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Sandecka V.,Interni hematoonkologicka klinika FN Brno | Spicka I.,Interni klinika VFN | Gregora E.,FN Kralovske Vinohrady | Scudla V.,III. interni klinika FN a LF UP Olomouc | And 10 more authors.
Onkologie | Year: 2011

Bortezomib (Velcade) is a representative of class of medicines called proteasome inhibitors. This drug represents quite new and unique medical treatment of the patients with multiple myeloma (MM). This article presents a retrospective analysis of effectiveness and adverse effects in patients with multiple myeloma treated at reference centers of CMG in the Czech Republic. A total 424 patients with multiple myeloma treated with bortezomib from June 2004 to June 2010 were evaluated. The median follow-up was 12,4 months. The mean age of patients was 66 year (34,1-86,5) and majority of them were patients with relapsed multiple myeloma. Of the total 424 patients, 205 patients had bortezomib as second line therapy (48,3 %). Assessment of terapeutic response was possible in 83,3 % of treated patients (353/424). Therapeutic response (defined as a ≥ 50 % decrease in the serum MIG) was achieved in 52,7 % (186/353). Among mentioned responses, complete response was obtained in 14,2 % (50/353). The most severe toxicity observed was peripheral neuropathy, grade 3 or higher was developed in 14 % (49/358). There was recorded a thrombocytopenia grade 3 or higher in 28,8 % (103/357), further occurance of infections grade 2 or higher in 33,6 % (121/359) and eventually we could observe increased number of thromboembolic disease as well. Rapid onset of therapeutic responses and high percentage of obtained complete responses are the main reasons of extraordinary clinical benefit of bortezomib. The most of adverse effects are well controllable by means of appropriate prophylactic precautions, short-term interruptions of treatment, followed by adjustments based on the valid recommendations.


Illa P.,Klinika Nemoci Plicnich A TBC LF MU A FN | Tomiskova M.,Klinika Nemoci Plicnich A TBC LF MU A FN | Tomiska M.,Interni Hematoonkologicka Klinika FN Brno | Skrickova J.,Klinika Nemoci Plicnich A TBC LF MU A FN
Studia Pneumologica et Phthiseologica | Year: 2010

Most lung cancers are already advanced at the time of diagnosis. In these patients, a frequent symptom is protein-energy malnutrition, often diagnosed prior to oncological treatment. Malnutrition results in poor tolerance of treatment and increased morbidity and mortality. Early detection of malnutrition is important to determine the prognosis of cancer patients as well as to plan effective supportive care. Early systematic identification of already malnourished patients or those at increased risk of malnutrition should be ensured by correctly performed and designed nutritional screening. If cancer malnutrition is diagnosed late in the clinical course of the disease, nutritional support is also delayed and a great deal of its potential benefit is lost. Late detection of cancer malnutrition with all the consequences is reflected by treatment costs as well as the cancer patient's quality of life/.


Brancikova D.,Interni Hematoonkologicka Klinika FN Brno
Interni Medicina pro Praxi | Year: 2012

Anemia is not a single disease but a condition, with many possible causes and many forms. Cause of anemia include nutritional deficiencies, inherited genetic defects, medication-related side effects (examply NSA), and chronic disease (often times gastrointestinal malignancy). It can also occur be cause of blood loss from injury or internal bleeding, the destruction of red blood cells, or insufficient red blood cell production. The condition may be temporary or long-term, and can manifest in mild or severe forms. We are able to influence anemia with sufficient doses of the iron and vitamines in the foods, and with abolition of some specific factors in the diet, when metabolic deficit is attended.

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