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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.
Autoimmune cytopenia in patients with chronic lymphocytic leukemia
05/2020 MUDr. Jana Zuchnická; MUDr. Jana Mihályová; MUDr. Jaromír Gumulec; prof. MUDr. Roman Hájek, CSc.
Chronic lymphocytic leukemia is accompanied by dysfunction of the immune system. Immune dysbalances are manifested, among other things, in an increased incidence of autoimmune cytopenias. In order to choose the right therapeutic procedure, it is important to differentially diagnose other causes of anemia, thrombocytopenia or granulocytopenia. Corticoids, intravenous immunoglobulins, rituximab, or other immunosuppressants are mainly used in therapy. Inadequate response to therapy is an indication to initiate treatment for chronic lymphocytic leukemia.
ENTIRE ARTICLE
Chronic lymphocytic leukemia is accompanied by dysfunction of the immune system. Immune dysbalances are manifested, among other things, in an increased incidence of autoimmune cytopenias. In order to choose the right therapeutic procedure, it is important to differentially diagnose other causes of anemia, thrombocytopenia or granulocytopenia. Corticoids, intravenous immunoglobulins, rituximab, or other immunosuppressants are mainly used in therapy. Inadequate response to therapy is an indication to initiate treatment for chronic lymphocytic leukemia.
Obinutuzumab in the treatment of patients with chronic lymphocytic leukemia and follicular lymphoma
03/2017 MUDr. Jana Zuchnická, MUDr. Jana Fečková Mihályová, MUDr. Juraj Ďuraš, prof. MUDr. Roman Hájek, CSc.
Monoclonal antibodies are used in the treatment of chronic lymphocytic leukemia and follicular lymphoma especially in combination with chemotherapy. The introduction of rituximab into clinical practice meant a real turning point, it changed medical procedures and the results of the treatment of both diseases. As of recently new monoclonal antibodies are being introduced into clinical practice which are being developed to enhance the antitumor effect. One of them is a humanized monoclonal antibody obinutuzumab. Obinutuzumab combined with chlorambucil is in the Czech Republic approved for the treatment of chronic lymphocytic leukemia in previously untreated patients with multiple comorbidities, who can't undergo fludarabin based treatment. In follicular lymphoma the indication of using obinutuzumab in combination with bendamustine is used for treating patients with rituximab refractory follicular lymphoma, we refer to the current summary of product characteristics. The use of obinutuzumab for patients with follicular lymphoma in the Czech Republic is still bound to being approved by the payer according to §16 of Act No. 48/1997 Coll.
ENTIRE ARTICLE
Monoclonal antibodies are used in the treatment of chronic lymphocytic leukemia and follicular lymphoma especially in combination with chemotherapy. The introduction of rituximab into clinical practice meant a real turning point, it changed medical procedures and the results of the treatment of both diseases. As of recently new monoclonal antibodies are being introduced into clinical practice which are being developed to enhance the antitumor effect. One of them is a humanized monoclonal antibody obinutuzumab. Obinutuzumab combined with chlorambucil is in the Czech Republic approved for the treatment of chronic lymphocytic leukemia in previously untreated patients with multiple comorbidities, who can't undergo fludarabin based treatment. In follicular lymphoma the indication of using obinutuzumab in combination with bendamustine is used for treating patients with rituximab refractory follicular lymphoma, we refer to the current summary of product characteristics. The use of obinutuzumab for patients with follicular lymphoma in the Czech Republic is still bound to being approved by the payer according to §16 of Act No. 48/1997 Coll.