within the frame of the WAA register

Transfusion and apheresis science. 2021 ; 60 (5) : 103172. [pub] 20210527

Transfus Apher Sci
ISSN 1473-0502
Medvik
Zdroj

The aim of the study was to investigate safety and if extracorporeal photopheresis (ECP) may change health criteria (HC) and quality of life (QoL).MATERIAL AND METHOD: 560 patients (33 % women) were treated with ECP for a total of 13,871 procedures during a 17-years period. Mean age was 48 years (±18, range 3-81 years). Self-estimation of QoL was graded: 0 (suicidal) up to 10 (best ever) and HC: 0 (Bed ridden, ICU condition) up to 10 (athletic). Adverse events were analyzed. ANOVA and paired comparisons were performed. RESULTS: Patients were treated due to graft versus host disease (GVHD, n = 317), skin lymphoma (n = 70), solid organ transplants (n = 47), skin diseases (n = 20) and other diseases (n = 106). Adverse events (AEs) were registered in 5.4 % of the first treatments and in 1.2 % of the subsequent procedures. Severe AEs were present in 0.04 % of all procedures. No patient died due to the procedure. Tingling and stitching were the most common AE. For those with GVHD an improvement was noticed within approximately 10 procedures of ECP in the severity stage, QoL (from a mean of 6.1 to 6.8, p < 0.002) and the HC (6.1 -> 6.4, p < 0.014) and improved further with added procedures. CONCLUSION: Photopheresis is an established therapy with few side effects. The present study of soft variables indicate that GVHD shows benefits upon ECP within approximately 10 procedures in regard to the severity of mainly skin GVHD, and lower baseline levels of HC and QoL.

MeSH
chronická nemoc MeSH
dítě MeSH
dospělí MeSH
fotoferéza metody MeSH
hemodynamika MeSH
kvalita života MeSH
lidé středního věku MeSH
lidé MeSH
lymfom psychologie terapie MeSH
mladiství MeSH
mladý dospělý MeSH
nádory kůže psychologie terapie MeSH
nemoc štěpu proti hostiteli psychologie terapie MeSH
předškolní dítě MeSH
registrace MeSH
retrospektivní studie MeSH
senioři nad 80 let MeSH
senioři MeSH
Check Tag
dítě MeSH
dospělí MeSH
lidé středního věku MeSH
lidé MeSH
mladiství MeSH
mladý dospělý MeSH
mužské pohlaví MeSH
předškolní dítě MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Článek

Využití kombinované terapie u pacientky s mycosis fungoides
[Combined treatment of mycosis fungoides – case report]

Fialová, Petra
Autor Autorita I. dermatovenerologická klinika FN u sv. Anny v Brně a LF MU Masarykův onkologický ústav, Brno

Referátový výběr z dermatovenerologie (2002, Print). 2021 ; 63 (4) : 36-44.

ISSN 1213-9106
Medvik
Zdroj

Primární kožní lymfomy (PCL, primary cutaneous lymphomas) jsou nehodgkinské lymfomy, pro které je charakteristická přítomnost maligních T nebo B buněk v kůži. Nejčastějším typem PCL je mycosis fungoides (MF). Typicky má onemocnění mnohaletý vývoj, ve kterém rozlišujeme stadium skvrn, plaků a tumorů. V pokročilých stadiích choroby může dojít k šíření maligních buněk z kůže do lymfatických uzlin, vnitřních orgánů nebo periferní krve. Zásadní pro stanovení diagnózy MF je klinický obraz a histologické vyšetření. Léčebné možnosti u pacientů s mycosis fungoides lze rozdělit na terapii cílenou na kůži (SDT, skin directed therapy) a systémovou léčbu. V kazuistice pacientky sledované pro mycosis fungoides je popsán průběh onemocnění a využití léčebných metod a jejich kombinací.

Primary cutaneous lymphomas (PCL) are non-hodgkin lymphomas which are characterised by presence of malignant T-cells or B-cells in the skin. The disease has typically long-term development, where we differentiate three clinical stages – patches, plaques and tumours. In advanced stages of the disease malignant cells can spread from skin to lymphatic nodes, visceral organs or peripheral blood. MF diagnosis is established through clinical picture and crucially through histology. Treatment modalities of patients with MF can be divided into skin directed therapy (SDT) and systemic treatment. The case report of female patient with mycosis fungoides descri- bes the course of disease and use of treatment modalities and their combinations.

MeSH
aplikace kožní MeSH
bexaroten aplikace a dávkování MeSH
celotělové ozáření metody MeSH
diferenciální diagnóza MeSH
glukokortikoidy terapeutické užití MeSH
klobetasol terapeutické užití MeSH
kombinovaná farmakoterapie MeSH
lidé středního věku MeSH
lidé MeSH
mycosis fungoides * farmakoterapie klasifikace patologie MeSH
PUVA terapie metody MeSH
retinoidy terapeutické užití MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
ženské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek online

Variation of selected genotoxic and epigenetic markers due to therapeutic exposure to PAHs and ultraviolet radiation

Bratislavské lekárske listy. 2020 ; 121 (8) : 558-564.

ISSN 0006-9248
Medvik
Zdroj

BACKGROUND: Goeckerman therapy (GT) of psoriasis involves dermal application of crude coal tar containing polycyclic aromatic hydrocarbons (PAHs) and exposure to ultraviolet radiation (UVR). Little is known about GT influence on DNA epigenetics. OBJECTIVE: The study aim was to discover epigenetic mechanisms altered by the exposure related to the GT of psoriasis. METHODS: Observed group of patients with plaque psoriasis (n = 23) was treated by GT with 3 % CCT. Before and after GT, we analyzed the levels of benzo[a]pyrene-7,8-diol-9,10-epoxide-DNA adducts (BPDE-DNA), p53 protein in serum, 5-methylcytosine (5-mC, global DNA methylation), and methylation in selected CpG sites of p53 gene. RESULTS: We found a significant increase in the levels of BPDE-DNA (p < 0.01) and serum levels of p53 protein (p < 0.01) after GT, and an insignificant decrease in the percentage of 5-mC in peripheral blood DNA. Methylation of p53 CpG sites was affected neither by psoriasis nor by GT. The study confirmed good effectiveness of GT (significantly reduced psoriasis area and severity index; p < 0.001). CONCLUSION: Our findings indicate that there is a significantly increased genotoxic hazard related to the exposure of PAHs and UV radiation after GT of psoriasis. However, global DNA methylation and p53 gene methylation evade the effect of GT, as they remained unchanged (Tab. 4, Fig. 3, Ref. 50).

Klíčová slova
Goeckermanova terapie,
MeSH
5-methylcytosin krev MeSH
adukty DNA krev MeSH
dehet uhelný škodlivé účinky MeSH
dospělí MeSH
genetické markery účinky léků účinky záření MeSH
lidé MeSH
metylace DNA účinky léků účinky záření MeSH
nádorový supresorový protein p53 krev MeSH
polycyklické aromatické uhlovodíky * škodlivé účinky MeSH
psoriáza farmakoterapie komplikace radioterapie MeSH
terapie ultrafialovými paprsky * škodlivé účinky MeSH
Check Tag
dospělí MeSH
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
klinická studie MeSH
práce podpořená grantem MeSH

Článek

European dermatology forum - updated guidelines on the use of extracorporeal photopheresis 2020 - part 1

Journal of the European Academy of Dermatology and Venereology. 2020 ; 34 (12) : 2693-2716. [pub] 20201006

J Eur Acad Dermatol Venerol
ISSN 1468-3083
Medvik
Zdroj

BACKGROUND: Following the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. It has confirmed recognition in well-known documented conditions such as graft-versus-host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease. MATERIALS AND METHODS: In order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added. RESULTS AND CONCLUSION: These updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines are divided in two parts: PART I covers cutaneous T-cell lymphoma, chronic graft-versus-host disease and acute graft-versus-host disease while PART II will cover scleroderma, solid organ transplantation, Crohn's disease, use of ECP in paediatrics practice, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.