Oncology, 2013, issue 3

Editorial

Potřebují lékaři lékařskou etiku?

doc. MUDr. Jiří Šimek, CSc.

Onkologie. 2013:7(3):107

Main topic

Lymfoidní malignity se zaměřením na vzácnější nehodgkinovy lymfomy- úvodní slovo

doc. MUDr. Andrea Janíková, Ph.D.

Onkologie. 2013:7(3):112

Advances in treatment of acute lymphoblastic leukemia in adults

František Folber, Michael Doubek

Onkologie. 2013:7(3):113-116

Acute lymphoblastic leukemia in adults belongs among rare precursor malignant lymphoproliferative disorders. This paper summarizes recommendations for diagnosis and treatment, and identifies some promising new drugs to be tested in clinical trials.

Chronic lymphocytic leukemia - diagnosis and treatment

Anna Panovská, Michael Doubek

Onkologie. 2013:7(3):117-120

Chronic lymphocytic leukemia (CLL) is a low-grade lymphoma, typically found in eldery people. CLL is the most common leukemia in the Western World, it makes up almost 30% of all leukemias. Pathogenesis of CLL is still unknown, however, an antigen stimulation, apoptotic defects and the role of microenvironment are often discussed. At present, new prognostic factors are being analyzed in order to define a risk subgroup of patients that would benefit from early and intensive start of therapy. Treatment of CLL has made a great progress in the last decade. While a few years ago chlorambucil was a golden standard in the CLL therapy, currently, the...

New perspectives in the pathogenesis and diagnosis of mantle cell lymphoma

David Šálek, Andrea Janíková, Pavla Veselá, Jiří Mayer

Onkologie. 2013:7(3):121-126

Mantle cell lymphoma represents about 7-8 % of all non-Hodgkin lymphomas. This entity is characterized by a combination of mostly aggresive clinical course and frequent relapses. The prognosis remains poor with a median overall survival of 4-5 years. It is hypothesized that a coincidence of several pathological events is necessary for arise of clinically manifest MCL. The primary oncogenic mechanism is considered to be a chromosomal translocation t(11;14) with juxtaposition of BCL1 gene to the IGH gene. It results in overexpression of cyclin D1, which positively affects the G1-S transition of cell cycle. Another frequent mutation is a deletion...

Primary central nervous system lymphoma

Heidi Móciková

Onkologie. 2013:7(3):127-129

Primary central nervous system lymphomas constitute a rare group of extranodal non-Hodgkin´s lymphoma with aggressive clinical course and unsatisfactory outcome. High dose methotrexate based chemotherapy combined with whole brain radiotherapy is the current standard of treatment. Combination of chemotherapy and whole brain radiotherapy improves response rate, however, the addition of radiotherapy increases the risk of neurotoxicity. Radiotherapy alone is a therapeutic approach in older patients not suitable for systemic chemotherapy. The significance of high dose chemotherapy with autologous stem cell transplantation and new drugs are investigated...

CNS progression in aggressive lymphomas: incidence, risk factors, prophylactic and treatment possibilities

Robert Pytlík

Onkologie. 2013:7(3):129-134

The risk of CNS progression in highly aggressive lymphomas (lymphoblastic, Burkitt‘s) reached up to 30% in historical cohorts, but it was significantly diminished by intrathecal prophylactic treatment and by incorporation of systemic cytostatics penetrating blood-brain barrier into treatment protocols. In other aggressive lymphomas, the risk of CNS progression is lower (under 10% in recent studies), but in selected patients can even here reach 25–30 %. Unfortunately, unlike in lymphoblastic and Burkitt‘s lymphomas, prophylaxis does not seem to be particularly effective in other histologies. This article discusses incidence,...

Review articles

Vemurafenib in the target therapy of metastatic melanoma

Ivo Kocák, Ilona Kocáková, Stanislav Špelda

Onkologie. 2013:7(3):140-143

Metastatic melanoma is an aggressive disease. Historical treatment options have been limited (e.g. dacarbazine, temozolomide, high dose interleukin-2) and associated with poor outcomes. Vemurafenib is a first-in-class, small molecule BRAFV600 inhibitor. Vemurafenib is approved in the EU as monotherapy in adult patients with BRAFV600 mutation-positive unresectable or metastatic melanoma. In the trial BRIM-2 a BRIM-3 vemurafenib significantly improved both overall survival (OS) and progression free survival (PFS) in patients with unresectable melanoma.

Treatment options for multicentric Castleman disease

Petr Szturz

Onkologie. 2013:7(3):144-147

Backgrounds: Castleman disease is a rare nonclonal lymphoproliferative disorder with 2 clinical (unicentric and multicentric) and 4 histomorphologic (hyaline-vascular, plasma-cell, mixed and plasmablastic) types. Typically, multicentric plasma-cell Castleman disease is an aggressive, relapsing disorder with generalized lymphadenopathy and systemic symptoms. Due to absence of randomised comparison studies, treatment recommendations for this disease form are not united and mostly, the practicing physicians take guidance from retrospective reports of single cases and small groups of patients. Aim: This paper summarizes the available treatment...

Original articles

The incidence of other neoplasms in patients with leukemia

Edvard Geryk, Radim Štampach, Jiří Kozel, Petr Dítě, Milan Konečný

Onkologie. 2013:7(3):135-139

A total of 30,166 cases of leukemia, based on the Czech Cancer Registry in 1976–2005, there were notificated 3,937 multiple cases associated with the ocurrence of other neoplasms. Of them there were 2,450 (62.2 %) in males and 1,487 (37.8 %) in females, i.e. 14.7 % cases in males and 11 % in females of total registered leukemia. There were diagnosed 2,064 other neoplasms after 1,715 primary leukemias and 2,642 other primary neoplasms before 2,222 subsequent leukemias. A total of 14 Czech regions were distributed 35.5 % multiple leukemias in the three regions (Southern and Northern Moravia, Prague). In the average interval 4.9 years in...

Case report

Outcomes of treatment and follow-up of patients with squamous cell head and neck cancers after concomitant

Jana Neuwirthová, Pavel Smilek, Jan Rottenberg, Rom Kostřica, Renata Červená

Onkologie. 2013:7(3):148-150

treatment with cetuximab and radiotherapy The paper presents outcomes of treatment with cetuximab and radiotherapy in patients with squamous cell head and neck cancers as well as of post-treatment follow-up. Treatment outcomes were very good in our patients; among 30 patients, a total of 90% of complete remissions in locoregionally advanced stages were observed. In the subsequent follow-up, the 2-year overall survival was achieved in 82% and the 2-year symptom-free survival in 76% of patients.

For nurses

Reversible isolation - protects or bothers the patients after bone marrow transplantation?

Alice Cetlová

Onkologie. 2013:7(3):155-158

Nursing care of patients who have undergone transplantation of bone marrow or peripheral stem cells is highly specialized care provided by specialized haematological-oncology centres. This care is provided not only to adult patients, but also to children. To provide immunocompromised patients with the most suitable conditions for their treatment. To ensure that these patients are as little threatened by external infections as possible and that the level of their social isolation from their family and the surroundings is as low as possible. The level of reverse – protective isolation is a subject of discussions by specialists all over the world.