BACKGROUND: Peripheral blood stem cells are the preferred source for transplantation of hematopoiesis in patients with non-Hodgkin's lymphoma. Application of hematopoietic growth factors is a part of the mobilization chemotherapy regimen. Time overlap of the highest leukocyte and CD34+ cell count is required for optimal graft collection. Authors analyzed the effect of two growth factors (leridistim and filgrastim) on the kinetics and phenotype of CD34+ cells in patients with non-Hodgkin's lymphoma indicated for autologous peripheral blood stem cell transplantation. METHODS AND RESULTS: Authors analyzed phenotype of CD34+ cell subpopulations and their kinetics in peripheral blood and leukapheresis products by flow cytometry during mobilization and graft collection. Statistically significant differences in expression of lineage-committed antigens between growth factors were found (CD3, CD5--T-lineage, CD56 NK-lineage, CD20 for B-lineage, p < 0.05), as well as for lineage non-specific antigens (CD38, p < 0.05 and CD54, p < 0.01). The most significant divergence was observed between CD34+CD19+ subpopulations of leridistim and filgrastim stimulated blood and graft (p < 0.001). CONCLUSIONS: Expression of lineage-committed antigens on CD34+ subpopulations between two growth factors was statistically different. Kinetics of CD34+ cells during mobilization regimen with leridistim was not superior to filgrastim concerning the quality of graft.
- MeSH
- antigeny CD34 analýza MeSH
- dospělí MeSH
- faktor stimulující kolonie granulocytů farmakologie MeSH
- filgrastim MeSH
- imunofenotypizace MeSH
- interleukin-3 farmakologie MeSH
- kmenové buňky imunologie MeSH
- leukaferéza MeSH
- leukocyty imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mobilizace hematopoetických kmenových buněk * MeSH
- nehodgkinský lymfom terapie MeSH
- rekombinantní fúzní proteiny farmakologie MeSH
- rekombinantní proteiny MeSH
- transplantace periferních kmenových buněk * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- antigeny CD34 MeSH
- faktor stimulující kolonie granulocytů MeSH
- filgrastim MeSH
- interleukin-3 MeSH
- leridistim MeSH Prohlížeč
- rekombinantní fúzní proteiny MeSH
- rekombinantní proteiny MeSH
Chronic myeloid leukemia has got an outstanding position among the other oncology diseases, particularly due to specific chromosomal abnormality called Philadelphia chromosome, its molecular consequence BCR/ABL fusion gene and its biologic product BCR/ABL tyrosinekinase, which is responsible for the leukemic transformation of the hematopoetic cells. We can see a real revolution in the treatment of the chronic myeloid leukemia in the last few years. The authors pay attention to the developement of the new drugs in the large historical consequences from the beginning in the 19th century (describing leukemia first time) to the introduction of the new small specific molecules into the clinical practice.
- MeSH
- chronická myeloidní leukemie farmakoterapie genetika MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- ambulantní péče * MeSH
- lidé MeSH
- mnohočetný myelom diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- směrnice pro lékařskou praxi MeSH
BACKGROUND: Evaluation of practical value of monitoring t(14:18) in peripheral blood in follicular lymphoma. METHODS AND RESULTS: t(14;18) was tested in 115 follicular lymphoma patients by methods: FISH, nested and multiplex PCR of blood, bone marrow and lymph node specimens. We tested the patients with rearrangement MBR quantitatively by real-time PCR. Testing intervals of t(14;18) in peripheral blood were 1 month during treatment, 2-3 months during the first year after the end of treatment, then every 4 to 6 months. Patients were clinically examined in the same intervals and regular restaging was done by CT/PET. Each patient was evaluatee separately. Total detection of t(14;18) was 97% regardless tissue and methods of detection, FISH was superior to PCR (95% vs. 72%). The higher number of copies were observed in lymph nodes in comparison to bone marrow (p = 0.036) and peripheral blood (p = 0.016); 46/115 (40%) patients were positive for MBR, we followed up behaviour of t(14;18) in peripheral blood in 33 of them in long intervals (>6 months, med. 33 months). Molecular and clinical courses correlated in 20/33 (61%) patients, 7/33 (21%) clinically relapsed in lasting molecular remission. We found very short interval to clinical relaps in 7 cases of molecular relapses (0-5 months, median 3 months). We could not define "threshold quantity" of clinically important molecular relaps. Lasting molecular remission was associated with clinical in about 60% cases; lasting molecular activity corresponded with clinical relaps in 86% patients. CONCLUSIONS: t(14;18) is highly associated with follicular lymphoma. In practice, monitoring of t(14;18) is feasible only in part of patients. Even if there is some correlation of clinical and molecular course, monitoring of t(14;18) in blood bears only limited prognostic value for the concrete patient. The treatment of patient can not be accomplished on the basis of these results only.
- MeSH
- dospělí MeSH
- folikulární lymfom farmakoterapie genetika MeSH
- hybridizace in situ fluorescenční MeSH
- lidé středního věku MeSH
- lidé MeSH
- lidské chromozomy, pár 14 genetika MeSH
- lidské chromozomy, pár 18 genetika MeSH
- polymerázová řetězová reakce s reverzní transkripcí MeSH
- polymerázová řetězová reakce MeSH
- recidiva MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- translokace genetická * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
BACKGROUND: Amount of CD34+ cells is a critical parameter for quality assessment and successful engraftment of peripheral blood hematopoietic stem cells (PBSC) during the transplantation of haemopoisis. CD34+ cells are routinely analysed by immunophenotyping in PBSC and in peripheral blood during mobilization. Other leukocyte subpopulations are not usually assessed. METHODS AND RESULTS: The authors present results of immunophenotyping of subpopulations of CD34+ cells and leucocytes in samples from donors of PBSC for allogeneic transplantations, who were stimulated with the growth factor G-CSF at dose 16 micrograms/kg/day. The amount of CD34+ cells was not significantly different between days 4 and 5; however, there was a significant drop at day 6. CD34+90+ and CD34+61+ subpopulations reached their maximum at the day 4; partially differentiated CD34+ cells with co-expression of CD33, CD19, and CD7 reached maximum at the day 6. CD4+ Th-lymphocytes were concentrated in the grafts during leukapheresis, CD4/CD8 ratio in the grafts was increased to average 3.06. CONCLUSIONS: The knowledge of kinetics of CD34+ subpopulations, together with stem cell selection and ex vivo manipulation, may have an impact on the speed of engraftment or GvHD prevention in transplanted patients.
- MeSH
- antigeny CD34 analýza MeSH
- dárci tkání * MeSH
- faktor stimulující kolonie granulocytů farmakologie MeSH
- filgrastim MeSH
- imunofenotypizace * MeSH
- lidé MeSH
- mobilizace hematopoetických kmenových buněk MeSH
- podskupiny lymfocytů * MeSH
- rekombinantní proteiny MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- antigeny CD34 MeSH
- faktor stimulující kolonie granulocytů MeSH
- filgrastim MeSH
- rekombinantní proteiny MeSH
In cancer patients with persistent fever and neutropenia, amphotericin B is administered for the early treatment and prevention of the clinically occult invasive fungal infections. The major drawback of the conventional amphotericin B is its nephrotoxicity. We have previously showed that massive potassium, sodium, and magnesium supplementation, which corresponds to the amount lost in kidney during amphotericin B administration, as well as vigorous hydration, can markedly reduce nephrotoxicity of conventional amphotericin B. Clinical courses of four oncological patients treated with conventional amphotericin B suspected or proven fungal infection for a period of 24 days (two patients), 39 days, and 47 days are described. During the long-term amphotericin B administration with nephroprotective measures, no severe renal function decrease was observed in any of our patients. Massive ion supplementation corresponding to the amounts lost in kidney, as well as the vigorous hydration are effective in the prevention of the renal function decrease induced by the long-term conventional amphotericin B therapy.
- MeSH
- amfotericin B aplikace a dávkování škodlivé účinky MeSH
- antifungální látky aplikace a dávkování škodlivé účinky MeSH
- dospělí MeSH
- imunokompromitovaný pacient * MeSH
- ledviny účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- mykózy farmakoterapie prevence a kontrola MeSH
- nádory imunologie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- amfotericin B MeSH
- antifungální látky MeSH
Some types of non-Hodgkin lymphomas cannot be treated by contemporary preparations. After repeated relapses and chemotherapy moreover damage of bone marrow occurs and further intense cytostatic treatment is not possible. Monoclonal antibodies against structures on tumour cells are an interesting alternative of cytostatic treatment. In 2000 the authors administered anti CD20 monoclonal antibody (rituximab, Mabthera Roche), 375 mg/m2, on the 1st, 8th, 15th and 22nd day i.v. to a total of 24 patients with relapsing non-Hodgkin lymphoma. In five patients the relapse developed after high dosage chemotherapy and autologous transplantation of peripheral stem cells. Treatment was well tolerated with minimal side-effects. Favourable therapeutic results were recorded in patients with follicular lymphoma (70% of the therapeutic responses), small lymphocyte lymphomas (64% of therapeutic responses) and in patients with a relapse after autologous transplantations (80% of therapeutic responses). Anti CD20 monoclonal antibody is a new effective alternative of cytostatic treatment. Its position in the therapeutic strategy in patients with non-Hodgkin lymphoma awaits elaboration.
- MeSH
- dospělí MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- monoklonální protilátky škodlivé účinky terapeutické užití MeSH
- myší monoklonální protilátky MeSH
- nehodgkinský lymfom farmakoterapie MeSH
- protinádorové látky škodlivé účinky terapeutické užití MeSH
- recidiva MeSH
- rituximab MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- klinické zkoušky MeSH
- Názvy látek
- monoklonální protilátky MeSH
- myší monoklonální protilátky MeSH
- protinádorové látky MeSH
- rituximab MeSH
High-dosage chemotherapy with autologous transplantation of haematopietic stem cells prolonged the survival of patients with multiple myeloma as compared with results of standard chemotherapy, on average by 1.5 years. Nowadays this method is the standard treatment for suitable patients. Findings assembled recently are discussed by the authors.
- MeSH
- autologní transplantace MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- mnohočetný myelom terapie MeSH
- protinádorové látky aplikace a dávkování MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- protinádorové látky MeSH
Patients with AL-amyloidosis are treated at present by conventional or large-dose chemotherapy with autologous transplantation of haematopoietic stem cells, similarly as patients with multiple myeloma. Only the timing of treatment is different. In myeloma treatment is usually indicated only in clinical stage II or III, in clinical stage I only in case of adverse prognostic factors. In AL-amyloidosis treatment is indicated immediatelyafter establishment of the diagnosis. It was found that high-dose chemotherapy with autologous transpantation of haematopoietic cells is at present the most effective treatment for selected patients with not advanced forms of primary systemic AL-amyloidosis. Allogenic transplantation of the liver is treatment of choice in ATTR amyloidosis. In AA-amyloidosis the basis of treatment is removal or suppression of the chronic inflammatory process, possibly colchicin administration.
- MeSH
- amyloidóza terapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
Amyloidosis is the term for specific pathological peptide deposits in various tissues. Amyloid substances may be the manifestation of the following nosological units: AL-amyloidosis, AA-amyloidosis, ATTR-amyloidosis, beta2-microglobulin amyloidosis and possibly othr familiar forms of amyloidosis. The most frequent symptoms of amyloidosis are: 1. proteinuria with nephrotic syndrome, 2. cardiac failure with restrictive cardiomyopathy, 3. unexplicable hepatomegaly, 4. idiopathic peripheral polyneuropathy, 5. haemorrhagic manifestations and symptoms of increased fragility of the capillaries while the number of thrombocytes is normal, 6. periorbital haematomas and 7. macroglossia. Diagnostic and therapeutic procedures differ according to the type of amyloidosis and are analyzed in detail in the text.
- MeSH
- amyloidóza klasifikace diagnóza patofyziologie MeSH
- diferenciální diagnóza MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
