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Brejcha M.,Hematologicke Oddeleni | Doubek M.,Interni Hematoonkologicka Klinika LF MU a FN Brno | Cmunt E.,I. Interni Klinika VFN | Schwarz J.,Ustav Hematologie a Krevni Transfuze | And 6 more authors.
Transfuze a Hematologie Dnes | Year: 2010

The goal of the study was an analysis of the influence of conventional as well as new prognostic factors on overall survival (OS) of CLL patients. We retrospectively analyzed data of patients entered into the databases of four hematological centers. Monitored parameters were clinical stage, age, gender, status of IgVH gene mutation, deletion 17p, deletion 11q, trisomy 12, deletion 13q, CD38, ZAP-70. The analysis of individual influence of each factor on OS, as well as multiparametric analysis of prognostic factors were performed. The total of 1146 patients (median age 61 years, 32-90; sex: 707 male, 439 female) underwent the analysis. Through the use of uniparametric analysis, it was determined that advanced stage of CLL (Rai II-IV) (p<0.001), unmutated IgVH status (p<0.001), deletion 17p (p<0.001) and increased expression of CD38 (p=0.01) had significant negative influence on OS. Multiparametric analysis revealed that OS was significantly influenced by gender (men with CLL have approximately three times higher risk of death than women; p=0.02), age (p=0.04), IgVH status (p=0.03) and deletion 17p (p=0.007).


Huser M.,Gynekologicko porodnicka Klinika LF MU a FN Brno | Smardova L.,Interni Hematoonkologicka Klinika LF MU a FN Brno | Ventruba P.,Gynekologicko porodnicka Klinika LF MU a FN Brno | Mayer J.,Interni Hematoonkologicka Klinika LF MU a FN Brno
Klinicka Onkologie | Year: 2010

Infertility is one of the most common permanent implications of oncology treatment of patients in reproductive age. The aim of this paper is to summarize current knowledge about the impact of basic modalities of oncology treatment on human reproduction. The authors describe the influence of chemotherapy, radiotherapy and pelvic surgery on the reproductive functions of men and women. Both chemotherapy and radiotherapy diminish the ovarian reserve of follicles, which is the main determining factor of premature ovarian failure. Modern markers of ovarian reserves are introduced, which in common clinical practice can effectively help to evaluate the risk of irreversible damage to the gonadal cells done by oncological disease or its curative treatment. If there is a good chance to permanently cure malignant disease in an oncological patient of fertile age, it is advisable to consider new modern techniques of reproductive protection in cooperation with reproductive medicine specialists.


PubMed | Interni hematoonkologicka klinika LF MU a FN Brno
Type: Journal Article | Journal: Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti | Year: 2012

The effectiveness of cladribine depends on the ratio of activating (deoxycytidine kinase) and inactivating (5-nucleotidase) enzymes. Not only is this ratio high in resting lymphocytes but also in Langerhans cells as well in some other histiocytic cells. Therefore, cladribine shows high effectiveness in patients with Langerhans cell histiocytosis (LCH). In 2003, the first report on excellent results with cladribine in first line treatment of patients with multisystem or multifocal LCH was published. That is why we use cladribine for adult patients with relapsing form of LCH and also for first line treatment of multifocal and multisystem LCH at our department.Since 2001, we have treated altogether 10 adults (9 male and 1 female) with cladribine. The median age at diagnosis was 31.5 years (range: 5-45). The multiorgan form of the disease was present in 8 patients, and 2 patients had the multifocal skeletal form with aggressive disease course. Cladribine at a dose of 5 mg/m2 SC per day was given as a 5-day course at 28-day intervals. In cases of insufficient effectiveness, in two patients after the 3rd cycle with cladribine monotherapy, we proceeded to combination therapy with cladribine of 5 mg/m2 per day, cyclophosphamide 150 mg/m2 per day and dexamethasone 20 mg per day, all on days 1-5. We planned 6 cycles at the most.The median of cladribine cycles was 5 (range: 4-6). Altogether, 10 patients finished therapy; out of them 9 are in complete remission with the follow-up median of 26 months (range: 16-94). Treatment failure was noted only in 1 patient - in 60 days after therapy cessation the disease progressed and required further treatment (CHOEP, high-dose BEAM chemotherapy with autologous transplantation followed by Revlimid treatment and allogeneic transplantation). Treatment response - disappearance of infiltrate in the pituitary infundibulum - was observed in 2 patients with LCH affecting the pituitary infundibulum.Cladribine is a suitable medication for multiorgan and multifocal forms of LCH. In our group of ten evaluated patients, cladribine therapy resulted in 90% of long-term complete remissions. Three patients had CNS involvement and in all three patients, treatment responses have been achieved.

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