Mnoho\u010detn\u00fd myelom \u2013 z\u00e1ke\u0159n\u00e9 n\u00e1dorov\u00e9 onemocn\u011bn\u00ed vyr\u016fstaj\u00edc\u00ed z bun\u011bk kostn\u00ed d\u0159en\u011b, kter\u00e9 nelze vyl\u00e9\u010dit. To je dogma, kter\u00e9 u\u017e o nemoci neplat\u00ed. L\u00e9ka\u0159i toti\u017e d\u00edky modern\u00ed l\u00e9\u010db\u011b dok\u00e1\u017eou toto onemocn\u011bn\u00ed krve efektivn\u011b l\u00e9\u010dit. Des\u00edtky pacient\u016f um\u00ed uzdravit \u00fapln\u011b. Pot\u0159ebuj\u00ed k tomu ale v\u00edce nov\u00fdch \u00fa\u010dinn\u00fdch l\u00e9k\u016f. Ty zat\u00edm nejsou b\u011b\u017en\u011b dostupn\u00e9. Jejich vstupu na trh br\u00e1n\u00ed \u0161patn\u011b nastaven\u00fd syst\u00e9m \u00fahrad. Osudy stovek pacient\u016f tak z\u00e1vis\u00ed na zm\u011bn\u011b syst\u00e9mu, po kter\u00e9 volaj\u00ed odborn\u00edci.
\n
\n\u201eZa z\u00e1sadn\u00ed pokroky v l\u00e9\u010db\u011b mnoho\u010detn\u00e9ho myelomu vd\u011b\u010d\u00edme modern\u00ed terapii. To dokazuj\u00ed nejenom data z klinick\u00fdch studi\u00ed, ale i z vlastn\u00edho registru pacient\u016f s t\u00edmto onemocn\u011bn\u00edm, kter\u00fd v hematoonkologii vedeme 10 let. Ten je jedn\u00edm z nejv\u011bt\u0161\u00edch a nejkvalitn\u011bj\u0161\u00edch registr\u016f sv\u00e9ho druhu v Evropsk\u00e9 Unii. Dnes v n\u011bm evidujeme data ji\u017e p\u011bti tis\u00edc nemocn\u00fdch s mnoho\u010detn\u00fdm myelomem. Z nich vypl\u00fdv\u00e1, \u017ee se od dob zaveden\u00ed modern\u00ed l\u00e9\u010dby do praxe prodlou\u017eila pr\u016fm\u011brn\u00e1 d\u00e9lka \u017eivota pacient\u016f o 2,5 roku, tj. v\u00edce ne\u017e dvojn\u00e1sobn\u011b,\u201c vysv\u011btluje prof. MUDr. Vladim\u00edr Maisnar, Ph.D., MBA, ze IV. intern\u00ed hematologick\u00e9 kliniky Fakultn\u00ed nemocnice Hradec Kr\u00e1lov\u00e9 a dod\u00e1v\u00e1: \u201ePokud by byly b\u011b\u017en\u011b dostupn\u00e9 l\u00e9ky pou\u017e\u00edvan\u00e9 v klinick\u00fdch studi\u00edch, do\u0161lo by k dal\u0161\u00edmu prodlou\u017een\u00ed \u017eivota o 1\u20132 roky. P\u0159ed \u00e9rou nov\u00fdch l\u00e9k\u016f p\u0159e\u017e\u00edvalo d\u00e9le ne\u017e 10 let 5 % nemocn\u00fdch. Dnes je to d\u00edky inovativn\u00ed l\u00e9\u010db\u011b 20 %. U nemocn\u00fdch podstupuj\u00edc\u00edch intenzivn\u011bj\u0161\u00ed l\u00e9\u010dbu v\u010detn\u011b transplantace tk\u00e1n\u011b 30 %. Je\u0161t\u011b podstatn\u011bj\u0161\u00ed je ale skute\u010dnost, \u017ee se setk\u00e1v\u00e1me s des\u00edtkami p\u0159\u00edpad\u016f, kdy nemocn\u00e9ho uzdrav\u00ed inovativn\u00ed l\u00e9\u010dba \u00fapln\u011b.\u201c
\nPo\u010det pacient\u016f, kte\u0159\u00ed dlouhodob\u011b p\u0159e\u017eij\u00ed nebo se vyl\u00e9\u010d\u00ed, by ale mohl b\u00fdt mnohem vy\u0161\u0161\u00ed. \u201eK tomu pot\u0159ebujeme z\u00edskat \u00fahradu na v\u011bt\u0161\u00ed po\u010det inovativn\u00edch l\u00e9k\u016f,\u201c \u0159\u00edk\u00e1 prof. MUDr. Roman H\u00e1jek, CSc., p\u0159ednosta Kliniky hematoonkologie Fakultn\u00ed nemocnice Ostrava. \u201ePro z\u00e1sadn\u00ed prodlou\u017een\u00ed \u017eivota je d\u016fle\u017eit\u00e9 naj\u00edt kombinaci l\u00e9k\u016f, na kterou je nemocn\u00fd citliv\u00fd. Jestli\u017ee m\u00edsto st\u00e1vaj\u00edc\u00edch p\u011bti \u00fa\u010dinn\u00fdch l\u00e9k\u016f jich budeme m\u00edt k dispozici deset, stoup\u00e1 \u0161ance na nalezen\u00ed \u00fa\u010dinn\u00e9 kombinace pro pacienta z 30\u201360 % podle pokro\u010dilosti nemoci a\u017e na 100 %. To d\u00e1v\u00e1 nad\u011bji pacient\u016fm, kte\u0159\u00ed na sou\u010dasn\u011b dostupn\u00e9 a pou\u017e\u00edvan\u00e9 l\u00e9ky nereaguj\u00ed. Nap\u0159\u00edklad v obdob\u00ed 2007\u20132015 se p\u0159id\u00e1n\u00edm p\u0159edev\u0161\u00edm dvou l\u00e9k\u016f do praxe zlep\u0161il medi\u00e1n p\u0159e\u017eit\u00ed z 16 na 55 m\u011bs\u00edc\u016f,\u201c \u0159\u00edk\u00e1 prof. H\u00e1jek.
\nK vyl\u00e9\u010den\u00ed pom\u00e1h\u00e1 i v\u010dasn\u00e9 odhalen\u00ed nemoci. Mnoho\u010detn\u00fd myelom se projevuje pl\u00ed\u017eiv\u011b a p\u0159\u00edznaky jsou zpo\u010d\u00e1tku nejasn\u00e9. \u010casto proto odborn\u00edci chorobu u pacienta odhal\u00ed a\u017e v pokro\u010dil\u00e9m stadiu. \u201eJakmile l\u00e9ka\u0159 stanov\u00ed diagn\u00f3zu, m\u011bl by nemocn\u00e9mu v p\u0159\u00edpad\u011b pot\u0159eby hned na za\u010d\u00e1tku nasadit intenzivn\u00ed l\u00e9\u010dbu v\u010detn\u011b transplantace kmenov\u00fdch bun\u011bk,\u201c \u0159\u00edk\u00e1 prof. Maisnar. L\u00e9ka\u0159i tuto terapii doporu\u010duj\u00ed pacient\u016fm do 70 let. Lid\u00e9 si ji mohou p\u0159edstavit jako n\u011bkolik \u00fa\u010dinn\u00fdch, na r\u016fzn\u00e9 \u00farovni p\u016fsob\u00edc\u00edch l\u00e9k\u016f. Pot\u00e9 n\u00e1sleduje p\u0159echodn\u00e1 udr\u017eovac\u00ed l\u00e9\u010dba. \u201eJde sice o re\u017eim zpo\u010d\u00e1tku n\u00e1kladn\u00fd, ale d\u00edky n\u011bmu je mo\u017en\u00e9 udr\u017eet pacienta ve stavu, kdy nemoc pak \u0159adu let \u017e\u00e1dnou dal\u0161\u00ed l\u00e9\u010dbu nevy\u017eaduje. Dos\u00e1hneme tak lep\u0161\u00edch v\u00fdsledk\u016f, ne\u017e kdy\u017e chorobu l\u00e9\u010d\u00edme postupn\u00fdm pod\u00e1v\u00e1n\u00edm r\u016fzn\u00fdch l\u00e9\u010debn\u00fdch p\u0159\u00edpravk\u016f s pouh\u00fdmi \u00fapravami jejich d\u00e1vek,\u201c dod\u00e1v\u00e1 prof. Maisnar. Tento zp\u016fsob dob\u0159e funguje ve Spojen\u00fdch st\u00e1tech, kde p\u0159e\u017eije d\u00edky v\u011bt\u0161\u00edmu po\u010dtu dostupn\u00fdch l\u00e9k\u016f 10 let asi 50 % nemocn\u00fdch. Se vstupem dal\u0161\u00edch nov\u00fdch l\u00e9k\u016f do praxe by se mohlo v \u010cesk\u00e9 republice do roku 2020 do\u017e\u00edt 10 let a\u017e 40 % pacient\u016f. \u201ePokud se v budoucnu zv\u00fd\u0161\u00ed investice do inovativn\u00edch l\u00e9k\u016f hned v po\u010d\u00e1tku p\u00e9\u010de o pacienta, zv\u00fd\u0161\u00ed se i po\u010det vyl\u00e9\u010den\u00fdch. Z\u00e1sadn\u00ed je ale tak\u00e9 nutnost sestaven\u00ed dobr\u00e9 l\u00e9\u010debn\u00e9 strategie. St\u00e1le v\u0161ak nar\u00e1\u017e\u00edme na regula\u010dn\u00ed omezen\u00ed, nez\u00e1jem poji\u0161\u0165oven a tak\u00e9 na konzervatismus l\u00e9ka\u0159\u016f,\u201c dod\u00e1v\u00e1 prof. H\u00e1jek.
\nRozpor mezi t\u00edm, co nov\u00e9 l\u00e9\u010debn\u00e9 mo\u017enosti nab\u00edz\u00ed, a t\u00edm, co je \u010desk\u00fd zdravotn\u00ed syst\u00e9m schopen zaplatit, je nyn\u00ed zjevn\u00fd nap\u0159\u00ed\u010d medic\u00ednsk\u00fdmi obory. Probl\u00e9m je obzvl\u00e1\u0161\u0165 patrn\u00fd v hematoonkologii. \u201eBez adekv\u00e1tn\u00ed l\u00e9\u010dby pacient trp\u00ed nep\u0159edstaviteln\u00fdmi bolestmi, proto\u017ee choroba postupn\u011b rozkl\u00e1d\u00e1 jeho kosti. Modern\u00ed l\u00e9\u010dba v\u0161ak dok\u00e1\u017ee v\u00fdrazn\u011b utlumit p\u0159\u00edznaky, zastavit postup nemoci, a pacient tak m\u016f\u017ee \u017e\u00edt plnohodnotn\u00fd \u017eivot,\u201c \u0159\u00edk\u00e1 prof. Maisnar.<\/p>\n
O mnoho\u010detn\u00e9m myelomu
\nMnoho\u010detn\u00fd myelom je druh\u00e9 nej\u010dast\u011bj\u0161\u00ed n\u00e1dorov\u00e9 onemocn\u011bn\u00ed krve, vznikaj\u00edc\u00ed prom\u011bnou a hromad\u011bn\u00edm plazmatick\u00fdch bun\u011bk v kostn\u00ed d\u0159eni. Choroba nejv\u00edce postihuje lidi ve v\u011bku 75\u201379 let. Do v\u011bku 40 let se vyskytuje vz\u00e1cn\u011b. P\u0159\u00ed\u010diny onemocn\u011bn\u00ed nejsou p\u0159esn\u011b zn\u00e1m\u00e9. Rizikov\u00fdmi faktory m\u016f\u017eou b\u00fdt obezita, zv\u00fd\u0161en\u00fd kontakt s organick\u00fdmi rozpou\u0161t\u011bdly, pesticidy nebo dioxiny. Nemoc se projevuje pestr\u00fdmi p\u0159\u00edznaky, p\u0159edev\u0161\u00edm bolest\u00ed p\u00e1te\u0159e. Na vznik nemoci maj\u00ed vliv tak\u00e9 poruchy imunity a vystaven\u00ed se z\u00e1\u0159en\u00ed. Celosv\u011btov\u011b trp\u00ed mnoho\u010detn\u00fdm myelomem 230 tis\u00edc osob. V \u010cesk\u00e9 republice l\u00e9ka\u0159i nemoc objev\u00ed zhruba u 450 nemocn\u00fdch ro\u010dn\u011b.<\/p>\n
Tiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"
Mnoho\u010detn\u00fd myelom \u2013 z\u00e1ke\u0159n\u00e9 n\u00e1dorov\u00e9 onemocn\u011bn\u00ed vyr\u016fstaj\u00edc\u00ed z bun\u011bk kostn\u00ed d\u0159en\u011b, kter\u00e9 nelze vyl\u00e9\u010dit. To je dogma, kter\u00e9 u\u017e o nemoci neplat\u00ed. L\u00e9ka\u0159i toti\u017e d\u00edky […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15130,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-26956","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26956","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=26956"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26956\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15130"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26956"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26956"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26956"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}