K hodnocení léčebné odpovědi u pacientů s mnohočetným myelomem slouží sledování přítomnosti monoklonálního proteinu pomocí rutinně používaných laboratorních metod, jako je elektroforéza a elektroforéza s následnou imunofixací. V posledních letech jsou při léčbě těchto pacientů používány monoklonální protilátky. První takovou protilátkou, schválenou v terapii nemoci, byl daratumumab. Již během testování a jeho následného použití v léčbě pacientů vyšly najevo problémy při laboratorních vyšetřeních, zejména při stanovení monoklonálního proteinu pomocí elektroforetických metod, kdy může dojít k potížím při hodnocení léčebné odpovědi. V tomto sdělení jsou stručně popsány mechanismy účinku terapeutických monoklonálních protilátek a jejich možné interference při stanovení přítomnosti monoklonálního proteinu pomocí elektroforetických metod a jejich praktické řešení.
Monitoring of the presence of monoclonal protein, using routinely used laboratory methods such as electrophoresis and electrophoresis followed by immunofixation, serves to evaluate the treatment response in patients with multiple myeloma. In recent years monoclonal antibodies have been used in the treatment of patients with this disease. The first monoclonal antibody approved in therapy was daratumumab. Already during the testing and its subsequent use in the treatment of patients, problems in laboratory examinations, especially in the determination of monoclonal protein using electrophoretic methods, were revealed, which may cause difficulties in the evaluation of the treatment response. This article describes briefly the mechanisms of action of therapeutic monoclonal antibodies and their possible interference in determining the presence of a monoclonal protein using electrophoretic methods and their practical solution.
BACKGROUND: A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study. METHODS: A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions - Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) - or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. DISCUSSION: This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.
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- antitumorózní látky škodlivé účinky MeSH
- dyslipidemie klasifikace komplikace prevence a kontrola MeSH
- lidé MeSH
- metabolické vedlejší účinky léčivých látek * klasifikace škodlivé účinky MeSH
- porucha glukózové tolerance chemicky indukované prevence a kontrola MeSH
- přežívající onkologičtí pacienti MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
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- lidé MeSH
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- přehledy MeSH
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