Warsaw, Poland
Warsaw, Poland

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Plasma cell myeloma (PCM) constitutes 10% of all diagnosed haematological malignancies. Whenever indicated, such patients aged below 65 years receive a regimen of cytotoxic treatment along with autologous hematopoietic stem cell transplantation (auto-HSCT). Using a case study example of a 62 year old man, this article describes a standard regimen for treating patients in Poland from this age group, who qualify for the auto-HSCT. © 2015 Via Medica.

Diffuse large B-cell lymphoma (DLBCL) is a group of lymphoid malignancies derived from mature peripheral B lymphocytes arising in germinal centres. It is the most commonly occurring of all lymphoma types (appr. 30%) and aggressive subtypes (appr. 80%). Its heterogeneity serve as the basis for DLBCL classification into clinical, morphological, molecular and immunohistochemical subtypes. To achieve optimal use of all available diagnostic and therapeutic resources in DLBCL patient management, the Institute of Hematology and Transfusion Medicine has developed and implemented a set of internal recommendations. As in previous publications of this kind, these recommendations refer mostly to clinical practice. For further details please consult; http://www. ihit.waw.pl/rekomendacje-ihit.html. © 2013 Via Medica.

The last decade witnessed significant improvement of myelodysplastic syndrome (MDS) therapy results. This was due to more objective criteria for histopathological diagnosis according to World Health Organization (WHO) classification and risk stratification of International Prognostic System Score (IPSS). Treatment strategies are tailored based on the therapeutic goals within each classification and prognostic risk groups and consist of the best supportive care with or without less or more intense cytoreduction. This was allowed due to the emergence of new therapies, including lenalidomide in patients with IPSS low or intermediate-low risk MDS with del(5q), and demethylating agents (azacitidine, decitabine) in the treatment of patients with intermediate-high and high risk or refractory MDS. © 2010 Via Medica.

Wrobel T.,Klinika Hematologii
Acta Haematologica Polonica | Year: 2015

Abstract Despite high curability rate 10-30% Hodgkin lymphoma patients relapse or fail to respond to the first-line therapy. Routine approaches to these patients are salvage chemotherapy and HDT/ASCT. Brentuximab vedotin, conjugated antibody antyCD30, has demonstrated significant anti-tumor activity in HL. This drug has been registered for the treatment of patients who relapse after ASCT or after multiple relapses. Recently there have been very encouraging reports of the efficacy of antiPD-1 in these patients. This article summarizes the possibilities of treatment of relapsed/refractory Hodgkin lymphoma with monoclonal antibodies. © 2015 Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii. Published by Elsevier Sp. z o.o. All rights reserved.

During nearly two decades there has been continuous progress in the therapy of plasma cell myeloma resulting in significant prolongation of patients' overall survival. Since 2010 the efficacy and toxicity of chemotherapy regimens including immunomodulatory drugs and proteasome inhibitors have been further optimized based on the results of numerous, large phase 3 randomized clinical trials. Moreover, intensive efforts have been made to identify novel molecular drug targets to individualize treatment and overcome resistance to existing therapies. Currently, the most promising therapeutic strategy is immunotherapy, especially development of monoclonal antibodies against CD38 antigen. © 2015 Via Medica.

Warzocha K.,Klinika Hematologii
Acta Haematologica Polonica | Year: 2015

Abstract The last decade has witnessed significant advances in understanding the pathogenesis of diffuse large B-cell lymphoma (DLBCL). This has been evidenced by a 2008 classification published by the World Health Organisation (WHO), describing several clinical-pathologically distinct subtypes of DLBCL as well as at least two molecular categories which include GCB (germinal centre B-cell like) and ABC (activated B-cell like) DLBCL. Hence in such cases, designing any uniform or effective therapy is practically impossible, unlike that for other more homogenous cancers. It has become therefore necessary to optimize basic chemotherapeutic procedures, common to large patient groups, whilst simultaneously adopting individually tailored approaches targeted at those genetic aberrations proven significant in the pathogenesis of DLBCL. In addition, important differences in patient management are adviced in treating the elderly. © 2015 Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii. Published by Elsevier Sp. z o.o. All rights reserved.

Abstract Polycythaemia Vera (PV) and Essential Thrombocythaemia (ET) are classical Chronic Myeloproliferative Neoplasms BCR-ABL(-). Despite their low incidence rates, survival of PV and ET patients is high, thereby making up a significant proportion of those cared for at the haematology clinic. Most patients requiring cytoreductive therapy receive hydroxycarbamide (HU) as the drug of choice, however around 20% prove to be either HU resistant or intolerant. In such cases, this article discusses the therapeutic options available for their treatment. © 2015 Published by Elsevier Sp. z o.o. on behalf of Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii.

During recent years there has been a significant progress in the diagnosis and therapy of myeloproliferative neoplasms and myelodysplastic syndromes. The application of novel sequencing techniques has led to the discovery of multiple recurrently mutated genes that has largely improved our understanding of the biological complexity of these malignancies. Most importantly, these new findings on molecular pathogenesis have resulted in the development of effective targeted therapies as well as construction of new prognostic indexes that facilitate patients' assignment to proper type of treatment. © 2015 Via Medica.

Leukemias of large granular lymphocytes (LGL) include a heterogeneous group of rare lymphoid malignancies derived from T cells (T-LGL) and natural killers (NK-LGL) T-LGL leukemia arises from long-term antigen stimulation and the survival of LGL cells is associated with constitutive activation of anti-apoptotic intracellular pathways JAK/STAT, RAS/RAF/MEK/ERK, sphingolipids and extracellular FAS/FASL. The clinical course may be indolent or aggressive where majority of patients present clinical symptoms such as cytopenia, organomegaly and underlying autoimmune diseases; particularly rheumatoid arthritis. Diagnosing LGL leukemia is based on flow cytometry and T-cell receptor gene rearrangement. Most patients also require treatment for severe neutropenia complicated infections. T-LGL leukemia therapy is mainly immunosuppressive; the drug of choice in the first line is methotrexate or cyclophosphamide but there are no established standards for treating LGL leukemia. Both chronic T/NK-LGL leukemias exhibit an indolent clinical course with a favorable prognosis, whereas aggressive T/NK-LGL leukemias are progressive diseases with poor prognosis. © 2015 Via Medica.

Ruxolitinib is the first JAK kinase inhibitor registered for the treatment of primary myelofibrosis and post-polycythaemia vera myelofibrosis and post-essential thrombocytaemia myelofibrosis. The article is a summary of current clinical data with ruxolitinib therapy both in myelofibrosis and in other Ph-negative myeloproliferative neoplasms. © 2015 Polskie Towarzystwo Hematologów i Transfuzjologów, Instytut Hematologii i Transfuzjologii.

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