561
PŘEHLEDOVÉ42522001004388130181216258306358404446
ČLÁNKY88722001003973122176223272
Nové42533001005190126161
terapeutické6023300100256084120158194231258274305339373
možnosti99133001005998129167206235263279
a1286330010034
trendy13363300100255085123161198
v1550330010035
léčbě16013300100155081120156
mnohočetného177333001005997136174213244278305343379416455
myelomu224533001005995129145184244282
17621022001002859101
|351220010018
VNITŘNÍ4268040010746106127172220280301
LÉKAŘSTVÍ748804001074185130188236280325378400
/11948040010731
Vnitř1270804001074693112140166
Lék.1456804001074083122140
2025;71(3):176-1821615804001074487129173186227268286329350364402438478508547585628
/22888040010731
www.casopisvnitrnilekarstvi.cz442680400107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2025.03142544001003865941331631802022236484400100418310274944001001554791171398904400100287389124167204247293316355396414432470516552587605649682711
Nové4259800275152277399514
terapeutické1016980027585202295414543661789880946104711741289
možnosti23829800275182308411539665768857923
a33829800275116
trendy3546980027585178297426554683
v42512400275120
léčbě5931240027560179280409528
mnohočetného1198124002751813094355636897909079971126124513731499
myelomu277412400275182308423489616802930
Roman4251630013765129224282347
Hájek1,2,79416300137761341652242841077164008036518911671630013729
Ludmila12181630013756119185280311341399
Muroňová1,2,164016300137931571992633283914485062139164008036518922301630013729
Jana22811630013745103168226
Mihályová1,2,252916300137931241892472773353974545123033164008036518931241630013729
Michaela31751630013793124174239297355386445
Horňáková1,36421630013776140182246304364426483541417516400803642091630013729
Tereza42601630013760111153212264323
Popková1,2,460516300137641261922523153714295027164008036518951181630013729
Hana4251780013776134199257
Plonková1,705178001376393157221281343400458115617900803611901780013729
Tomáš12411780013760116211270317
Jelínek1,21581178001374510313416522928834819271790080365189
1Klinika425194007833456193001336087111172197247301
hematoonkologie7801930013362117208260296355416476527586612672734759814
FN16171930013354124
Ostrava17641930013376119156191244295348
2Klinika425209007833458208001336087111172197247301
hematoonkologie,7832080013361116207260295354415475526585611671733758813834
Lékařská16412080013352106157211246290341395
fakulta2059208001333286137197222258311
Ostravské23942080013376119156191244295337388442
univerzity28592080013360121146199252288336362398452
Pokrok4252590012153107156191246295
v7482590012148
léčbě824259001212375121179231
mnohočetného10832590012183139196252308355405439496547604660
myelomu17712590012183130180205262346402
(MM)22012590012128108190217
je2446259001212576
mimořádný.25502590012183108192248281331389445491509
Kombinované30872590012154109193251276332388436486542593
režimy,3709259001213283127152236282299
které4036259001214784135168219
se4283259001214091
u44032590012155
nové44862590012155111159210
diagnózy4724259001215680129186242298341392
dostávají51442590012157113153188238285335360384
do4252730012156112
standardně557273001214075125181239288321378434486
používané10632730012157114170214238287337393444
terapie,1527273001213384118167225249301321
dosahují18682730012157113153203259315340364
doby22522730012156112170218
do24902730012156112
progrese2622273001215791146204238288329380
více3022273001214873119169
než32112730012155107151
sedm3382273001213991149233
let.3635273001212475110132
V37872730012156
České38632730012158107148195245
republice4128273001213384142198256281305351401
očekáváme45492730012155101151199249297346430482
v50512730012148
roce5119273001213388135185
202553242730012151102152204
schválení425287001214086142189239263314371395
čtyřkombinace848287001214581132166214269353411436492541587637
anti-CD3815122870012149105138162195258324374426
monoklonální19662870012183139196252300326382439488513569593
protilátky2586287001215791147181205229278311359410
(mAb)30242870012128110172230257
spolu3308287001214097154179235
s35712870012139
proteasomovým3638287001215791146180230279320376460517565616702
inhibitorem4367287001212480136160218243277332366416501
(PI),4896287001212881105133153
imunomodulační507728700121231071632192753604164253010012156112137185231287311
látkou757301001212473106154208265
(IMiD)1042301001212953134159226254
a13163010012149
dexametazonem.13853010012157108156205290341376425470526582634718740
Není21463010012166118174198
zatím2365301001214394127151236
jasné,2621301001212574114170221242
zda28843010012143100149
konsolidace30543010012147101158198254279303361410456506
autologní35803010012149104138193218275332389413
transplantaci4013301001213467117173213270295344401434484530554
při4587301001215791115
této4723301001213384118173
čtyřkombinaci4917301001214581132166214269353411436492541587611
bude4253150012157113171222
přínosem675315001215791115172228268319404
stran1107315001214074108157214
prodloužení1349315001215790146204229285341385436493517
doby18943150012156112170218
do21393150012157113
progrese.2280315001215791146204237288329380401
Doslova27093150012167124164188244292342
exploze3079315001215098156181237280331
nastala34383150012156105145180230254303
ve3769315001214898
vývoji38953150012148100152207232256
imunoterapie.41793150012124108163220276310360394443501526577598
Autologní48053150012161116150205230286344400424
T-lymfocyty5257315001215077103152237425329001212985132182220271
s7253290012140
chiméricky7953290012144100125209260294319364412463
upraveným12883290012155113147196244294350397482
receptorem1800329001213283130180238272327361412497
(CAR2326329001212985149203
T-lymfocyty)2559329001215077103151237267323369420457508536
cíleným312432900121456995147203250335
na34893290012155104
BCMA36233290012154113194257
antigen39093290012149105138162219271327
se4266329001213991
v43873290012148
USA44643290012165114175
již466932900121244992
dostaly47913290012156112153188237262310
do51313290012156113
druhé5273329001215790147203254
linie425343001212448104128179
léčby.629343001212475121179226244
Vývoj8973430012156105158213238
je1159343001212576
ještě1260343001212475116151201
rychlejší1486343001213284129185209260285325349
u18603430012155
bispecifických1940343001215782122179231278302332360405453504549605
protilátek2570343001215791146180204228277311361409
(bsAb).3004343001212886126188246273293
V33213430012156
pozdním34023430012157114157214270294379
relapsu3805343001213384109158216256311
máme41413430012184133217268
k44343430012147
dispozici4506343001215680120178235278302348372
bsAb,4903343001215797159217237
které5165343001214784134168219
cílí540934300121446895119
na4253570012155105
BCMA5513570012154113194257
a8293570012149
GPRC5D8993570012165119173232285351
antigen.12713570012148105138162219270327349
V16413570012156
rámci1719357001213282166212236
klinických197635700121477397153178223271322367423
studií2421357001213974130188212236
se2678357001214091
zkouší2791357001214390145202242266
další30783570012157106130170194
terapeutické3294357001213383117166224276332367391436484534
cíle384935700121456995147
(např.4017357001212882131189222239
FcRH5)4277357001214994148215266294
i45923570012123
kombinované46373570012147102186244269325381429478535586
režimy5245357001213283127152236282
(např.425371001212882131189222239
bsAb,693371001215797159217237
PI,95937100121547799
IMiD).10873710012124106131198225245
Účinnost13613710012164109133189246302342377
těchto1767371001213383130186219274
kombinací20703710012147102186244269325374420444
v25433710012148
první2620371001215791143200224
linii2873371001212448104128152
je3054371001212476
90–10031593710012151104159205253307
%,34953710012179102
přičemž3626371001215791115161211295339
vysoké39943710012148100140197245295
procento4318371001215791146193243299333388
pacientů47353710012157106152176227284317373
dosahuje51373710012157113153203259315340391
negativní4253850012155107165214247271321378402
minimální8513850012183107163188272321345401425
reziduální1300385001213384128152210266315339395419
nemoci17433850012156107192248294318
(MRD).20853850012129108163231259278
Vyhodnocování23873850012156105162218276332388435490538587644668
MRD30783850012181136204
v33063850012148
klinických337838500121477397153177223270322366422
studiích3824385001214075131188213237282338
bylo41863850012157104129186
v43953850012148
roce4467385001213389135185
202446763850012151102152201
schváleno4901385001214086142189239263314371427
jako5352385001212473121176
primární425399001215791115199249282339363
výsledkový8113990012148100141165216274322377425477
cíl131139900121456995
a14293990012148
je1501399001212475
pravděpodobné,1599399001215791141188245296354411469525583640691712
že2334399001214394
směřujeme24513990012140124175208264289340425476
do29513990012156112
období30863990012155113172228286310
MRD34203990012180135203
řízené3647399001213257100151208260
terapie.3930399001213383117167224249300321
Klíčová425416001235885111155211261312
slova:758416001234268124174225248
imunoterapie,10274160012123107161217272305354387435492515566586
minimální16344160012183106162185268316339394418
reziduální2073416001213282126149206260308332387410
nemoc,25044160012156106190245290312
CAR28374160012158120174
T-lymfocyty,3032416001214976101148232261317362412448498514
bispecifické3567416001215781120176227273296325351396443492
protilátky.4080416001215790144177200223271304350401417
New4254410015083146238
therapeutic7014410015046115178228291360423491539574627
options13674410015065134182217284352408
and18134410015063132201
trends2052441001504696159228297352
in24434410015032101
the25824410015046115179
treatment2799441001504696159224271373436504552
of33894410015066114
multiple35414410015099168202250285353388451
myelom40314410015099166227262330430
Progress425461001215385140196229279318357
in801461001212379
multiple8994610012183138161194217274298348
myeloma12664610012183129178202257341389
(MM)16744610012129107188214
treatment1907461001213366116164196279330386418
is2344461001212362
remarkable.2425461001213383166214247294343400424474494
Combined29384610012158112196252276331382439
regimens3396461001213282139162245296352391
for3805461001213085118
newly39424610012155105179203250
diagnosed4211461001215679127183239294333383441
MM46714610012180161
patients48514610012156105138161211267299340
achieve5209461001214993148172222269318
progression-free425475001215790144201234283323362385440496528558591641692
survival1143475001213994126177201249298321
of1490475001215584
more15994750012184139172222
than1846475001213388136192
seven2063475001214090138187243
years.2331475001214796145177217239
In2595475001212480
the2700475001213388139
Czech28644750012158103153199254
Republic,31434750012154104162217274298321365387
the3555475001213388139
approval37194750012148105162195250297345369
of4113475001215584
a42234750012148
four-drug4297475001212984139172199258291346402
combination4725475001214598182239262318366398421476532
of5282475001215584
anti-CD385392475001214810342548900121335688149215264315
monoclonal7584890012184139195250295319374429477501
antibody12784890012148103136159215271328376
(mAb)16734890012128108169226252
with1944489001217397130185
a21484890012148
proteasome2215489001215790145177227275314369453503
inhibitor2737489001212379134157214237270324357
(PI),3113489001212981104131149
immunomodulatory32814890012124107190245300355439494551606629677710764797847
agent41474890012148104154210242
(IMiD)4408489001212851132155222248
and46754890012148103160
dexamethasone48544890012156107154202285336369424472512567622673
is425503001212362
expecting511503001215097155206251287310365421
in956503001212378
2025.10585030012151101150201220
It1302503001212457
is1382503001212463
not14695030012155110143
yet1636503001214796129
clear1789503001214568118166199
whether20115030012174130180214269319352
consolidation2387503001214598154193248272295352400432455510566
with2977503001217397130185
autologous31865030012148103136190214269326381436475
transplantation3685503001213366114169208265289337392425473506529584640
will4348503001217498121144
be45165030012156107
beneficial46475030012157108164214244270315338385409
in5079503001212479
terms5182503001213382115199238
of5443503001215584
extending425517001215097133182237294317372427
the870517001213388138
time1026517001213356139189
to1233517001213387
progression.1337517001215790144201233283322361383438494515
The18695170012150106156
development20435170012156106154203227281338422472527560
of2620517001215584
immunotherapy27225170012123106189243298353386441491524572628675
has34145170012156103142
literally357451700121244679128161209233256303
exploded.3895517001215097154178232289340397417
Autologous43305170012161115148201225280337392447486
chimeric48335170012145100123206256289312357
antigen52075170012149104136159214264320
receptor425531001213383128177234267321354
T-cell800531001215076124173197220
therapy1041531001213388138171220276323
(CAR1384531001212985147200
T-cells)1605531001215076124173197220259284
targeting1909531001213482115171221254277333389
the2318531001213489139
BCMA24785310012154112192254
antigen27535310012148103135158214265320
have30945310012155103150199
already3314531001214872104154202258306
been36415310012157108159214
approved38765310012148105162195250297346403
for4300531001212984117
second-line4438531001213990136189245302333358381436487
therapy4946531001213388138171220276323
in5290531001212378
the5389531001213388139
USA.4255450012164111169191
The6335450012149104153
development8035450012155104151199222275331413462516548
of1367545001215583
bispecific1466545001215679117172222266289317342386
antibodies18685450012148102133155210265321343392430
(bsAb)2315545001212883121181236261
is2593545001212361
even2671545001214995143197
faster.2885545001212976114147195227243
Bispecific3144545001215476114169219264286314339383
antibodies35445450012147101132154210264320342391429
targeting3990545001213380112166215247270323378
BCMA43855450012153110188248
and46505450012147101157
GPRC5D48235450012164116167224274338
antigens51785450012147101132154209258312350
are425559001214881130
available578559001214995144167190238295319369
in970559001212378
late1071559001212472104154
relapse.1247559001213383107155212251301321
Clinical1591559001215881104159182227276299
trials191355900121336689137161200
are2136559001214880130
testing2289559001213382122156179234290
additional26025590012148105161184218241296351399423
therapeutic3048559001213388138171220276327383416439484
targets3554559001213482115171221254295
(e.g.,387255900121287595151171193
FcRH5)4088559001214892145211261288
and43995590012148103160
combination4582559001214598182239262317365398421476532
regimens5137559001213282139162245296351390
(e.g.,42557300121287595151172193
bsAb,637573001215796157214234
PI,89057300121537597
IMiD).10065730012124104128194221239
Response12645730012154105144201256312351402
rates1685573001213281113163202
to1906573001213387
these2013573001213388138178228
combinations2260573001214599182239263318366399422477532571
in2850573001212479
the2948573001213388139
first310657300121295588128162
line3287573001212447102152
treatment3458573001213366116164196280330386418
are3895573001214881131
90-10040455730012151103138183230283
%,43475730012179101
with4467573001217497130186
a46725730012148
high4739573001215579134190
percentage49485730012157108141185234290322371427477
of5444573001215584
patients4255870012156104136159209263295335
achieving777587001214892147169219266289344399
minimal11935870012183106160183265312335
residual1546587001213281120142198252300323
disease1886587001215678117167214253302
(MRD)22065870012128105159225251
negativity.24745870012155105161208240263310334366415431
In2923587001212378
2024,30185870012151101148196216
assessment3251587001214887125175214252334384439471
of3739587001215583
MRD38405870012179133199
was40565870012173121159
approved42335870012147103160192246292341397
as4648587001214786
a47515870012148
primary4816587001215789112194242274323
outcome51575870012154109141184237320370
in425601001212379
clinical52560100121456891146169214262286
trials83260100121336689137161200
and10536010012148103160
it1234601001212457
is1312601001212362
likely139660100121234693142166213
that1630601001213388136169
we18206010012174123
are1964601001214981131
now21166010012156111184
moving23216010012183138185209265321
to2663601001213387
wals27716010012174122146185
an29776010012148103
era3101601001215183132
of3254601001215584
MRD-driven33596010012181135202236295328351399449504
therapy.3884601001213489139172220277323340
Key4256180012358108158
words:6046180012374130166224266290
immunotherapy,9156180012123106190244300355388443493526575631678694
minimal16306180012183106162185268316339
residual1991618001213282122144201256304327
disease,2339618001215780119169218257307327
CAR26876180012158121174
T-cells,2882618001215076124173197220259280
bispecific3183618001215781120176227273296325352396
antibodies.36016180012148103135158215271328351401441462
Úvod4256610013874137198262
Mnohočetný5656780010770119167216264305347375424462
myelom10476780010773112155174223297
(MM)1363678001072492162185
tvoří1567678001072871119146165
117516780010744
%18146780010767
všech1900678001074174118160208
nádorových2127678001074889138187214261301344384432
onemocnění2578678001074897141215263304425692001074892140159
a6056920010741
přibližně66769200107507796145165183220268312
101001692001074383
%11056920010767
krevních1193692001073866109150199217257305
nádorů.1519692001074989139187214262277
V18176920010746
léčbě1884692001071963104154199
MM21046920010770140
bylo2265692001075089109157
v24436920010741
posledních2505692001075099133151195245293312352400
deseti425706001074993127171199218
letech66970600107196391133175223
dosaženo918706001074997131172210252301349
značného1293706001073785126167215259307356
pokroku.1675706001075099137165212251299315
Do20177060010758107
léčby2150706001071963104154193
bylo2369706001075089109157
zavedeno2553706001073678118161211255303352
více3047664001074161102145
než3219664001074994132
203378664001074589
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