PURPOSE: The AIEOP-BFM ALL 2009 protocol included, at the end of the induction phase, a randomized study of patients with high-risk (HR) ALL to investigate if an intensive exposure to pegylated L-asparaginase (PEG-ASNASE, 2,500 IU/sqm once a week × 4) on top of BFM consolidation phase IB allowed us to decrease minimal residual disease (MRD) and improve outcome. PATIENTS AND METHODS: A total of 1,097 patients presented, from June 2010 to February 2017, with one or more of the following HR criteria: KMT2A::AFF1 rearrangement, hypodiploidy, prednisone poor response, poor bone marrow response at day 15 (Flow MRD ≥10%), or no complete remission (CR) at the end of induction. Of them, 809 (85.1%) were randomly assigned to receive (404) or not receive (405) four weekly doses of PEG-ASNASE. RESULTS: By intention to treat (ITT) analysis, there was no significant difference in the proportion of patients with polimerase chain reaction MRD ≥5 × 10-4 at the end of phase IB in the experimental versus control arm (13.9% v 17.0%, P = .25). The 5-year event-free survival (median follow-up 6.3 years) by ITT in the experimental and control arms was 70.4% (2.3) versus 75.0% (2.2; P = .18), and the 5-year overall survival was 81.5% (2.0) versus 84.0% (1.9; P = .25), respectively. The corresponding 5-year cumulative incidence of death in CR was 9.5% (1.5) versus 5.7% (1.2; P = .08), and that of relapse was 17.7% (1.9) versus 17.2% (1.9), respectively (P = .94). Adverse reactions in phase IB occurred in 22.2% and 8.9% of patients in the experimental and control arm, respectively (P < .001). CONCLUSION: Additional PEG-ASNASE in phase IB did not translate into a benefit for decreasing relapse incidence but was associated with higher toxicity. Further improvements with conventional chemotherapy might be difficult in the context of intensive treatment protocols.

• MeSH
• akutní lymfatická leukemie * MeSH
• asparaginasa * MeSH
• kojenec MeSH
• lidé MeSH
• lokální recidiva nádoru farmakoterapie   MeSH
• polyethylenglykoly MeSH
• prednison škodlivé účinky   MeSH
• přežití po terapii bez příznaků nemoci MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   MeSH
• randomizované kontrolované studie jako téma MeSH
• recidiva MeSH
• výsledek terapie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• protokol klinické studie MeSH

BACKGROUND AND OBJECTIVES: Vamorolone is a dissociative agonist of the glucocorticoid receptor that has shown similar efficacy and reduced safety concerns in comparison with prednisone in Duchenne muscular dystrophy (DMD). This study was conducted to determine the efficacy and safety of vamorolone over 48 weeks and to study crossover participants (prednisone to vamorolone; placebo to vamorolone). METHODS: A randomized, double-blind, placebo-controlled and prednisone-controlled clinical trial of 2 doses of vamorolone was conducted in participants with DMD, in the ages from 4 years to younger than 7 years at baseline. The interventions were 2 mg/kg/d of vamorolone and 6 mg/kg/d of vamorolone for 48 weeks (period 1: 24 weeks + period 2: 24 weeks) and 0.75 mg/kg/d of prednisone and placebo for the first 24 weeks (before crossover). Efficacy was evaluated through gross motor outcomes and safety through adverse events, growth velocity, body mass index (BMI), and bone turnover biomarkers. This analysis focused on period 2. RESULTS: A total of 121 participants with DMD were randomized. Vamorolone at a dose of 6 mg/kg/d showed maintenance of improvement for all motor outcomes to week 48 (e.g., for primary outcome, time to stand from supine [TTSTAND] velocity, week 24 least squares mean [LSM] [SE] 0.052 [0.0130] rises/s vs week 48 LSM [SE] 0.0446 [0.0138]). After 48 weeks, vamorolone at a dose of 2 mg/kg/d showed similar improvements as 6 mg/kg/d for North Star Ambulatory Assessment (NSAA) (vamorolone 6 mg/kg/d-vamorolone 2 mg/kg/d LSM [SE] 0.49 [1.14]; 95% CI -1.80 to 2.78, p = 0.67), but less improvement for other motor outcomes. The placebo to vamorolone 6 mg/kg/d group showed rapid improvements after 20 weeks of treatment approaching benefit seen with 48-week 6 mg/kg/d of vamorolone treatment for TTSTAND, time to run/walk 10 m, and NSAA. There was significant improvement in linear growth after crossover in the prednisone to vamorolone 6 mg/kg/d group, and rapid reversal of prednisone-induced decline in bone turnover biomarkers in both crossover groups. There was an increase in BMI after 24 weeks of treatment that then stabilized for both vamorolone groups. DISCUSSION: Improvements of motor outcomes seen with 6 mg/kg/d of vamorolone at 24 weeks of treatment were maintained to 48 weeks of treatment. Vamorolone at a dose of 6 mg/kg/d showed better maintenance of effect compared with vamorolone at a dose of 2 mg/kg/d for most (3/5) motor outcomes. Bone morbidities of prednisone (stunting of growth and declines in serum bone biomarkers) were reversed when treatment transitioned to vamorolone. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT03439670. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for boys with DMD, the efficacy of vamorolone at a dose of 6 mg/kg/d was maintained over 48 weeks.

• MeSH
• biologické markery MeSH
• dítě MeSH
• Duchennova muskulární dystrofie * farmakoterapie   MeSH
• lidé MeSH
• prednison škodlivé účinky   MeSH
• předškolní dítě MeSH
• pregnadiendioly * škodlivé účinky   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Idiopatická retroperitoneální fibróza je vzácné onemocnění charakterizované rozvojem fibroinflamatorních infiltrátů v periaortální a periiliakální oblasti s výraznou fibrózou. Aberantní tkáň obvykle obklopuje infrarenální abdominální aorty, dolní dutou žílu a iliakální cévy. Tento proces se může šířit do okolí a často zachytit uretery. Zavzetí ureteru do těchto fibrózních hmot způsobuje poruchu drenáže ledviny s rozvojem obstrukční uropatie a renálního selhání. Častým příznakem této nemoci jsou bolesti v bederní oblasti, břišní bolesti. Bolesti jsou často pociťovány v oblasti třísla a mohou vyzařovat do laterální strany stehna, často se zhoršují v noci a nejsou ovlivnitelné změnou polohy. Chorobu často provázejí projevy systémové zánětlivé odpovědi (patologická únava, horečka, anorexie a úbytek hmotnosti). Popisovaný 56letý pacient uváděl zprvu bolesti v bederní krajině, které byly mylně interpretovány jako vertebrogenní. Později se objevily také bolesti v oblasti pravého hypogastria s vyzařováním do třísla kolikovitého charakteru, které vzbu- dily podezření na ledvinovou koliku, a vedly k odeslání na urologii. Urologové zjištěnou hydronefrózu vyřešili JJ stentem a odebrali histologii s průkazem retroperitoneální fibrózy se znaky onemocnění asociovaného s IgG4 (IgG4 related disease – IgG4-RD). Léčba byla zahájena prednisonem v dávce 1 mg/kg. Uvedenou dávku však pacient netoleroval, a tak jsme přešli na kombinovanou léčbu a podali anti -CD20 monoklonální protilátku, rituximab 375 mg/m2 den 1, cyklofosfamid 300 mg/m2 den 1 a 15 a dexametazon 20 mg, celková dávka v infuzi 1. a 15. den dvacetiosmidenního cyklu. Ve čtvrtém měsíci léčby kontrolní FDG -PET/CT zobrazení prokázalo přetrvávající reziduální aktivitu v retroperitoneálním ložisku, a proto jsme léčbu prodloužili na 8 měsíců. Subjektivní potíže při ukončení léčby již téměř vymizely a vývoj ložiska budeme sledovat metodou FDG -PET/CT. Poté navázala udržovací léčba rituximabem v 6měsíčních intervalech. Základem léčby retroperitoneální fibrózy jsou glukokortikoidy. Onemocnění je ale také léčitelné imunosupresivy (cyk- lofosfamid, azathioprin, metotrexát, mykofenolát mofetil) a také biologickou léčbou (rituximab, tocilizumab infliximab a nejnověji sirolimus). Účinek těchto léků byl popsán formou popisů případů či malých souborů pacientů. Tyto léky umožní snížit kumulativní dávku glukokortikoidů a jejich nežádoucí účinky. A proto jsme u našeho pacienta použili tento způsob léčby s nižší kumulativní dávkou glukokortikoidů, a tedy i menšími nežádoucími účinky. Kombinovaná léčba je vhodná pro všechny pacienty, u nichž je léčba glukokortikoidy spojena s intenzivními nežádoucími účinky anebo samotná gluko- kortikoidní léčba nevede k ústupu nemoci.

Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by the development of a peri-aortic and peri-iliac tissue showing chronic inflammatory infiltrates and pronounced fibrosis. Ureteral entrapment with consequent obstructive uropathy is one of the most common complications, which can lead to acute renal failure and, in the long term, to varying degrees of chronic kidney disease. Common symptoms at onset include lower back, abdominal or flank pain, and constitutional symptoms such as malaise, fever, and anorexia and weight loss. Pain is frequently referred to the hip, to the groin and to the lateral regions of the leg, with nocturnal exacerbations, and typically does not modify with position. We report a case of 56 year-old male with recurrent lower back pain and lower abdominal pain. Contrast-enhanced computed tomography and was suggestive of retroperitoneal fibrosis and unilateral ureteral occlusion. Histologic examination with immunohistochemical staining for IgG4 demonstrate IgG4-related retroperitoneal fibrosis. Therapy was started with prednison 1 mg/kg, but the tolerance of this dose was poor. Therefore the therapy was switched to combination of rituximab 375 mg/m2 on day 1, cyclophosphamide 300 mg/m2 mg infusion and dexamethasone 20 mg total dose infusion on day 1 and 15 in 28 days cycle. FDG-PET/CT control in fourth month showed residual accumulation of FDG in retroperitoneal fibrotic mass, and therefore the therapy was prolonged to 8 month. The subjective symptoms of this diseases disappeared in the 8th month. Then the maintenance therapy, administration of rituximab in 6 month interval, was started. The activity of this disease be further evaluated by FDG-PET/CT imagination. Glucocorticoids are considered the cornerstone of therapy. The use of other immunosuppressive agents, including cyclophosphamide, azathioprine, methotrexate, mycophenolate mofetil and biological agents such as rituximab, tocilizumab and infliximab and sirolimus have been reported as a valuable option mostly in case reports, cases series and small studies. This agents allowed to reduce cumulative dose of glucocorticoids and its adverse effects. Therefore in our patients we preferred combination of rituximab cyclophosphamide s dexamethasone with lover dose of prednisonem. This combination is preferable for patients who cannot tolerate glucocorticoids or who are likely to suffer from significant glucocorticoids -related toxicity.

• MeSH
• cyklofosfamid aplikace a dávkování   terapeutické užití   MeSH
• dexamethason aplikace a dávkování   terapeutické užití   MeSH
• diagnostické zobrazování metody   MeSH
• glukokortikoidy aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• IgG4 asociovaná nemoc diagnóza   patofyziologie   terapie   MeSH
• imunosupresivní léčba metody   MeSH
• kombinovaná farmakoterapie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• PET/CT metody   MeSH
• prednison aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• retroperitoneální fibróza * diagnóza   farmakoterapie   komplikace   patofyziologie   MeSH
• rituximab aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• biopsie metody   MeSH
• dospělí MeSH
• granulomatózní mastitida * diagnóza   patologie   terapie   MeSH
• histologické techniky MeSH
• lidé MeSH
• mamografie metody   MeSH
• prednison aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• ultrasonografie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Anti-CD19 immunotherapy tafasitamab is used in combination with lenalidomide in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) who are ineligible for autologous stem cell transplant. Open-label, phase 1b, First-MIND study assessed safety and preliminary efficacy of tafasitamab + R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) ± lenalidomide as first-line therapy in patients with DLBCL. From December 2019 to August 2020, 83 adults with untreated DLBCL (International Prognostic Index 2-5) were screened and 66 were randomly assigned (33 per arm) to R-CHOP-tafasitamab (arm T) or R-CHOP-tafasitamab-lenalidomide (arm T/L) for 6 cycles. Primary end point was safety; secondary end points included end-of-treatment (EoT) overall response rate (ORR) and complete response (CR) rate. All patients had ≥1 treatment-emergent adverse event, mostly grade 1 or 2. Grade ≥3 neutropenia and thrombocytopenia occurred, respectively, in 57.6% and 12.1% (arm T) and 84.8% and 36.4% (arm T/L) of patients. Nonhematologic toxicities occurred at similar rates among arms. R-CHOP mean relative dose intensity was ≥89% in both arms. EoT ORR was 75.8% (CR 72.7%) in arm T and 81.8% (CR 66.7%) in arm T/L; best ORR across visits was 90.0% and 93.9%. Eighteen-month duration of response and of CR rates were 72.7% and 74.5% (arm T) and 78.7% and 86.5% (arm T/L); 24-month progression-free and overall survival rates were 72.7% and 90.3% (arm T) and 76.8% and 93.8% (arm T/L). Manageable safety and promising signals of efficacy were observed in both arms. Potential benefit of adding tafasitamab + lenalidomide to R-CHOP is being investigated in phase 3 frontMIND (NCT04824092). This study is registered at www.clinicaltrials.gov as #NCT04134936.

• MeSH
• cyklofosfamid škodlivé účinky   MeSH
• difúzní velkobuněčný B-lymfom * patologie   MeSH
• dospělí MeSH
• doxorubicin škodlivé účinky   MeSH
• lenalidomid terapeutické užití   MeSH
• lidé MeSH
• myší monoklonální protilátky škodlivé účinky   MeSH
• prednison škodlivé účinky   MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   MeSH
• rituximab škodlivé účinky   MeSH
• vinkristin škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze I MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is typically treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, only 60% of patients are cured with R-CHOP. Polatuzumab vedotin is an antibody-drug conjugate targeting CD79b, which is ubiquitously expressed on the surface of malignant B cells. METHODS: We conducted a double-blind, placebo-controlled, international phase 3 trial to evaluate a modified regimen of R-CHOP (pola-R-CHP), in which vincristine was replaced with polatuzumab vedotin, as compared with standard R-CHOP, in patients with previously untreated intermediate-risk or high-risk DLBCL. Patients 18 to 80 years of age were randomly assigned in a 1:1 ratio to receive six cycles of either pola-R-CHP or R-CHOP, plus two cycles of rituximab alone. The primary end point was investigator-assessed progression-free survival. Secondary end points included overall survival and safety. RESULTS: Overall, 879 patients underwent randomization: 440 were assigned to the pola-R-CHP group and 439 to the R-CHOP group. After a median follow-up of 28.2 months, the percentage of patients surviving without progression was significantly higher in the pola-R-CHP group than in the R-CHOP group (76.7% [95% confidence interval (CI), 72.7 to 80.8] vs. 70.2% [95% CI, 65.8 to 74.6] at 2 years; stratified hazard ratio for progression, relapse, or death, 0.73 by Cox regression; 95% CI, 0.57 to 0.95; P = 0.02). Overall survival at 2 years did not differ significantly between the groups (88.7% [95% CI, 85.7 to 91.6] in the pola-R-CHP group and 88.6% [95% CI, 85.6 to 91.6] in the R-CHOP group; hazard ratio for death, 0.94; 95% CI, 0.65 to 1.37; P = 0.75). The safety profile was similar in the two groups. CONCLUSIONS: Among patients with previously untreated intermediate-risk or high-risk DLBCL, the risk of disease progression, relapse, or death was lower among those who received pola-R-CHP than among those who received R-CHOP. (Funded by F. Hoffmann-La Roche/Genentech; POLARIX ClinicalTrials.gov number, NCT03274492.).

• MeSH
• cyklofosfamid škodlivé účinky   terapeutické užití   MeSH
• difúzní velkobuněčný B-lymfom farmakoterapie   mortalita   MeSH
• doba přežití bez progrese choroby MeSH
• dospělí MeSH
• doxorubicin škodlivé účinky   terapeutické užití   MeSH
• dvojitá slepá metoda MeSH
• imunokonjugáty aplikace a dávkování   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• monoklonální protilátky aplikace a dávkování   škodlivé účinky   MeSH
• prednison škodlivé účinky   terapeutické užití   MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   terapeutické užití   MeSH
• rituximab škodlivé účinky   terapeutické užití   MeSH
• senioři MeSH
• vinkristin škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

CONTEXT: R-CHOP is the standard of care for newly diagnosed DLBCL patients; however, 40% remain uncured. Polatuzumab vedotin (Pola), a CD79b-targeting antibody-drug conjugate, has shown promising activity/safety in a Phase Ib/II study (Tilly, et al. Lancet Oncol 2019). We report the Phase III double-blind, placebo-controlled, international POLARIX study (NCT03274492), which compared Pola-R-CHP with R-CHOP in treatment-naïve DLBCL patients with an International Prognostic Index score of 2-5. DESIGN: Patients were randomized (1:1) to six cycles of Pola-R-CHP or R-CHOP and on Day 1 of each cycle received Pola 1.8mg/kg or vincristine 1.4mg/m2, plus intravenous rituximab 375mg/m2, cyclophosphamide 750mg/m2, and doxorubicin 50mg/m2. Patients also received oral prednisone 100mg once daily (Days 1-5) and two further cycles of rituximab. The primary endpoint was investigator-assessed progression-free survival (PFS). RESULTS: Overall, 879 patients (median age 65 [range 19-80] years) were randomized (Pola-R-CHP: n=440; R-CHOP: n=439). At primary data cut-off (28 June 2021), median follow-up was 28.2 months. PFS was superior with Pola-R-CHP vs R-CHOP (hazard ratio [HR] 0.73; 95% confidence interval [CI]: 0.57-0.95; P=0.02) and 2-year PFS rate was improved (76.7% [95% CI: 72.7-80.8] vs 70.2% [95% CI: 65.8-74.6], respectively). Investigator-assessed event-free survival favored Pola-R-CHP vs R-CHOP (HR 0.75; 95% CI: 0.58-0.96; P=0.02) and overall survival was comparable (HR 0.94; 95% CI: 0.65-1.37; P=0.75). While independent review committee-assessed end-of-treatment complete response rate by positron emission tomography-computed tomography was not significantly different with Pola-R-CHP (78.0%) vs R-CHOP (74.0%; P=0.16), disease-free survival suggested more durable responses with Pola-R-CHP vs R-CHOP (HR 0.70; 95% CI: 0.50-0.98). Safety profiles were similar for Pola-R-CHP vs R-CHOP: grade 3-4 adverse event (AE) rates, 57.7% vs 57.5%, respectively; serious AEs, 34.0% vs 30.6%; grade 5 AEs, 3.0% vs 2.3%; AEs leading to dose reduction, 9.2% vs 13.0%; and peripheral neuropathy, any grade, 52.9% vs 53.9%. At data cut-off, fewer patients treated with Pola-R-CHP (23%) vs R-CHOP (30%) had received ≥1 subsequent anti-lymphoma therapy. CONCLUSIONS: As the first-line treatment of DLBCL, Pola-R-CHP demonstrated a 27% reduction in the relative risk of disease progression, relapse, or death, and a similar safety profile, compared with R-CHOP.

• MeSH
• cyklofosfamid škodlivé účinky   MeSH
• difúzní velkobuněčný B-lymfom * terapie   MeSH
• dospělí MeSH
• doxorubicin škodlivé účinky   MeSH
• imunokonjugáty * škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru farmakoterapie   MeSH
• mladý dospělý MeSH
• monoklonální protilátky MeSH
• prednison škodlivé účinky   MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   MeSH
• rituximab terapeutické užití   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vinkristin škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas, the majority of which have high relapse rates following standard therapy. Despite use of consolidative stem cell transplant (SCT) following frontline therapy, there remains no consensus on its utility. The double-blind randomized phase 3 ECHELON-2 study (#NCT01777152; clinicaltrials.gov) demonstrated improved progression-free survival (PFS) and overall survival with frontline brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP). Herein, we conducted an exploratory subgroups analysis of the impact of consolidative SCT on PFS in patients with previously untreated CD30+ PTCL (ALK- anaplastic large cell lymphoma [ALCL] and non-ALCL) who were in complete response (CR) after frontline treatment with A+CHP or cyclophosphamide, doxorubicin, vincristine, and prednisone. Median PFS follow-up was 47.57 months. The PFS hazard ratio was 0.36, equating to a 64% reduction in the risk of a PFS event in patients who underwent SCT. The median PFS in patients who underwent SCT was not reached, vs 55.66 months in patients who did not undergo SCT. PFS results favored the use of SCT in both ALK- ALCL and non-ALCL subgroups. These data support the consideration of consolidative SCT in patients with CD30+PTCL who achieve CR following treatment with A+CHP.

• MeSH
• anaplastický velkobuněčný lymfom * chemicky indukované   terapie   MeSH
• antigen Ki-1 MeSH
• brentuximab vedotin MeSH
• cyklofosfamid škodlivé účinky   MeSH
• doxorubicin škodlivé účinky   MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• prednison škodlivé účinky   MeSH
• transplantace hematopoetických kmenových buněk * MeSH
• vinkristin škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Research Support, N.I.H., Extramural MeSH

• MeSH
• doping ve sportu * prevence a kontrola   MeSH
• ekdysteron analogy a deriváty   MeSH
• léky rostlinné čínské analýza   MeSH
• lidé MeSH
• plazmaferéza škodlivé účinky   MeSH
• potravní doplňky analýza   škodlivé účinky   MeSH
• prednison škodlivé účinky   terapeutické užití   MeSH
• tradiční čínská medicína MeSH
• Check Tag
• lidé MeSH

Sarkoidóza je systémové onemocnění neznámé etiologie, které je charakterizováno tvorbou nekaseifikujících granulomů. Nejčastěji postihuje nitrohrudní uzliny a plicní tkáň, ale může se projevit téměř ve všech orgánech. Asi u třetiny nemocných sarkoidóza probíhá asymptomaticky a spontánní zhojení plicní sarkoidózy lze očekávat v 50-60 %. Pokud ale ke spontánní remisi nedochází, pacient je symptomatický a dochází k poklesu plicních funkcí, je indikována léčba. Od 50. let 20. století jsou stále lékem první linie kortikoidy. Ve druhé linii se uplatňují další imunosupresiva, hlavně methotrexát, a ve třetí linii biologická léčba. Cílem léčby je zabránit přechodu onemocnění do vyšších stadií, snížit nemocnost, zachovat a/nebo zlepšit kvalitu života nemocného.

Sarcoidosis is a multisystem inflammatory disease of unknown etiology. It is characterized by the presence of noncaseating granulomas. The lungs and lymphatic system are most often affected, but sarcoidosis may affect any organ. Almost one third of patients with pulmonary sarcoidosis are asymptomatic and spontaneous remission occurs in 50-60% of patients. The indications for the treatment of sarcoidosis are pulmonary symptoms and reduced lung function. Since the beginning of the 1950s, corticosteroids have been used in the first line of treatment of sarcoidosis. The second-line treatment is other immunosuppressive medication mainly methotrexate. Biologicals have gained a place as third-line therapy in sarcoidosis. The goals of sarcoidosis management are to prevent or control organ damage, relieve symptoms, and improve the patient's quality of life.

• MeSH
• diagnostické zobrazování MeSH
• infliximab terapeutické užití   MeSH
• kombinace léků trimethoprim a sulfamethoxazol terapeutické užití   MeSH
• lidé MeSH
• methotrexát škodlivé účinky   terapeutické užití   MeSH
• plicní sarkoidóza farmakoterapie   MeSH
• prednison škodlivé účinky   terapeutické užití   MeSH
• sarkoidóza diagnóza   farmakoterapie   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH