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Stanowisko polskich ekspertów dotyczące zastosowania leku brentuksymab vedotin w leczeniu chorych na pierwotne chłoniaki skóry CD30+
Q4 Medicine Pub Date : 2018-08-17 DOI: 10.5603/HEM.2018.0015
Małgorzata Sokołowska-Wojdyło, J. Walewski, W. Jędrzejczak, T. Robak, Monika Prochorec-Sobieszek, Joanna Zaucha, Alina Jankowska-Konsur, M. Słowińska, E. Chmielowska, L. Rudnicka, Sebastian Giebel
The group of primary cutaneous T-cell lymphomas (CTCLs) expressing CD30 + is consisted of primary cutaneous anaplastic T-cell lymphoma (pcACTL), lymphomatoid papulosis (LyP), some cases of mycosis fungoides (MF) and Sezary syndrome (SS). It is well known that patient cannot be cured completely by available therapeutic methods. In addition, the effectiveness of available therapies is especially limited in advanced stages of the disease. Based on the results of the most recent trials, the experts recommend that brentuximab vedotin (BV) should be reimbursed in Poland for the treatment of adult patients with CTCL expressing CD30 who have had at least one prior systemic treatment. In case of MF BV should be preferred to bexarotene or MTX therapy due to the higher efficacy in stage IIB or higher. BV treatment should be also considered as an alternative to bexarotene (after ineffectiveness of local treatment, phototherapy and IFN/MTX therapy) in early stages of MF (IB-IIA).
表达CD30 +的原发性皮肤t细胞淋巴瘤(CTCLs)组包括原发性皮肤间变性t细胞淋巴瘤(pcACTL)、类淋巴瘤丘疹病(LyP)、部分蕈样真菌病(MF)和Sezary综合征(SS)。众所周知,现有的治疗方法不能完全治愈病人。此外,在疾病的晚期,现有疗法的有效性尤其有限。根据最近的试验结果,专家们建议,在波兰,对于表达CD30且至少接受过一次全身治疗的成年CTCL患者,brentuximab vedotin (BV)治疗应该报销。在MF BV的情况下,应优先考虑贝沙罗汀或甲氨蝶呤治疗,因为在IIB期或更高的疗效更高。在MF (IB-IIA)的早期阶段,BV治疗也应考虑作为贝沙罗汀的替代方案(在局部治疗、光疗和IFN/MTX治疗无效后)。
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引用次数: 0
Znaczenie oceny minimalnej choroby resztkowej u chorych na przewlekłą białaczkę limfocytową
Q4 Medicine Pub Date : 2018-08-17 DOI: 10.5603/HEM.2018.0013
B. Pula, Adrian Burdacki, M. Dudziński
Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder of mature B lymphocytes characterized by a heterogenous clinical course. Approximately 60% of cases require treatment initiation due to disease advancement. Immunochemotherapy enables achievement of durable remissions in some of the patients, however despite the observed complete responses relapses occur. These are explained by the persistence of residual leukemic cells in blood, bone marrow and lymph nodes, defined as minimal residual disease (MRD). Use of flow cytometry and molecular methods in assessment of treatment response allows for more detailed response quantification and detection of leukemic cells with ≥ 10-5 sensitivity. Elimination of MRD is an important prognosticator of durable remissions following immunochemotherapy. Furthermore, the significance of MRD assessment increases due to its possible role in CLL treatment individualization and potential surrogate marker of response without the need of long lasting observations. Herein in this publication, the clinical significance of MRD assessment emphasizing flow cytometric methodology is summarized.
慢性淋巴细胞白血病(CLL)是一种成熟B淋巴细胞的淋巴增生性疾病,其特点是具有异质性的临床病程。由于疾病进展,大约60%的病例需要开始治疗。免疫化疗可以使一些患者获得持久的缓解,然而,尽管观察到完全缓解,复发仍会发生。这可以解释为血液、骨髓和淋巴结中残留的白血病细胞持续存在,定义为微小残留病(MRD)。使用流式细胞术和分子方法评估治疗反应,可以更详细地定量和检测白血病细胞,灵敏度≥10-5。MRD的消除是免疫化疗后持久缓解的重要预测指标。此外,MRD评估的重要性增加,因为它可能在CLL治疗个体化和潜在的替代反应标志物中发挥作用,而不需要长期观察。本文总结了流式细胞术方法在MRD评估中的临床意义。
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引用次数: 0
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Hematologia
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