{"id":14699,"date":"2014-02-07T16:40:12","date_gmt":"2014-02-07T15:40:12","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=14699"},"modified":"2014-02-07T16:40:12","modified_gmt":"2014-02-07T15:40:12","slug":"onkolog-odpovidal-na-dotazy-posluchacu","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=14699","title":{"rendered":"Onkolog odpov\u00eddal na dotazy poslucha\u010d\u016f"},"content":{"rendered":"

V souvislosti s prob\u011bhl\u00fdm Sv\u011btov\u00fdm dnem boje proti rakovin\u011b hovo\u0159il v \u010cesk\u00e9m rozhlase z\u00e1stupce prim\u00e1\u0159e hematologicko-onkologick\u00e9ho odd. Fakultn\u00ed nemocnice v Plzni docent Daniel Lys\u00e1k. Odpov\u00eddal i na dotazy poslucha\u010d\u016f.<\/strong> <\/p>\n

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Fakultn\u00ed nemocnice v Plzni je jedinou nemocnic\u00ed v \u010cesk\u00e9 republice, kter\u00e1 nab\u00edz\u00ed hematologicky onkologick\u00fdm pacient\u016fm novou inovativn\u00ed metodu l\u00e9\u010dby kmenov\u00fdmi bu\u0148kami. Poda\u0159ilo se vyvinout p\u0159\u00edpravek, kter\u00fd je ur\u010den k l\u00e9\u010db\u011b komplikac\u00ed po transplantaci kostn\u00ed d\u0159en\u011b, tak\u017ee to je dal\u0161\u00ed \u0161ance pro vyl\u00e9\u010den\u00ed, pro pacienty s leuk\u00e9mi\u00ed a jin\u00fdmi n\u00e1dorov\u00fdmi onemocn\u011bn\u00ed krvetvorby.<\/strong><\/p>\n

Ur\u010dit\u011b, je to tak, jak \u0159\u00edk\u00e1te, tahle nov\u00e1 metoda l\u00e9\u010debn\u00e1 by m\u011bla pomoci zlep\u0161it v\u00fdsledky, kter\u00fdch dosahujeme po transplantaci kostn\u00ed d\u0159en\u011b.<\/p>\n

m\u016f\u017eete stru\u010dn\u011b vysv\u011btlit n\u00e1m laik\u016fm, jak\u00fdm zp\u016fsobem ta metoda funguje, co je na n\u00ed tak p\u0159evratn\u00e9ho, co se zlep\u0161uje v t\u00e9 l\u00e9\u010db\u011b.<\/strong><\/p>\n

Transplantace kostn\u00ed d\u0159en\u011b nen\u00ed jednoduch\u00e1 procedura a pacient, kter\u00fd ji podstoup\u00ed, m\u016f\u017ee trp\u011bt \u0159adou r\u016fzn\u00fdch komplikac\u00ed. A jednou z takov\u00fdch ob\u00e1van\u00fdch komplikac\u00ed je situace, kdy podan\u00e9 krvetvorn\u00e9 bu\u0148ky, ten transplant\u00e1tor, d\u00e1rce, m\u016f\u017ee tro\u0161ku \u0161kodit tk\u00e1n\u00edm nebo organismu pacienta, doch\u00e1z\u00ed tam k takov\u00e9 nezdrav\u00e9 imunologick\u00e9 reakci. A ty kmenov\u00e9 bu\u0148ky, kter\u00e9 my jsme za\u010dali vyr\u00e1b\u011bt, by pr\u00e1v\u011b m\u011bly tuto nezdravou imunitn\u00ed reakci m\u00edrnit, tlumit nebo j\u00ed \u00fapln\u011b odstranit.<\/p>\n

Pane docente, kdybyste vysv\u011btlil, co jsou ty kmenov\u00e9 bu\u0148ky?<\/strong><\/p>\n

Proto\u017ee se bav\u00edme zejm\u00e9na o kostn\u00ed d\u0159eni, tak kmenov\u00e9 bu\u0148ky jsou vlastn\u011b takov\u00e9 nezral\u00e9 mate\u0159sk\u00e9 bu\u0148ky, ze kter\u00fdch vyzr\u00e1vaj\u00ed ostatn\u00ed specializovan\u00e9 bu\u0148ky, v p\u0159\u00edpad\u011b kostn\u00ed d\u0159en\u011b mluv\u00edme o krvetvorn\u00fdch kmenov\u00fdch bu\u0148k\u00e1ch – z nich vlastn\u011b rostou v\u0161echny krvinky, kter\u00e9 pot\u0159ebujeme, kter\u00e9 najdeme pak v krvi, b\u00edl\u00e9 krvinky, \u010derven\u00e9 krvinky, krevn\u00ed desti\u010dky, a vedle toho v kostn\u00ed d\u0159eni nach\u00e1z\u00edme takzvan\u00e9 mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky, kter\u00e9 pr\u00e1v\u011b jsou podstatou t\u00e9 na\u0161\u00ed l\u00e9\u010debn\u00e9 metody. Z t\u011bch mohou vyr\u016fstat jin\u00e9 tk\u00e1n\u011b, a\u0165 u\u017e je to tuk, chrupavka, kost. A ty bu\u0148ky maj\u00ed dv\u011b d\u016fle\u017eit\u00e9 vlastnosti,\u00a0 jak jsme tady u\u017e zm\u00ednili, maj\u00ed schopnost zas\u00e1hnout do n\u011bkter\u00fdch nezdrav\u00fdch imunitn\u00edch mechanism\u016f a maj\u00ed tak\u00e9 schopnost podporovat regeneraci tk\u00e1n\u00ed.<\/p>\n

te\u010f je\u0161t\u011b, kdy\u017e u\u017e jsme mluvili o leuk\u00e9mii jako takov\u00e9, v \u010dem tkv\u00ed podstata tohoto onemocn\u011bn\u00ed, co se s t\u011blem stane, jak\u00e9 p\u0159\u00edznaky leuk\u00e9mie m\u00e1?<\/strong><\/p>\n

Leuk\u00e9mie na rozd\u00edl od takov\u00fdch t\u0159eba t\u011bch klasick\u00fdch solidn\u00edch n\u00e1dor\u016f plic, je takov\u00fd n\u00e1dor tekut\u00fd, najdeme ho v kostn\u00ed d\u0159eni, najdeme ho v krvi, najdeme ho t\u0159eba i v jin\u00fdch org\u00e1nech, kter\u00e9 m\u016f\u017ee ta nemoc postihovat. V podstat\u011b doch\u00e1z\u00ed k tomu, \u017ee jedna z t\u011bch b\u00edl\u00fdch krvinek, kter\u00e9 m\u00e1me v kostn\u00ed d\u0159eni, se vymkne takov\u00e9 t\u00e9 p\u0159irozen\u00e9 regulaci, kter\u00e1 pro krvetvorbu funguje, a za\u010dne se nekontrolovan\u011b mno\u017eit, vypln\u00ed n\u00e1m celou tu kostn\u00ed d\u0159e\u0148 a t\u00edm vlastn\u011b ztr\u00e1c\u00edme ten prostor pro tvorbu norm\u00e1ln\u00edch zdrav\u00fdch krvinek. A to se potom projev\u00ed v krevn\u00edm obraze, kde je nedostatek t\u011bch zdrav\u00fdch krvinek, \u010derven\u00fdch krvinek, b\u00edl\u00fdch krvinek, desti\u010dek a naopak tam mohou p\u0159eb\u00fdvat ty n\u00e1dorov\u00e9 krvinky, kter\u00e9 pacientovi n\u011bjak nepom\u00e1haj\u00ed, naopak mu \u0161kod\u00ed.<\/p>\n

A krv\u00ed se rozn\u00e1\u0161\u00ed vlastn\u011b ta leuk\u00e9mie po cel\u00e9m t\u011ble, ch\u00e1pu to dob\u0159e?<\/strong><\/p>\n

P\u0159esn\u011b tak, ano.<\/p>\n

poslucha\u010dka: Dobr\u00fd den. U n\u00e1s je to takov\u00fd stra\u0161n\u011b aktu\u00e1ln\u00ed, v\u010dera jsme o tom mluvili do p\u016flnoci. J\u00e1 m\u00e1m p\u0159\u00edbuznou 60 let, je to man\u017eelka m\u00e9ho synovce, kter\u00e1 \u010dek\u00e1 na d\u00e1rce kostn\u00ed d\u0159en\u011b, ona se rok l\u00e9\u010dila, potom byla rok zdrav\u00e1, chodila na kontroly a po roce se j\u00ed to vr\u00e1tilo. Te\u010f m\u011bla u\u017e j\u00edt na operaci, m\u011bla dostat kostn\u00ed d\u0159e\u0148 od sv\u00e9ho bratra a na posledn\u00ed …, je mu 52 let, a na posledn\u00ed chv\u00edli z toho se\u0161lo, pon\u011bvad\u017e mu tam na\u0161li, jak jsem pochopila, n\u011bjakou \u017eloutenku, kterou on nem\u00e1, ale p\u0159itom ona by j\u00ed z t\u00fd krve jeho dostala, tak\u017ee te\u010f \u010dek\u00e1 na transplantaci. \u017dije v Praze. Je mo\u017en\u00e9, aby ona n\u011bjak si za\u017e\u00e1dala o tuto l\u00e9\u010dbu, nebo vy m\u00e1te kontakty s Prahou a sami za\u0159azujete pacienty na tu l\u00e9\u010dbu. J\u00e1, jestli by mohla n\u011bco d\u011blat, aby j\u00ed to pomohlo.<\/strong><\/p>\n

Tak zkus\u00edme odpov\u011bd\u011bt. Samoz\u0159ejm\u011b tato situace nast\u00e1v\u00e1 celkem pravideln\u011b, my p\u0159i vyhled\u00e1v\u00e1n\u00ed d\u00e1rce se sna\u017e\u00edme v\u017edy za\u010d\u00edt t\u00edm vyhled\u00e1v\u00e1n\u00edm v rodin\u011b. Stane se n\u00e1m, \u017ee d\u00e1rce v rodin\u011b nen\u00ed nebo nen\u00ed schopen odb\u011bru tak, jako je v tomto p\u0159\u00edpad\u011b, a pak by m\u011bl nastat druh\u00fd krok, kdy toho d\u00e1rce se sna\u017e\u00edme naj\u00edt v registru. V\u0161echna pracovi\u0161t\u011b, v\u010detn\u011b \u010desk\u00fdch, v\u010detn\u011b pra\u017esk\u00fdch pracovi\u0161\u0165, maj\u00ed mo\u017enost vyhled\u00e1vat d\u00e1rce p\u0159es plze\u0148sk\u00fd \u010desk\u00fd n\u00e1rodn\u00ed registr d\u00e1rc\u016f kostn\u00ed d\u0159en\u011b, \u010dili pokud ten o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 pacientky se na n\u00e1s obr\u00e1t\u00ed, r\u00e1di se pokus\u00edme d\u00e1rce, a\u0165 u\u017e v \u010cech\u00e1ch nebo v zahrani\u010d\u00ed pro tu pacientku nal\u00e9zt, nen\u00ed to probl\u00e9m.<\/p>\n

„Dobr\u00fd den, r\u00e1da bych se zeptala, kdy\u017e se malinko uhod\u00edm, d\u011blaj\u00ed se mod\u0159iny, jsem po infarktu a u\u017e\u00edv\u00e1m Anopyrin, m\u016f\u017ee to n\u011bco znamenat v souvislosti s rakovinou?“
\n<\/strong>
\nJe velice t\u011b\u017ek\u00e9 odpov\u00eddat na konkr\u00e9tn\u00ed dotaz bez znalosti dal\u0161\u00edch t\u011bch klinick\u00fdch okolnost\u00ed, sp\u00ed\u0161e si mysl\u00edm, \u017ee v souvislosti s rakovinou by to nem\u011blo znamenat nic, ale pokud je mo\u017en\u00e9 poslucha\u010dce n\u011bco doporu\u010dit, tak nav\u0161t\u00edvit praktick\u00e9ho l\u00e9ka\u0159e, nechat si nabrat krevn\u00ed obraz, pokud ten krevn\u00ed obraz bude v po\u0159\u00e1dku, tak pravd\u011bpodobn\u011b se o \u017e\u00e1dn\u00e9 takov\u00e9to v\u00e1\u017en\u00e9 onemocn\u011bn\u00ed nebude jednat.
\n Dal\u0161\u00ed SMSku poslala poslucha\u010dka Pavla: „Dobr\u00fd den, v d\u011btstv\u00ed, ve v\u011bku 10 let, jsem prod\u011blala n\u00e1dor lymfatick\u00fdch uzlin. L\u00e9\u010dila jsem se v Motole na onkologii, oza\u0159ov\u00e1n\u00ed, chemoterapie a tak d\u00e1le. Je riziko, \u017ee moje dv\u011b d\u011bti onemocn\u00ed. Je tu n\u011bjak\u00e1 d\u011bdi\u010dnost. D\u011bkuje Pavla.“<\/strong><\/p>\n

Toho bych se v\u016fbec neb\u00e1l. Obecn\u011b n\u00e1dorov\u00e1 onemocn\u011bn\u00ed krvetvorby neb\u00fdvaj\u00ed d\u011bdi\u010dn\u00e1, tak\u017ee d\u011bti by nem\u011bly m\u00edt zv\u00fd\u0161en\u00e9 riziko podobn\u00e9ho onemocn\u011bn\u00ed.<\/p>\n

K t\u00e9 leuk\u00e9mii je\u0161t\u011b mo\u017en\u00e1 ne\u0159ekli jsme nic o p\u0159\u00ed\u010din\u00e1ch t\u00e9to nemoci, pro\u010d vlastn\u011b vznik\u00e1?<\/strong><\/p>\n

K t\u011bm p\u0159\u00ed\u010din\u00e1m my ani vlastn\u011b moc toho nev\u00edme, pacienti samoz\u0159ejm\u011b, kte\u0159\u00ed k n\u00e1m p\u0159ijdou s novou diagn\u00f3zou leuk\u00e9mie, maj\u00ed tendenci se pt\u00e1t, pro\u010d leuk\u00e9mie vznikla, co jsem d\u011blal v \u017eivot\u011b \u0161patn\u011b, nebo co jsem naopak ned\u011blal a m\u011bl d\u011blat a my na to odpov\u011bd\u011bt neum\u00edme. Obecn\u011b nejen u leuk\u00e9mi\u00ed, se v\u017edycky jedn\u00e1 o n\u011bjakou mutaci v t\u00e9 genetick\u00e9 informaci, kter\u00e1 zp\u016fsob\u00ed to, \u017ee zase se naru\u0161\u00ed to, jak bu\u0148ky spr\u00e1vn\u011b maj\u00ed vyzr\u00e1vat, jak spr\u00e1vn\u011b maj\u00ed fungovat, jak spr\u00e1vn\u011b maj\u00ed um\u00edrat, kdy\u017e u\u017e nejsou pot\u0159eba nebo jsou n\u011bjak\u00fdm zp\u016fsobem po\u0161kozen\u00e9, a my tu p\u0159\u00ed\u010dinu nezn\u00e1me, m\u016f\u017eeme u n\u011bkter\u00fdch pacient\u016f nal\u00e9zt nebo m\u016f\u017eeme spekulovat o tom, \u017ee t\u0159eba byli exponov\u00e1ni n\u011bjak\u00e9mu z\u00e1\u0159en\u00ed, n\u011bjak\u00fdm karcinogenn\u00edm l\u00e1tk\u00e1m a tam samoz\u0159ejm\u011b to riziko se tro\u0161ku zvy\u0161uje. Zaj\u00edmav\u011bj\u0161\u00ed je mo\u017en\u00e1 to pov\u00edd\u00e1n\u00ed o t\u011bch rizikov\u00fdch faktorech. M\u00e1me Den boje s rakovinou, tam se nab\u00edz\u00ed si p\u0159ipomenout nejen to, \u017ee leuk\u00e9mie a n\u00e1dory jsou samoz\u0159ejm\u011b z\u00e1va\u017en\u00e1 onemocn\u011bn\u00ed, ale \u017ee jsou ur\u010dit\u00e9 cesty, jak si malinko mo\u017en\u00e1 to riziko t\u011bhle onemocn\u011bn\u00ed sn\u00ed\u017eit, v\u0161ichni v\u00ed, \u017ee nen\u00ed dobr\u00e9 kou\u0159it, ur\u010dit\u00e9 nen\u00ed dobr\u00e9 m\u00edt nadv\u00e1hu, to je dal\u0161\u00ed rizikov\u00fd faktor spojen\u00fd obecn\u011b s n\u00e1dory, nen\u00ed dobr\u00e9 se nadm\u011brn\u011b slunit a v podstat\u011b v\u0161echno to sm\u011b\u0159uje k n\u011bjak\u00e9 snaze o jak\u00fdsi, je to modern\u00ed slovo, jak\u00fdsi zdrav\u00fd \u017eivotn\u00ed styl, p\u0159im\u011b\u0159en\u00fd pohyb, n\u011bjakou rozumnou, rozumnou stravu a to je to, co asi m\u016f\u017ee pro sebe ud\u011blat ka\u017ed\u00fd v r\u00e1mci t\u00e9 prevence.<\/p>\n

p\u0159ed chvilkou volala pan\u00ed poslucha\u010dka ze Zb\u016fchu, ptala se na sv\u00e9ho man\u017eela, kter\u00fd zem\u0159el na leuk\u00e9mii v roce 93. Mimo jin\u00e9 vzpom\u00ednala na za\u010d\u00e1tky pana prim\u00e1\u0159e Kozy, kter\u00fd zakl\u00e1dal ten registr kostn\u00ed d\u0159en\u011b, d\u00e1rc\u016f kostn\u00ed d\u0159en\u011b, \u010d\u00edm ta nemoc za\u010d\u00edn\u00e1. Pt\u00e1 se poslucha\u010dka, jestli existuje n\u011bjak\u00fd pau\u0161\u00e1ln\u00ed za\u010d\u00e1tek leuk\u00e9mie, kter\u00fd se projevuje t\u0159eba jako pr\u00e1v\u011b v p\u0159\u00edpad\u011b jej\u00edho man\u017eela, bolestmi kloub\u016f, otoky kon\u010detin a takovou jakoby ang\u00ednou, je to pravda?<\/strong><\/p>\n

Ono samoz\u0159ejm\u011b leuk\u00e9mi\u00ed je cel\u00e1 \u0159ada, my se tady bav\u00edme o takov\u00fdch t\u011bch takzvan\u00fdch akutn\u00edch leuk\u00e9mi\u00edch, to znamen\u00e1 leuk\u00e9mi\u00edch, kter\u00e9 za\u010d\u00ednaj\u00ed pom\u011brn\u011b rychle. A tam ty p\u0159\u00edznaky, kter\u00e9 pacienta vedou k l\u00e9ka\u0159i, b\u00fdvaj\u00ed pom\u011brn\u011b typick\u00e9. To, co ta poslucha\u010dka zm\u00ednila, n\u011bjak\u00e1 angina, n\u011bjak\u00e1 infekce d\u00fdchac\u00edch cest, teploty, to b\u00fdv\u00e1 dost typick\u00e1 symptomatologie, vedle toho se objevuj\u00ed dost \u010dasto mod\u0159iny nebo snadn\u00e1 tvorba mod\u0159in, n\u011bjak\u00e9 krv\u00e1civ\u00e9 projevy, \u00fanava z nedostatku \u010derven\u00fdch krvinek, \u010dili ty historky, kter\u00e9 pacienti n\u00e1m pov\u00eddaj\u00ed, kdy se k n\u00e1m dostanou, b\u00fdvaj\u00ed pom\u011brn\u011b podobn\u00e9.<\/p>\n

12 let u\u017e\u00edv\u00e1m Litalir na polycythemii vera.\u00a0Nen\u00ed za tu dobu jin\u00fd l\u00e9k, m\u00e1m toti\u017e dost vedlej\u0161\u00edch \u00fa\u010dink\u016f, pt\u00e1 se poslucha\u010dka?<\/strong><\/p>\n

Bohu\u017eel pro polycythemii- je to takov\u00e9 chronick\u00e9, roky trvaj\u00edc\u00ed onemocn\u011bn\u00ed, po\u0159\u00e1d Litalir je t\u00edm z\u00e1kladn\u00edm l\u00e9kem a objevuj\u00ed se sice n\u011bjak\u00e9 nov\u00e9 modern\u00ed biologick\u00e9 l\u00e9ky, ale ty v tuto chv\u00edli je\u0161t\u011b nejsou ur\u010den\u00e9 pro l\u00e9\u010dbu pr\u00e1v\u011b tohoto onemocn\u011bn\u00ed.<\/p>\n

Dal\u0161\u00ed SMSku poslala pan\u00ed Hru\u0161kov\u00e1: „Dobr\u00fd den, sly\u0161ela jsem, \u017ee se kmenov\u00fdmi bu\u0148kami d\u00e1 l\u00e9\u010dit i onemocn\u011bn\u00ed kloub\u016f, artr\u00f3za ky\u010dl\u00ed, kolen, je to pravda, m\u00e1m toti\u017e ky\u010del levou – druh\u00fd a\u017e t\u0159et\u00ed stupe\u0148, pravou druh\u00fd stupe\u0148, pomohlo by mi to, m\u00e1m tam v\u00fdr\u016fstky. D\u00e1 se i v m\u00e9m p\u0159\u00edpad\u011b t\u00edm l\u00e9\u010dit?“<\/strong><\/p>\n

Je pravda, \u017ee kmenov\u00e9 bu\u0148ky se daj\u00ed vyu\u017e\u00edt k regeneraci r\u016fzn\u00fdch org\u00e1n\u016f, nejsou to jenom klouby chrupavky, ale mohou to b\u00fdt p\u0159\u00edpady p\u0159i nedokrevnosti t\u0159eba doln\u00edch kon\u010detin, infarkt myokardu, po\u0161kozen\u00ed srde\u010dn\u00ed sval\u016f a tak d\u00e1le. Tahleta cel\u00e1 oblast je regenerativn\u00ed medic\u00edna – za\u017e\u00edv\u00e1 a bude za\u017e\u00edvat obrovsk\u00fd boom, souvis\u00ed to s t\u00edm, jak cel\u00e1 populace st\u00e1rne, do\u017e\u00edv\u00e1me se vy\u0161\u0161\u00edho v\u011bku, trp\u00edme \u010d\u00edm d\u00e1l v\u00edce civiliza\u010dn\u00edmi chorobami. A pr\u00e1v\u011b regenerativn\u00ed medic\u00edna, respektive vyu\u017eit\u00ed kmenov\u00fdch bun\u011bk, by n\u00e1m v tomhletom tro\u0161ku mohlo pomoci, vedle samoz\u0159ejm\u011b prevence, \u010dasn\u00e9 diagnostiky a tak d\u00e1le. \u010cili l\u00e9\u010dba onemocn\u011bn\u00ed chrupavek je jednou z mo\u017enost\u00ed, ov\u0161em ob\u00e1v\u00e1m se, \u017ee v tuto chv\u00edli to nen\u00ed mo\u017enost, kter\u00e1 je rutinn\u011b dostupn\u00e1. V\u0161echna ta l\u00e9\u010dba se odehr\u00e1v\u00e1 v\u017edycky v r\u00e1mci n\u011bjak\u00fdch klinick\u00fdch studi\u00ed, n\u011bjak\u00fdch klinick\u00fdch hodnocen\u00ed a pokud by pacientka o n\u00ed m\u011bla z\u00e1jem, tak mus\u00ed zkontaktovat n\u011bjak\u00e9 pracovi\u0161t\u011b ortopedick\u00e9, pravd\u011bpodobn\u011b p\u0159i n\u011bjak\u00e9 fakultn\u00ed nemocnici, kter\u00e9 t\u0159eba n\u011bjakou studii na toto t\u00e9ma \u0159e\u0161\u00ed.<\/p>\n

Dal\u0161\u00ed SMSku poslala Petra: „Dobr\u00fd den, jako 3-let\u00e9 d\u00edt\u011b jsem prod\u011blala hnisav\u00fd z\u00e1n\u011bt kostn\u00ed d\u0159en\u011b, m\u00e1m zapouzd\u0159en\u00e9 lo\u017eisko, m\u016f\u017ee se to znovu objevit?“<\/strong><\/p>\n

Nikdy ne\u0159\u00edkej nikdy se \u0159\u00edk\u00e1, samoz\u0159ejm\u011b, pokud to bylo v d\u011btsk\u00e9m v\u011bku, od t\u00e9 doby se nic ned\u011blo, mysl\u00edm si, \u017ee m\u016f\u017ee poslucha\u010dka z\u016fstat v klidu, ale stoprocentn\u00ed garanci v medic\u00edn\u011b ned\u00e1v\u00e1me nikdy.<\/p>\n

„Dobr\u00fd den, sly\u0161el jsem v r\u00e1diu o l\u00e9\u010den\u00ed leuk\u00e9mie virem, kter\u00fd se naprogramuje a zni\u010d\u00ed pouze leuk\u00e9mick\u00e9 bu\u0148ky, m\u016f\u017eeme tuto metodu o\u010dek\u00e1vat v bl\u00edzk\u00e9 dob\u011b?“<\/strong><\/p>\n

Tenhle ten dotaz sm\u011b\u0159uje k takzvan\u00fdm DNA vakc\u00edn\u00e1m, kde jsme schopni pomoc\u00ed viru nebo pomoc\u00ed n\u011bjak\u00e9 jin\u00e9 technologie, vlo\u017eit ur\u010dit\u00e9 genetick\u00e9 sekvence do imunitn\u00edch bun\u011bk, do n\u00e1dorov\u00fdch bun\u011bk a pomoci porazit leuk\u00e9mii, ale v tuhle tu chv\u00edli se bav\u00edme o v\u00fdzkumu, \u010dili ta re\u00e1ln\u00e1 dostupnost, re\u00e1ln\u00e1 klinick\u00e1 aplikace…. budeme si muset po\u010dkat je\u0161t\u011b mnoho let, mo\u017en\u00e1 10 let, uvid\u00edme.<\/p>\n

Dal\u0161\u00ed dotaz je od Jarmily: „Pros\u00edm, jak pozn\u00e1m, \u017ee m\u00e1m leuk\u00e9mii, kdy\u017e nenav\u0161t\u011bvuji l\u00e9ka\u0159e?“<\/strong><\/p>\n

Pokud se c\u00edt\u00edte dob\u0159e, tak bych v\u016fbec my\u0161lenku na leuk\u00e9mii opustil, u\u017e jsme tady n\u011bjak\u00e9 ty p\u0159\u00edznaky zm\u00ednili, v\u017edycky to vych\u00e1z\u00ed z n\u011bjak\u00e9 t\u00e9 poruchy v krevn\u00edm obraze, to znamen\u00e1, ubude mi \u010derven\u00fdch krvinek, za\u010dnu b\u00fdt unaven\u00fd, du\u0161n\u00fd, ubude mi krevn\u00edch desti\u010dek, objev\u00ed se n\u011bjak\u00e9 krv\u00e1civ\u00e9 projevy, ubudou mi zdrav\u00e9 b\u00edl\u00e9 krvinky, kter\u00e9 \u010dlov\u011bk pot\u0159ebuje kv\u016fli obranyschopnosti, mohu dostat n\u011bjakou infek\u010dn\u00ed komplikaci, kter\u00e1 zpravidla \u0161patn\u011b t\u0159eba reaguje na antibiotika a typicky prob\u00edhaj\u00edc\u00ed ang\u00edna, jak u\u017e jsme tady zm\u00ednili.<\/p>\n

je tady dotaz od pan\u00ed Marie: „Dobr\u00fd den, t\u00fdk\u00e1 se tato nov\u00e1 l\u00e9\u010dba, nov\u00e1 metoda i chronick\u00e9 lymfocyt\u00e1rn\u00ed leuk\u00e9mie? „<\/strong><\/p>\n

T\u00fdkala by se t\u00e9to chronick\u00e9 lymfocyt\u00e1rn\u00ed leuk\u00e9mie pouze v p\u0159\u00edpad\u011b, \u017ee ten pacient, kter\u00fd by trp\u011bl t\u00edmto onemocn\u011bn\u00edm, by podstoupil transplantaci kostn\u00ed d\u0159en\u011b, proto\u017ee je to jedna z diagn\u00f3z, kterou je mo\u017en\u00e9 transplantovat, a pokud by se vyskytla ta imunologick\u00e1 komplikace po transplantaci, tak by l\u00e9\u010dba byla na m\u00edst\u011b.<\/p>\n

Dal\u0161\u00ed ot\u00e1zka: „Hrad\u00ed l\u00e9\u010dbu kmenov\u00fdmi bu\u0148kami poji\u0161\u0165ovny, pokud ne, kolik to stoj\u00ed, pt\u00e1 se Jana.“<\/strong><\/p>\n

V\u011bt\u0161inou ne, proto\u017ee, jak u\u017e jsme tady opakovan\u011b zm\u00ednili, bav\u00edme se o l\u00e9\u010db\u011b, kter\u00e1 je v\u011bt\u0161inou experiment\u00e1ln\u00ed, prob\u00edhaj\u00edc\u00ed v\u00a0 r\u00e1mci n\u011bjak\u00fdch klinick\u00fdch studi\u00ed, nejedn\u00e1 se o registrovan\u00e9 l\u00e9\u010div\u00e9 p\u0159\u00edpravky, nejedn\u00e1 se o l\u00e9\u010dbu, kter\u00e1 by standardn\u011b byla hrazena v r\u00e1mci syst\u00e9mu ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. To znamen\u00e1, ty pen\u00edze na takovou l\u00e9\u010dbu zpravidla sh\u00e1n\u00edme my, kte\u0159\u00ed, kte\u0159\u00ed ten v\u00fdzkum prov\u00e1d\u00edme, z r\u016fzn\u00fdch grant\u016f, z r\u016fzn\u00fdch sponzorsk\u00fdch dar\u016f, a toho pacienta to samoz\u0159ejm\u011b nestoj\u00ed nic, jinak cenov\u011b se bav\u00edme o desetitis\u00edc\u00edch korun\u00e1ch za t\u0159eba jednu aplikaci.<\/p>\n

Te\u010f je tu dotaz od Renaty: „Dobr\u00fd den, 15-let\u00e1 dcera mus\u00ed chodit ka\u017ed\u00fd rok na rentgen kv\u016fli skoli\u00f3ze, u\u017e 6 let, nehroz\u00ed ji n\u011bco?“ T\u00edm rentgenem, samoz\u0159ejm\u011b.<\/strong><\/p>\n

T\u00edm rentgenem… budeme zase optimisti\u010dt\u00ed, mysl\u00edme si, \u017ee nehroz\u00ed… dneska ta pravidla, kter\u00fdmi se \u0159\u00edd\u00ed rentgenologick\u00e1 pracovi\u0161t\u011b, pravidla pro radia\u010dn\u00ed ochranu jsou velice p\u0159\u00edsn\u00e1. Rentgenologov\u00e9 po\u010d\u00edtaj\u00ed kumulativn\u00ed d\u00e1vky, kter\u00e9 ten pacient absorbuje b\u011bhem t\u011bch opakovan\u00fdch vy\u0161et\u0159en\u00ed, jsou na to stanoveny velice p\u0159\u00edsn\u00e9 limity, nav\u00edc takov\u00e9 ty org\u00e1ny nebo ty \u010d\u00e1sti t\u011bla, kter\u00e9 jsou zv\u00fd\u0161en\u011b citliv\u00e9 k tomu z\u00e1\u0159en\u00ed, v\u017edycky p\u0159i tom vy\u0161et\u0159en\u00ed se n\u011bjak\u00fdm zp\u016fsobem vykr\u00fdvaj\u00ed, to se t\u00fdk\u00e1 pohlavn\u00edch org\u00e1n\u016f, \u0161t\u00edtn\u00e9 \u017el\u00e1zy a tak d\u00e1le.<\/p>\n

Je\u0161t\u011b je tady dal\u0161\u00ed SMSka: „M\u016f\u017ee z polycythemie vzniknout leuk\u00e9mie?“<\/strong><\/p>\n

M\u016f\u017ee. Pravd\u011bpodobnost je relativn\u011b mal\u00e1, ale m\u016f\u017ee.<\/p>\n

„Dobr\u00fd den, pozn\u00e1 gynekolog p\u0159i oby\u010dejn\u00e9m vy\u0161et\u0159en\u00ed odhalit nebo dok\u00e1\u017ee odhalit rakovinu vaje\u010dn\u00edku spodn\u00edch cest, m\u011bla bych \u017e\u00e1dat n\u011bjak\u00e9 speci\u00e1ln\u00ed vy\u0161et\u0159en\u00ed.“ D\u011bkuje Lenka.<\/strong><\/p>\n

To je pravd\u011bpodobn\u011b dotaz sp\u00ed\u0161e na gynekology ne\u017e na hematologa. J\u00e1 mysl\u00edm, \u017ee ten syst\u00e9m prevence zrovna u t\u011bch gynekologick\u00fdch n\u00e1dor\u016f d\u011blo\u017en\u00edho \u010d\u00edpku je docela propracovan\u00fd v \u010cesk\u00e9 republice. A pat\u0159\u00ed k t\u011bm, kter\u00e9 se da\u0159\u00ed docela v\u010das zachytit, j\u00e1 bych se spokojil se standardn\u00edm vy\u0161et\u0159en\u00edm.<\/p>\n

D\u011bkuji na sly\u0161enou.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

V souvislosti s prob\u011bhl\u00fdm Sv\u011btov\u00fdm dnem boje proti rakovin\u011b hovo\u0159il v \u010cesk\u00e9m rozhlase z\u00e1stupce prim\u00e1\u0159e hematologicko-onkologick\u00e9ho odd. Fakultn\u00ed nemocnice v Plzni docent Daniel Lys\u00e1k. Odpov\u00eddal […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":5657,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-14699","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14699","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14699"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14699\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/5657"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}