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Hemodialysis dependent patient with relapsed acute promyelocytic leukemia treated by arsenic trioxide
06/2020 MUDr. Kateřina Benková; MUDr. Zdeněk Kořístek, Ph.D.; MUDr. Petra Richterová; MUDr. Jana Mihályová; Mgr. Dagmar Zámoravcová; Ing. Karel Lach, CSc.; prof. MUDr. Roman Hájek, CSc.
Arsenic trioxide (ATO) is a drug of choice in the treatment of relapsed acute promyelocytic leukemia (APL). Guidelines for the treatment of hemodialysis dependent patients with APL do not exist. Here we describe the treatment of relapsed APL in a hemodialysis dependent patient by ATO at the dose of 10 mg three times a week after hemodialysis with frequent monitoring of laboratory values and QT interval. Molecular remission was achieved without serious adverse events. The authors further discuss the use of ATO in hemodialysis dependent patients and conclude, that ATO can be safely and effectively used in such patients under the condition of close monitoring of toxicity and adverse events; assessment of the arsenic concentration in blood is not useful for treatment management.
ENTIRE ARTICLE
Arsenic trioxide (ATO) is a drug of choice in the treatment of relapsed acute promyelocytic leukemia (APL). Guidelines for the treatment of hemodialysis dependent patients with APL do not exist. Here we describe the treatment of relapsed APL in a hemodialysis dependent patient by ATO at the dose of 10 mg three times a week after hemodialysis with frequent monitoring of laboratory values and QT interval. Molecular remission was achieved without serious adverse events. The authors further discuss the use of ATO in hemodialysis dependent patients and conclude, that ATO can be safely and effectively used in such patients under the condition of close monitoring of toxicity and adverse events; assessment of the arsenic concentration in blood is not useful for treatment management.
Atypical chronic myeloid leukemia in patients after breast cancer treatment
02/2019 MUDr. Jana Zuchnická, MUDr. Petra Richterová, MUDr. Zuzana Rusiňáková, prof. MUDr. Edgar Faber, CSc., MUDr. Roman Hájek, CSc.
Atypical chronic myeloid leukemia BCR/ABL1 negative is a rare disease. The prognosis is unfavorable; patients have a high risk of transformation in acute myeloid leukemia. Transplantation of allogeneic haematopoietic stem cells should therefore be considered in younger patients without significant associated illnesses for which a suitable donor has been found early in the course of disease. We use paliative treatment procedures for patients who are unsuitable for transplantation.
ENTIRE ARTICLE
Atypical chronic myeloid leukemia BCR/ABL1 negative is a rare disease. The prognosis is unfavorable; patients have a high risk of transformation in acute myeloid leukemia. Transplantation of allogeneic haematopoietic stem cells should therefore be considered in younger patients without significant associated illnesses for which a suitable donor has been found early in the course of disease. We use paliative treatment procedures for patients who are unsuitable for transplantation.
Optimal treatment approaches for patients with myelodysplastic syndrome
02/2017 MUDr. Petra Richterová, MUDr. Zdeněk Kořistek, Ph.D., MUDr. Lukáš Stejskal, prof. MUDr. Roman Hájek, CSc.
Myelodysplastic syndrome is a clonal disorder of the bone marrow caused by damage to the genetic information myeloid stem cell. It represents a heterogeneous group of disorders characterized by ineffective hematopoiesis with dysplasia of one or more myeloid lineage leading to cytopenia (or cytopenias) and the high incidence of progression to acute myeloid leukemia (about 1/3 cases). The blood count is most prevalently represented by anemia alone, in combination with thrombocytopenia or leucopenia, neutropenia. Clinical symptoms are consistent with the type and depth of the cytopenia – anemic syndrome, bleeding manifestation from thrombocytopenia or infectious complications in neutropenic patients. Myelodysplastic syndrome is a disease occurring almost solely in patients of older age (most frequent occurrence between 65–70 years), with an incidence of 3–5 new cases per 100,000 population per year. The incidence of myelodysplastic syndrome increases with age rapidly and in a group of people over 70 years amounts to 20 to 40 new cases per 100,000 inhabitants. Myelodysplastic syndrome is diagnosed as in the case of primary – unknown etiology, or secondary – often after chemotherapy or radiotherapy for an other cancer or after exposure to a known toxic agent.
ENTIRE ARTICLE
Myelodysplastic syndrome is a clonal disorder of the bone marrow caused by damage to the genetic information myeloid stem cell. It represents a heterogeneous group of disorders characterized by ineffective hematopoiesis with dysplasia of one or more myeloid lineage leading to cytopenia (or cytopenias) and the high incidence of progression to acute myeloid leukemia (about 1/3 cases). The blood count is most prevalently represented by anemia alone, in combination with thrombocytopenia or leucopenia, neutropenia. Clinical symptoms are consistent with the type and depth of the cytopenia – anemic syndrome, bleeding manifestation from thrombocytopenia or infectious complications in neutropenic patients. Myelodysplastic syndrome is a disease occurring almost solely in patients of older age (most frequent occurrence between 65–70 years), with an incidence of 3–5 new cases per 100,000 population per year. The incidence of myelodysplastic syndrome increases with age rapidly and in a group of people over 70 years amounts to 20 to 40 new cases per 100,000 inhabitants. Myelodysplastic syndrome is diagnosed as in the case of primary – unknown etiology, or secondary – often after chemotherapy or radiotherapy for an other cancer or after exposure to a known toxic agent.