- Publikační typ
- abstrakt z konference MeSH
Transplantace krvetvorných buněk je život zachraňující výkon u celé řady hematologických nemocí. Rozvoj transplantací se datuje od začátku 70. let minulého století, po objevení HLA systému. V ÚHKT byl transplantační program zahájen v roce 1986 a do konce roku 2011 zde bylo provedeno 918 transplantací krvetvorných buněk pro různá hematologická onemocnění. Dlouhodobé přežití všech pacientů po transplantaci se pohybuje kolem 50 %, a to v rozmezí 20–90 % v závislosti na typu a pokročilosti onemocnění, na typu dárce a na věku pacienta.
Haematopoietic cell transplantation is a life-saving procedure in a number of haematological diseases. Development of transplantation dates back to 1970s, following discovery of the HLA system. The Institute of Haematology and Blood Transfusion in Prague had initiated its transplantation programme in 1986 and 918 haematopoietic cell transplantations were performed for various haematological diseases until 2011. Long-term survival of all patients after transplantation is around 50%, ranging from 20 to 90%, depending on the type of the disease and its stage, the type of a donor and the patient’s age.
- Klíčová slova
- transplantace pro těžkou aplastickou anémii, transplantace pro chronickou lymfatickou leukemii, transplantace pro myelofibrózu s myeloidní metaplazií, transplantace u non-Hodgkinských lymfomů, transplantace u akutní lymfatické leukemie, transplantace pro myelodysplastický syndrom, transplantace u chronické myeloidní leukemie, transplantace u akutní myeloidní leukemie, historie transplantace,
- MeSH
- akutní lymfatická leukemie terapie MeSH
- akutní myeloidní leukemie terapie MeSH
- analýza přežití * MeSH
- chronická lymfatická leukemie terapie MeSH
- chronická myeloidní leukemie terapie MeSH
- homologní transplantace statistika a číselné údaje MeSH
- lidé MeSH
- myelodysplastické syndromy terapie MeSH
- nehodgkinský lymfom terapie MeSH
- nemoci kostní dřeně * terapie MeSH
- primární myelofibróza terapie MeSH
- transplantace hematopoetických kmenových buněk trendy MeSH
- transplantace kostní dřeně * dějiny statistika a číselné údaje trendy MeSH
- Check Tag
- lidé MeSH
Development of highly sensitive quantitative assays for cytomegalovirus (CMV) DNA detection is crucial for identification of immunodeficient patients at high risk of CMV disease. We designed 2 internally controlled competitive quantitative assays, enzyme-linked immunosorbent assay (ELISA)-based and real-time polymerase chain reaction (PCR) tests, using amplification of the same segment of the CMV genome. The aim of this study was to compare sensitivity, specificity, and laboratory performance characteristics of these assays. In both assays, a 159-bp segment of UL83 gene was amplified. External and internal controls were constructed by cloning the amplification product and heterogenous DNA segment flanked by target sequences for CMV-derived primers into bacterial plasmids, respectively. Real-time PCR was performed on LightCycler (Roche Diagnostics, Mannheim, Germany), and amplicons were detected using fluorescence resonance energy transfer probes. Alternatively, PCR products were labeled by digoxigenin, hybridized to immobilized probes, and detected by ELISA. The assays were tested on genomic DNA isolated from laboratory strains of CMV, QCMD control panel, and CMV DNA-positive peripheral blood DNA samples from hematopoietic stem cell transplant recipients, previously characterized by pp65 antigenemia and qualitative nested PCR. Real-time and ELISA-based PCR assays showed a linear course of 1-10(8) and 10-10(5) copies of CMV DNA per reaction, respectively. When compared with ELISA-based PCR, real-time PCR showed superiority in inter- and intra-assay reproducibility. Both assays were highly specific in detecting CMV DNA. No difference in amplification efficiency of internal or external standards and wild-type CMV DNA was found. The assays exhibited 83% concordance in CMV DNA detection from clinical samples, all discrepant samples having low CMV DNA copy numbers. There was a good correlation between viral DNA loads measured by the 2 assays. Statistically significant correlation was observed between the numbers of CMV DNA copies and pp65-positive leukocytes in the samples tested. Both variants of competitive PCR are adequately sensitive to be used for CMV DNA quantitation in clinical samples. LightCycler PCR, having superior performance characteristics and being less time-consuming, seems to be more suitable for routine diagnosis.
- MeSH
- cytomegalovirové infekce diagnóza MeSH
- Cytomegalovirus genetika izolace a purifikace MeSH
- DNA virů krev MeSH
- ELISA metody MeSH
- fosfoproteiny imunologie krev MeSH
- lidé MeSH
- polymerázová řetězová reakce metody přístrojové vybavení MeSH
- proteiny virové matrix imunologie krev MeSH
- senzitivita a specificita MeSH
- transplantace hematopoetických kmenových buněk MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- validační studie MeSH
Morphological examination is the routine first step in the diagnosis of hematological malignancies, including chronic lymphocytic leukemia (CLL). Atypical cell morphology according to the FAB criteria is known to herald disease progression. Several years ago, it was proposed that FAB morphology at diagnosis had a considerable prognostic impact. However, this proposal has not been widely adopted in practice. Thus we questioned the prognostic value of the morphological examination, which was performed retrospectively in 88 patients out of our 110 institutional registry patients (70 males and 40 females, median age 57 yrs) with CLL at diagnosis. We related the results to the more modern prognostic markers. Atypical FAB morphology was shown to correlate with IgVH gene mutation status, trisomy of chromosome 12 and deletion of 17p detected either by conventional G-banding or by fluorescence in situ hybridization (FISH) analysis. The correlation of FAB morphology with CD38 antigen expression or with the histopathological pattern of bone marrow infiltration was not significant. Overall survival (OS) data were available for 84 morphologically examined patients. The patients with atypical morphology (64 patients) had a significantly shorter OS (103 months) than the 20 patients presenting with typical CLL morphology (237 months; p=0.03). Only the mutation status of IgVH genes correlated more closely with OS (p=0.002). Of note, there was no leukemia-related death within "unmutated" cases who had typical FAB morphology (p=0.14), and vice versa, the mutation status had a significant prognostic impact within the morphologically atypical cases (p=0.01). Thus FAB morphology and the mutation status may yield complementary prognostic information. OS was affected both by the presence of cytogenetic aberrations (p=0.03) - most adversely by deletions of 17p and 11q, and by CD38 expression (p=0.003). We conclude that careful examination of peripheral blood smears according to FAB is a simple, cheap and valuable tool in the first-line assessment of prognosis of CLL patients and should not be overlooked even in 3rd millennium when more sophisticated prognostic markers are at hand. This ought to be confirmed in larger prospective studies with multivariate analysis of data.
- MeSH
- antigeny CD38 MeSH
- chronická lymfatická leukemie genetika mortalita patologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace * MeSH
- počet leukocytů MeSH
- prognóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- těžké řetězce imunoglobulinů * genetika MeSH
- variabilní oblast imunoglobulinu * genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
Telomere length was evaluated by terminal repeat fragment method (TRF) in 50 patients with myelodysplastic syndromes (MDS) and acute myelogenous leukemia (AML) arising from MDS and in 21 patients with untreated primary AML to ascertain, whether telomere erosion was associated with progression of MDS towards overt leukemia. Heterogeneity of TRF among MDS FAB subgroups (P=0.004) originated from its shortening in increased number of patients during progression of the disease. Chromosomal aberrations were present in 32% MDS patients with more eroded telomeres (P=0.022), nevertheless a difference between mean TRF in the subgroups with normal and abnormal karyotype diminished during progression of MDS. A negative correlation between individual TRF and IPSS value (P=0.039) showed that telomere dynamics might serve as a useful prognostic factor for assessment of an individual MDS patient's risk and for decision of an optimal treatment strategy.
- MeSH
- akutní myeloidní leukemie * diagnóza genetika MeSH
- chromozomální aberace MeSH
- dítě MeSH
- dospělí MeSH
- karyotypizace MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- myelodysplastické syndromy * diagnóza MeSH
- nádorové biomarkery * genetika MeSH
- nestabilita genomu * MeSH
- prognóza MeSH
- progrese nemoci MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- telomery * genetika MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
