Akutní promyelocytární leukemie: cesta k nejlépe léčitelné akutní leukemii dospělých

Z. Kořístek, J. Schwarz, P. Žák, J. Mayer

Vnitr Lek 2008, 54(7-8):685  

Therapy of acute promyelocytic leukemia in Czechia: results and analysis of prognostic factors

J. Schwarz, Z. Kořístek, J. Starý, P. Žák, T. Kozák, J. Marková, K. Michalová, D. Dvořáková, J. Mayer, P. Cetkovský

Vnitr Lek 2008, 54(7-8):757-770  

We have retrospectively evaluated a cohort of 144 patients (including 17 pediatric ones) with de novo acute promyelocytic leukemia registered in databases of institutions cooperating within the CELL group (The Czech Leukemia Study Group for Life). The patients were diagnosed according to WHO criteria from 1989 until 2006. The aim was to check how well fared the patients, the majority of whom was not included into clinical trials, in real life. Of 140 evaluable patients, 97 (69.3%) attained complete remission (CR). The projected overall survival (OS) 4 years after diagnosis was 58.9%, and 55.3% at 6 years. In 8 patients (6.0%), no antileukemic therapy...

What is the current treatment of patients with essential thrombocytopenia and other myeloproliferations accompanied with thrombocytopenia, and what can be the predictive sign of the risk of thrombosis in such patients - a report from the registry of patients treated by Thromboreductine®

M. Penka, J. Schwarz, T. Pavlík, R. Pytlík, M. Doubek, P. Dulíček, J. Kissová, A. Hluší, M. Schützová, O. Černá, Y. Brychtová, T. Szotkowski, Z. Volková, J. Seghetová, V. Vozobulová, I. Hadačová, I. Hochová, J. Voglová, L. Dušek

Vnitr Lek 2008, 54(7-8):775-782  

The registry of patients treated with Thromboreductine® (anagrelid) in the contributing centres in the Czech Republic has been updated with data on the patients receiving this medication since 2004. The original purpose of the registry was to record responses to Thromboreductine® therapy and adverse drug reactions in patients with essential thrombocytopenia. However, data on additional Ph negative myeloproliferations, as well as data on cytoreductive therapies other than exclusively that using Thromboreductine® has also been recorded in the course of its compilation, including data on combined regimes. At present, the database contains...

From chloroma to acute promyelocytic leukemia - a historical perspective

J. Schwarz

Vnitr Lek 2008, 54(7-8):686-700  

The progressing knowledge on chloroma and chloroleukemia is reviewed. However, it is uneasy to identify with certainty the cases of acute promyelocytic leukemia (APL) among the historical descriptions of chloroma since 1823. In part, this is due to confusion produced by the historical cytological nomenclature - in practice, the leukemic promyelocytes were regarded, quite inaccurately, as a subtype of paramyeloblasts until early 1960's. The term promyelocytic leukemia first appeared in Naegeli's text-book in 1931. However, no clinical associations of the morphological description were then given. As a clinico-pathological entity, APL was defined by...

Leukemogenesis and therapy of acute promyelocytic leukemia: from the worse to the most favorable subtype of acute myeloid leukemia

Z. Kořístek, J. Mayer

Vnitr Lek 2008, 54(7-8):701-727  

The evolution of therapy of acute promyelocytic leukemia (APL) from 1964 to present is reviewed. The paper is focused on the main findings and key studies which formed current and almost standard therapeutic approach to APL. The first important development was the use of anthracyclines for the initial therapy of APL in 1967. Starting 1972, heparin was introduced into a treatment of coagulopathy and the intensity of substitutional transfusion therapy was remarkably enhanced. The main breakthrough was the initiation of differentiation therapy using all-trans retinoic acid (ATRA). The first clinical study which brought information about the effect of...

An urgency in hematology: acute promyelocytic leukemia - principles of diagnosis

J. Schwarz, P. Kačírková, J. Marková, D. Mikulenková, I. Marinov, I. Ballingová, K. Michalová

Vnitr Lek 2008, 54(7-8):728-744  

A review of diagnosis of acute promyelocytic leukemia (APL) is presented. There are still many patients with progressive disease with leukocytosis at presentation. These are at greater risk of early death due to bleeding (often intracranial), or, less frequently, due to thrombotic complications. In Czechia, we have, in some instances, noted an unacceptably long time from the first symptoms to diagnosis and to administration of the highly specific differentiation therapy with tretinoin (ATRA) along with anthracycline chemotherapy. This combination is highly efficient - cures are seen in some 70% of patients. Therefore, we present a diagnostic minimum...

Coagulopathy and differentiation syndrome: the main complications of the initial treatment of acute promyelocytic leukemia

Z. Kořístek, P. Žák

Vnitr Lek 2008, 54(7-8):745-750  

Two main causes of early mortality of acute promyelocytic leukemia (APL) are rewieved, unique type of coagulopathy typical for APL and differentiation syndrome sometimes complicating treatment of APL with all-trans retinoic acid (ATRA) or arsenic trioxide (ATO). The information covers analysis of the patophysiologies of both conditions and also recommendations considering treatments and preventive measures.

Relapse in acute promyelocytic leukemia and the role of hematopoietic stem cell transplantation in the treatment of APL

P. Žák, Z. Kořístek

Vnitr Lek 2008, 54(7-8):751-756  

The authors focused on relapses and transplantation treatment in APL. The incidence of relapses, their risk factors, and extramedullary relapses are reviewed. Considering treatment of relapses in APL, arsenic trioxide is now the standard treatment of APL relapse, however, treatment with gentuzumab ozogamicin should be considered when only a molecular relapse is detected. The following part of the issue is focused on the current status of hematopoietic stem cell transplantation in APL and on indications of transplantations from a modern APL therapy point of view.

Brief case reports illustrate various initial courses in acute promyelocytic leukemia

Z. Kořístek, J. Schwarz, P. Žák

Vnitr Lek 2008, 54(7-8):771-773  

Authors present cases which illustrate a various initial symptoms and courses of patients between the first symptoms and the diagnosis of acute promyelocytic leukemia. Symptoms indicated possible serious hematological diseases are well-known: unusual bleeding, recurrent infections or infections not responded to antibiotics, fatigue, anemia symptoms. The disease progression was sometimes very rapid, however, in certain patients the symptoms were disappreciated or even minimized and the approaches were not adequate to risks resulted from newly diagnosed acute promyelocytic leukemia.

Z odborné literatury

Vnitr Lek 2008, 54(7-8):785-787  

Doc. MUDr. Juraj Hrnčiar, CSc., osemdesiatnikom

Milan Žuffa

Vnitr Lek 2008, 54(7-8):784  

Šobrův den, XXIV. konference o hyperlipoproteinemiích. Praha, 19. června 2008

Vnitr Lek 2008, 54(7-8):789-794  

XXVII. dny mladých internistů v Martině

P. Horák, D. Prídavková

Vnitr Lek 2008, 54(7-8):783