{"id":29787,"date":"2017-12-13T08:34:04","date_gmt":"2017-12-13T07:34:04","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29787"},"modified":"2017-12-13T08:34:04","modified_gmt":"2017-12-13T07:34:04","slug":"lecba-zvysuje-kvalitu-zivota-pacientu-s-mds-dojizdeni-za-ni-jim-ji-zase-ubira","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29787","title":{"rendered":"L\u00e9\u010dba zvy\u0161uje kvalitu \u017eivota pacient\u016f s MDS, doj\u00ed\u017ed\u011bn\u00ed za n\u00ed jim ji zase ub\u00edr\u00e1"},"content":{"rendered":"<p><strong>Myelodysplastick\u00fd syndrom (MDS) p\u0159edstavuje velmi r\u016fznorodou skupinu onemocn\u011bn\u00ed kostn\u00ed d\u0159en\u011b, jej\u00ed\u017e p\u0159\u00ed\u010dina nen\u00ed ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f zn\u00e1m\u00e1.<\/strong> <!--more--><\/p>\n<p>U zdrav\u00fdch osob produkuje kostn\u00ed d\u0159e\u0148 t\u0159i druhy krevn\u00edch bun\u011bk \u2013 c\u030cervene\u0301 krvinky (erytrocyty), bi\u0301le\u0301 krvinky (leukocyty) a krevni\u0301 destic\u030cky (trombocyty). V\u0161echny t\u0159i druhy vych\u00e1zej\u00ed ze spole\u010dn\u00e9 kmenov\u00e9 (z\u00e1rode\u010dn\u00e9) bu\u0148ky. Nezral\u00e9 krevn\u00ed bu\u0148ky, kter\u00e9 za norm\u00e1ln\u00edch okolnost\u00ed vyzr\u00e1vaj\u00ed ve funk\u010dn\u00ed \u010derven\u00e9 a b\u00edl\u00e9 krvinky \u010di krevn\u00ed desti\u010dky, se naz\u00fdvaj\u00ed blasty.<\/p>\n<p>U pacient\u016f s MDS je kmenov\u00e1 bu\u0148ka po\u0161kozena, blasty se akumuluj\u00ed v kostn\u00ed d\u0159eni, mohou m\u00edt zkr\u00e1cenou \u017eivotnost a c\u030ca\u0301st krvinek vykazuje abnorm\u00e1ln\u00ed zm\u011bny sv\u00e9ho vzhledu (dysplazie). D\u016fsledkem je nedostatek zral\u00fdch funk\u010dn\u00edch krvinek v krevn\u00edm ob\u011bhu. N\u00edzk\u00fd po\u010det c\u030cerveny\u0301ch krvinek se ozna\u010duje jako ane\u0301mie (chudokrevnost), sni\u0301z\u030ceni\u0301 poc\u030ctu bi\u0301ly\u0301ch krvinek jako leukopenie, resp. neutropenie a sni\u0301z\u030ceni\u0301 poc\u030ctu krevni\u0301ch destic\u030cek jako trombocytopenie. Pokud jsou ni\u017e\u0161\u00ed po\u010dty v\u0161ech typ\u016f krevn\u00edch bun\u011bk, hovo\u0159\u00ed se o tzv. pancytopenii.<\/p>\n<p>Pr\u016fb\u011bh MDS m\u016f\u017ee b\u00fdt velmi ru\u030aznorody\u0301 \u2013 u c\u030ca\u0301sti pacientu\u030a b\u00fdv\u00e1 pr\u030ci\u0301tomna pouze mi\u0301rna\u0301 chudokrevnost, onemocne\u030cni\u0301 mu\u030az\u030ce by\u0301t dlouhodobe\u030c stabilni\u0301, s minima\u0301lni\u0301mi projevy choroby a bez nutnosti le\u0301c\u030cby. Naopak u jin\u00fdch nemocn\u00fdch s MDS existuje vysoke\u0301 riziko rozvoje z\u00e1va\u017en\u00e9 akutni\u0301 leukemie. \u201eMyelodysplastick\u00fd syndrom je komplikovan\u00e9 a z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed krvetvorby, kter\u00e9 vede \u010dasto k v\u00fdznamn\u00e9mu zhor\u0161en\u00ed kvality a zkr\u00e1cen\u00ed \u017eivota nemocn\u00fdch,\u201c potvrzuje MUDr. Anna JON\u00c1\u0160OV\u00c1, Ph.D., z I. intern\u00ed kliniky \u2013 kliniky hematologie 1. LF UK a VFN v Praze. \u201eJeho diagnostika je velice komplexn\u00ed a vy\u017eaduje kooperaci zku\u0161en\u00fdch laborato\u0159\u00ed, proto\u017ee pot\u0159ebujeme nejen kompletn\u00ed vy\u0161et\u0159en\u00ed krve, ale i vy\u0161et\u0159en\u00ed kostn\u00ed d\u0159en\u011b. Z\u00e1kladem je morfologick\u00e9 a cytogenetick\u00e9 vy\u0161et\u0159en\u00ed, v dne\u0161n\u00ed dob\u011b ale st\u00e1le v\u00edce ke spr\u00e1vn\u00e9 diagn\u00f3ze p\u0159isp\u00edvaj\u00ed i vysoce specializovan\u00e9 molekul\u00e1rn\u011b genetick\u00e9 laborato\u0159e. L\u00e9\u010dba myelodysplastick\u00e9ho syndromu pak z\u00e1le\u017e\u00ed na stupni po\u0161kozen\u00ed krvetvorby i m\u00ed\u0159e rizika rychl\u00e9 progrese a v\u00fdvoje v akutn\u00ed leukemii.\u201c<\/p>\n<p>I pro vysoce rizikov\u00e9 pacienty s MDS jsou v sou\u010dasnosti k dispozici vysoce \u00fa\u010dinn\u00e9 l\u00e9ky. Pat\u0159\u00ed mezi n\u011b i tzv. hypometyla\u010dn\u00ed l\u00e1tky ovliv\u0148uj\u00edc\u00ed na \u00farovni genu procesy, kter\u00e9 se na vzniku choroby pod\u00edlej\u00ed. Tato dob\u0159e sn\u00e1\u0161en\u00e1 terapie bez v\u00fdznamn\u00fdch ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f je pod\u00e1van\u00e1 ve form\u011b podko\u017en\u00edch injekc\u00ed 7 dn\u016f po sob\u011b ka\u017ed\u00e9 4 t\u00fddny. \u201eHypometyla\u010dn\u00ed l\u00e9ky jsou indikov\u00e1ny u MDS se st\u0159edn\u00edm a vysok\u00fdm rizikem, d\u00e1le u chronick\u00e9 myelomonocyt\u00e1rn\u00ed leukemie a u akutn\u00ed myeloblastick\u00e9 leukemie. Zpravidla jsou pou\u017e\u00edv\u00e1ny u pacient\u016f, kte\u0159\u00ed nejsou schopni podstoupit transplantaci kostn\u00ed d\u0159en\u011b. Onemocn\u011bn\u00ed sice nemohou vyl\u00e9\u010dit, ale mohou je stabilizovat, v individu\u00e1ln\u00edch p\u0159\u00edpadech i na dlouhou \u0159adu let,\u201c up\u0159es\u0148uje MUDr. Ivan VONKE, MBA, prim\u00e1\u0159 odd\u011blen\u00ed Klinick\u00e9 hematologie Nemocnice \u010cesk\u00e9 Bud\u011bjovice, a. s. Ur\u010dit\u00fdm probl\u00e9mem v\u0161ak je, \u017ee zm\u00edn\u011bn\u00e9 l\u00e9ky pat\u0159\u00ed do skupiny tzv. centrov\u00e9 terapie, kter\u00e1 je k dispozici pouze v centrech vysoce specializovan\u00e9 hematoonkologick\u00e9 p\u00e9\u010de. T\u011bch je v \u010cR v sou\u010dasnosti osm, to znamen\u00e1, \u017ee n\u011bkte\u0159\u00ed nemocn\u00ed by 7kr\u00e1t v m\u011bs\u00edci m\u011bli za svou l\u00e9\u010dbou doj\u00ed\u017ed\u011bt t\u0159eba a\u017e stovky kilometr\u016f. \u201eJeliko\u017e jsou tyto l\u00e9ky u\u017e\u00edv\u00e1ny hlavn\u011b u star\u0161\u00edch nemocn\u00fdch, jejich\u017e schopnost doj\u00ed\u017ed\u011bt na velk\u00e9 vzd\u00e1lenosti je velmi problematick\u00e1, jsou tito lid\u00e9 o tuto mo\u017enost l\u00e9\u010dby p\u0159ipraveni,\u201c p\u0159ipom\u00edn\u00e1 prim. VONKE.<\/p>\n<p>Jana PELOUCHOV\u00c1, p\u0159edsedkyn\u011b Spolku Diagn\u00f3za leukemie, z. s., k tomu dod\u00e1v\u00e1: \u201eNen\u00ed to jen nepohodl\u00ed, kter\u00fdm trp\u00ed pacienti s myeodysplastick\u00fdm syndromem p\u0159i doj\u00ed\u017ed\u011bn\u00ed za hypometyla\u010dn\u00ed l\u00e9\u010dbou do vzd\u00e1len\u00e9ho hematoonkologick\u00e9ho centra. \u0158ada pacient\u016f ve star\u0161\u00edm v\u011bku trp\u00ed i p\u0159\u00eddavn\u00fdm onemocn\u011bn\u00edm, nehled\u011b na rizika infekce vlivem sn\u00ed\u017een\u00e9 imunity organismu. Je t\u0159eba, aby l\u00e9\u010dba, indikovan\u00e1 ve specializovan\u00e9m centru, putovala za nemocn\u00fdm, nikoli aby pacient absolvoval s\u00e9rii injekc\u00ed za cenu ohro\u017een\u00ed sv\u00e9ho zdravotn\u00edho stavu.\u201c<\/p>\n<p>Tiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Myelodysplastick\u00fd syndrom (MDS) p\u0159edstavuje velmi r\u016fznorodou skupinu onemocn\u011bn\u00ed kostn\u00ed d\u0159en\u011b, jej\u00ed\u017e p\u0159\u00ed\u010dina nen\u00ed ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f zn\u00e1m\u00e1.<\/p>\n<\/div>","protected":false},"author":1,"featured_media":27915,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-29787","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29787","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=29787"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29787\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/27915"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29787"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29787"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29787"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}