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Cernan M, Szotkowski T, Hisemova M, Cetkovsky P, Sramkova L, Stary J, Racil Z, Mayer J, Sramek J, Jindra P, Visek B, Zak P, Novak J, Kozak T, Furst T, Papajik T. Blastic plasmacytoid dendritic cell neoplasm: First retrospective study in the Czech Republic. Neoplasma 2020; 67:650-659. [PMID: 32064883 DOI: 10.4149/neo_2020_190507n407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/11/2019] [Indexed: 11/08/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy with aggressive behavior and poor prognosis. We present the first retrospective analysis mapping its incidence and therapeutic outcomes in patients diagnosed and treated from 2000 to 2017 in the Czech Republic. The cohort comprised 14 patients (10 males, 4 females) with a median age at diagnosis of 39 years (range, 5-68 years). Initially, skin involvement was noted in 10 (71%) patients and bone marrow infiltration was present in 9 (64%). The first complete remission was achieved in 6/14 (43%) patients after acute lymphoblastic leukemia/lymphoma induction therapy and in 3/14 (21%) patients after acute myeloid leukemia regimen. Nine patients underwent allogeneic hematopoietic cell transplantation, with two patients achieving the first complete remission only after allogeneic transplantation. Patients undergoing allogeneic hematopoietic cell transplantation had longer overall survival than those treated without transplantation (the median survival over the period 16.4 vs. 8.1 months). Relapse of the disease was a significant predictor of mortality (p=0.05). Over the study period, patients' survival ranged from 3.3 to 44.2 months, with a median overall survival of 13 months. Our results revealed an effectivity of allogeneic hematopoietic cell transplantation on complete remission achievement in refractory/relapsed disease. The study aimed to present the actual data from the Czech Republic and thus contribute to a global understanding of BPDCN.
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Affiliation(s)
- M Cernan
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - T Szotkowski
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - M Hisemova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - P Cetkovsky
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - L Sramkova
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - J Stary
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Z Racil
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - J Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - J Sramek
- Department of Hemato-Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - P Jindra
- Department of Hemato-Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - B Visek
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - P Zak
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - J Novak
- Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - T Kozak
- Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - T Furst
- Department of Mathematical Analysis and Application of Mathematics, Faculty of Science, Palacky University Olomouc, Olomouc, Czech Republic
| | - T Papajik
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
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Durinikova A, Folta A, Culen M, Kosarova Z, Tom N, Al Tukmachi D, Cetkovsky P, Jindra P, Szotkowski T, Zak P, Mayer J, Racil Z, Jeziskova I. PF247 CONSEQUENCES OF NRAS MUTATIONS IN PATIENTS WITH ACUTE MYELOID LEUKEMIA. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000559204.24910.9e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Valkova V, Jircikova J, Trnkova M, Steinerova K, Keslova P, Lanska M, Koristek Z, Raida L, Krejci M, Kruntoradova K, Dolezal T, Benesova K, Cetkovsky P, Trneny M. The quality of life following allogeneic hematopoietic stem cell transplantation - a multicenter retrospective study. Neoplasma 2019; 63:743-51. [PMID: 27468878 DOI: 10.4149/neo_2016_511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED Although allogeneic haematopoietic stem cell transplantation (allo-HSCT) offers a unique curative potential, it may be connected with high treatment-related morbidity and mortality. Besides many organ complications, allo-HSCT may significantly affect quality of life (QOL). PATIENTS AND METHODS Between January 2011 and December 2012, five hundred and ninety patients (pts) from 6 transplant centers in the Czech Republic filled in the questionnaire for the quantitative measurement of QOL using Functional Assessment of Cancer Therapy-General (FACT-G) version 4. Study cohort characteristics were as follows: 325 males, 340 pts received myeloablative conditioning, 383 pts received PBPC, representation of diagnoses; acute leukemia (n=270), bone marrow failure (n=36), chronic myeloid leukemia (n=74), myelodysplastic/myeloproliferative syndrom (n=110), lymphoproliferative disease (n=93). The median age at allo-HSCT was 43 years (range: 1.7 - 71.0), the median time from allo-HSCT to questionnaire completing was 3.8 years (range: - 0.2 - 21.6). The earliest allo-HSCT was performed in November 1989, the last in September 2012. In this retrospective study, we investigated the impact of various factors on the QOL after allo-HSCT: age, gender, diagnosis, type of conditioning, time from diagnosis to allo-HSCT, disease stage, graft type, donor type, time from allo-HSCT to questionnaire completing, GVHD, relapse. Only data from patients who were more than 3 months after allo-HSCT were used for the multivariate analysis. The overall results of the total FACT-G score (median=85.0; range: 29-108) as well as the results of each specific dimension - PWB (median=23.0; range: 5-28), SWB (median=24.0; range: 7-28), EWB (median= 19.0; range: 4-24), FWB (mean=21.0; range: 2-28) showed a value in the highest quartile of the possible evaluation. In multivariate analysis, an inferior QOL score was reported for patients with aGVHD (p=0.002), cGVHD (p<0.001), QOL decreased with increasing age (p=0.048) and increased with time elapsed since allo-HSCT (p<0.001).Allogeneic HSCT represents an important intervention into the overall integrity of the organism. In particular, the development of GVHD can cause very serious organ, but also mental problems which can significantly reduce the QOL. The QOL is steadily increasing with increasing interval from allo-HSCT but improvement and disappearance of these complications may take many years, and sometimes these effects may probably persist permanently.
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Cermak J, Vitek A, Markova-Stastna M, Maaloufova-Soukupova J, Cetkovsky P. Comparison of Efficiency of Hypomethylating Agents with Allogeneic SCT in Elderly Patients with Advanced MDS – A Single Center Study. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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5
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Hubacek P, Hrdlickova A, Muzikova K, Briksi A, Zelezna I, Spacek M, Zajac M, Sedlacek P, Cetkovsky P, Stary J. Chromosomally integrated HHV-6 in healthy donor and patients treated for haematological malignancy. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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6
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Hubacek P, Kouba M, Boutolleau D, Pliskova L, Vejrazkova E, Keslova P, Sedlacek P, Cetkovsky P. CMV resistance in patients after allogeneic haematopoietic stem cell transplantation. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Jindra P, Muzik J, Indrak K, Zak P, Sabty FA, Kozak T, Cetkovsky P, Karas VKM, Raida L, Szotkowski T. The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: an analysis of 96 allografted AML patients ≥ 50 years from the Czech acute leukaemia clinical register (alert). Neoplasma 2013; 60:576-83. [PMID: 23790178 DOI: 10.4149/neo_2013_075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients. In the multicentre retrospective study we analyzed 96 consecutive AML patients ≥ 50 years allografted with related (n=59) or unrelated (n=37) donor. The 2- year OS and DFS rates were 45 % and 42 % for the whole group. The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p= 0,896). The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts. Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011). Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS. In conclusion, our analysis indicates that outcomes of allografted AML patients aged ≥ 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor.
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Affiliation(s)
- P Jindra
- University Hospital, Pilsen, Czech Republic.
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8
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Hubacek P, Mejstrikova E, Markova M, Kouba M, Kabickova E, Zajac M, Hornofova L, Keslova P, Sedlacek P, Cetkovsky P. Normalised EBV Quantity in Patients After Allogeneic Haematopoietic Stem Cell Transplantation – Benign Reactivation, Localised and Generalised EBV Lymphoproliferative Disease. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Marinov I, Luxova A, Tkacova V, Gasova Z, Pohlreich D, Cetkovsky P. Comparison of three single platform methods for CD34+ hematopoietic stem cell enumeration by flow cytometry. Clin Lab 2011; 57:1031-1035. [PMID: 22239039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In the present study, we compared three single platform methods for CD34+ hematopoietic stem cell (HSC) enumeration by flow cytometry. For this purpose, we analyzed the performance characteristics and results obtained from different HSC sources. Interlaboratory coefficients of variation (CV) for precision/reproducibility analysis varied from 4.0% to 6.7% / 6.7% to 9.2% for the low and 3.2% to 4.1% / 4.3% to 6.7%, respectively, for the high stem cell control. Correlation between methods ranged from 0.92% to 0.99%; Wilcoxon test showed no significant differences (p > 0.05); Bland-Altman analysis confirmed good agreement between assays (mean bias ranging from -0.48 to 6.91). Our results demonstrate very good intralaboratory correlation and agreement between methods, confirm the major impact of single platform strategy for accurate and reproducible HSC enumeration and suggest that high interlaboratory variability could be influenced by incorrect performance of validated methods.
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Affiliation(s)
- I Marinov
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
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Klamova H, Faber E, Zackova D, Markova M, Voglova J, Cmunt E, Novakova L, Machova-Polakova K, Moravcova J, Dvorakova D, Michalova K, Brezinova J, Oltova A, Jarosova M, Cetkovsky P, Indrak K, Mayer J. Dasatinib in imatinib-resistant or -intolerant CML patients: data from the clinical practice of 6 hematological centers in the Czech Republic. Neoplasma 2010; 57:355-359. [PMID: 20429627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Dasatinib is effective second line treatment for patients with chronic myeloid leukemia (CML) resistant or intolerant to imatinib. We report here the first experiences with dasatinib therapy in 71 CML patients resistant or intolerant to imatinib from the real clinical practice of 6 hematological centers in the Czech Republic. Dose 100 mg daily and 70 mg twice daily was administered to patients with chronic phase (CP) and advanced phases (AP) CML. In chronic phase (n=46), complete hematological reponse (CHR) was achieved in 97%, major cytogenetic reponse (MCgR) in 77% and complete cytogenetic response (CCgR) in 67%. Major molecular reponse (MMR) was achieved in 19/31 patients in median of 10 months. In advanced phase (n=25), CHR was attained in 77%, MCgR in 39%, CCgR in 33% and MMR in 2/18 patients. Eleven different baseline mutations were followed up in 15 patients. Dasatinib eliminated mutations in most of the patients, but 3 patients acquired a new one. Novel mutations were detected under dasatinib therapy in 2 patients. Dasatinib was well tolerated, cytopenias were common and was managed by dose modification. The estimated progression free survival (PFS) at 12 months was 97+/-3% in CP and 62+/-21% in AP. The median time to treatment failure was 605 days in AP while it was not reached in CP patients. Our clinical experiences, described here, confirmed that dasatinib is associated with high response rates especially in imatinib resistant or intolerant CML patients in chronic phase.
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Affiliation(s)
- H Klamova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
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Hubacek P, Boutolleau D, Deback C, Hrdlickova A, Conan F, Lelabousse B, Zajac M, Markova M, Keslova P, Agut H, Sedlacek P, Cetkovsky P. PIX-3 Cytomegalovirus (CMV) resistance to antivirals in children and adult hematopoietic stem cell transplant recipients from the Czech Republic – a two centres experience. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(09)70208-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Hubacek P, Hrdlickova A, Muzikova K, Hyncicova K, Pohlreich D, Cetkovsky P, Sedlacek P. 257: Decrease of HHV6 DNAemia following Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Chromosomally Integrated HHV6. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Hubacek P, Maalouf J, Zajickova M, Kouba M, Cinek O, Hyncicova K, Fales I, Cetkovsky P. Failure of multiple antivirals to affect high HHV-6 DNAaemia resulting from viral chromosomal integration in case of severe aplastic anaemia. Haematologica 2007; 92:e98-e100. [PMID: 18024365 DOI: 10.3324/haematol.11592] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We report a fifty-year-old woman presenting with severe aplastic anaemia (SAA) and prolonged high Human Herpesvirus 6 (HHV6) variant A DNAeamia detected by quantitative PCR. Multiple antiviral treatments failed to affect the HHV6 DNAemia and subsequent immunosuppressive treatment reached only partial improvement as judged by bone marrow examinations. The patient remained dependent on thrombocyte transfusions and G-CSF treatment. After one year of steady high HHV6 DNA load in blood, viral chromosomal integration was proved by demonstrating the viral DNA in hair follicles. This condition appeared to be unconnected with, and to have no effect, on the original SAA.
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Affiliation(s)
- P Hubacek
- Department of Paediatric Haematology and Oncology, Motol University Hospital, Prague, The Czech Republic.
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Faber E, Koza V, Vitek A, Mayer J, Sedlacek P, Zak P, Zapletalova J, Benesova K, Krejcova H, Steinerova K, Maresova I, Cetkovsky P. Reduced-intensity conditioning for allogeneic stem cell transplantation in patients with chronic myeloid leukemia is associated with better overall survival but inferior disease-free survival when compared with myeloablative conditioning - a retrospective study of the Czech National Hematopoietic Stem Cell Transplantation Registry. Neoplasma 2007; 54:443-6. [PMID: 17688375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Allogeneic stem cell transplantation (AlloSCT) has been currently recommended in the treatment of patients with chronic myeloid leukemia (CML) as a second option after imatinib failure or in selected group of patients with high-risk CML and low risk for transplant-related mortality. The actual role of reduced-intensity conditioning (RIC) before AlloSCT in CML patients has not been yet conclusively established. The Czech National Hematopoietic Stem Cell Transplantation Registry has conducted a retrospective analysis of all patients (n=29) transplanted after RIC from the Registry database containing 295 patients with CML transplanted in the Czech Republic in years 1988-2005 and compared them with patients at comparable age (median age 48.3 and 50.6 years, respectively; p=0.587) transplanted during the same period of time using conventional myeloablative conditioning (n=26). Survival advantage of patients transplanted after RIC has been confirmed by log rank test (p=0.036) despite the fact that the relapse rate was significantly higher in RIC group (44.8% versus 0%). Both groups did not differ significantly in the use of voluntary unrelated donors, type of the grafts and in incidence of acute graft versus host disease (GVHD). However, there were trends for higher risk of CML and higher use of unrelated donors in the myeloablative group while peripheral stem cell grafts and chronic GVHD were observed more frequently in the RIC group. Transplant-related mortality was the leading cause of death in both groups of patients. Our results should be interpreted with caution because they may be influenced by small groups of subjects and also the impact of patients with high EBMT risk score on inferior survival in the myeloablative group cannot be fully eliminated. More retrospective and prospective studies are needed to elucidate the actual role of RIC before AlloSCT for CML.
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Affiliation(s)
- E Faber
- Department of Hemato-Oncology, University Hospital Olomouc, Czech Republic.
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15
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Pohlreich D, Vitek A, Maalouf J, Cetkovsky P. Decreased risk of acute gastrointestinal toxicity when substituting methotrexate with mycophenolate mofetil in the prevention of graft-versus-host disease in stem cell transplantation following myeloablative conditioning regimens. Bone Marrow Transplant 2006; 37:235-6; author reply 236-7. [PMID: 16284607 DOI: 10.1038/sj.bmt.1705227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Cetkovsky P, Vitek A, Pohlreich D, Zajickova M, Markova M, Valkova V, Cermak J, Maaloufova J, Kouba M, Soukup P, Klener P. Allogeneic hematopoietic stem cell transplantation in patients over 50: The single centre experience. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Vitek A, Cetkovsky P, Dobrovolna M, Ivaskova E, Korinkova P, Kovarova P, Kupkova L, Loudova M, Markova M, Matejkova E, Navratilova J, Pitrova H, Pohlreich D, Sajdova J, Sponerova D, Valkova V, Vrana M, Vytiskova J. HSCT from partially matched alternative donors—a single centre experience. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cetkovsky P, Koza V, Cepelák V, Vít L. The influence of induction chemotherapy and remission status on haemostasis in patients treated for acute myeloid leukaemia. Blood Coagul Fibrinolysis 1994; 5:349-53. [PMID: 7521222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Haemostatic parameters were studied in 31 adult patients treated for acute myeloid leukaemia (AML) using the 3 + 7 regimen. Lower values of antithrombin III (AT-III), alpha 2-antiplasmin (alpha 2AP) and plasminogen were observed on days 8 and 14 (P < 0.05). Fibrinopeptide A (FpA) levels were higher at diagnosis (P < 0.05), increased again during chemotherapy on days 4 and 8 and eventually returned to the normal range. Tissue plasminogen activator, plasminogen activator inhibitor, protein C and fibrin(ogen) degradation products were normal throughout the period of observation. Complete remission (CR) was achieved in 19 of 31 patients (61%). In order to compare haemostatic changes in CR patients with those in refractory cases, patients were divided into two groups. In patients with refractory AML (n = 12) AT-III, plasminogen and alpha 2 AP were significantly lower than in those in CR. FpA levels were increased in all patients at diagnosis. This elevation progressed in both groups during chemotherapy (on days 4 and 8) and then normalized only in patients in CR. However, in resistant patients, higher FpA values persisted or even increased further on day 14. The fact that none of our patients suffered from clinically manifest thrombotic complications suggested that haemostasis was well compensated and the observed changes were of no clinical importance, even if they were significant statistically.
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Affiliation(s)
- P Cetkovsky
- Department of Medicine I, Charles University Teaching Hospital, Czech Republic
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Cetkovsky P, Koza V, Čepelák V, Vít L, Šigutová P. Haemostatic changes in patients with acute lymphoblastic leukaemia during and after remission induction therapy. ACTA ACUST UNITED AC 1993. [DOI: 10.1016/0268-9499(93)90063-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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