\u010cT 24<\/p>\n\n\n\n
\u010cT 24 Za posledn\u00ed t\u00fdden se do dvou tuzemsk\u00fdch registr\u016f d\u00e1rc\u016f kostn\u00ed d\u0159en\u011b zapsalo na 2000 lid\u00ed. Ten p\u0159i IKEMu b\u011bhem v\u00edkendu z\u00edskal tolik d\u00e1rc\u016f, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":55846,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-55912","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\/55912","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=55912"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/55912\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/55846"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=55912"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=55912"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=55912"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Za posledn\u00ed t\u00fdden se do dvou tuzemsk\u00fdch registr\u016f d\u00e1rc\u016f kostn\u00ed d\u0159en\u011b zapsalo na 2000 lid\u00ed. Ten p\u0159i IKEMu b\u011bhem v\u00edkendu z\u00edskal tolik d\u00e1rc\u016f, kolik obvykle za \u010dty\u0159i m\u011bs\u00edce. Dal\u0161\u00ed n\u00e1bory se chystaj\u00ed tento t\u00fdden na dal\u0161\u00edch m\u00edstech mimo Prahu. Vlnu solidarity vyvolal p\u0159\u00edpad v\u00e1\u017en\u011b nemocn\u00e9 Madlenky. Dvacetim\u011bs\u00ed\u010dn\u00ed d\u00edvka trp\u00ed vz\u00e1cnou poruchou krvetvorby. Zat\u00edm podstoupila prvn\u00ed cyklus l\u00e9\u010dby.
Marie Ku\u0159\u00edkov\u00e1, vedouc\u00ed \u010cesk\u00e9ho registru d\u00e1rc\u016f krvetvorn\u00fdch bun\u011bk
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Tohle je vlastn\u011b p\u0159ibli\u017en\u011b polovina t\u011bch vzork\u016f, kter\u00e9 jsme nabrali za p\u00e1tek a za sobotu, se n\u00e1m p\u0159ihl\u00e1silo v\u00edce ne\u017e 730 lid\u00ed, co\u017e je vlastn\u011b t\u0159etina celkov\u00e9ho ro\u010dn\u00edho po\u010dtu d\u00e1rc\u016f, kter\u00e9 zaregistrujeme. Na cest\u011b m\u00e1me spoustu sad, kter\u00e9 jsme zaslali dom\u016f, z\u00e1rove\u0148 z t\u011bch odb\u011brov\u00fdch n\u00e1borov\u00fdch center na transfuzn\u00edch stanic\u00edch a plazma centrech p\u0159ijdou vzore\u010dky, o jejich\u017e mno\u017estv\u00ed v\u016fbec jako nem\u00e1me p\u0159edstavu.
moder\u00e1tor
——————–
P\u0159i hled\u00e1n\u00ed vhodn\u00e9ho d\u00e1rce jsou kl\u00ed\u010dov\u00e9 tzv. transplanta\u010dn\u00ed znaky. Ty rozhoduj\u00ed, jestli t\u011blo darovanou kostn\u00ed d\u0159e\u0148 p\u0159ijme, anebo nep\u0159ijme. P\u0159esnou shodu m\u00e1 p\u0159itom v pr\u016fm\u011bru jen jeden \u010dlov\u011bk ze sta tis\u00edc. Nejv\u011bt\u0161\u00ed \u0161ance je hledat v rodin\u011b, neplat\u00ed to ale v\u017edycky. Pravd\u011bpodobnost p\u0159esn\u00e9 schody je i mezi sourozenci nebo rodi\u010di jenom 25 %. V\u011bt\u0161ina pacient\u016f je tak odk\u00e1z\u00e1na na d\u00e1rce v registrech, ty jsou mezin\u00e1rodn\u011b prov\u00e1zan\u00e9, \u010d\u00edm v\u00edc lid\u00ed je v registrech, t\u00edm vy\u0161\u0161\u00ed je \u0161ance na \u00fasp\u011bch, stejn\u011b d\u016fle\u017eit\u00e1 je i genetick\u00e1 rozmanitost tak, aby v registrech byly zastoupeny i men\u0161iny nebo vz\u00e1cn\u00e9 genetick\u00e9 kombinace. Nejvy\u0161\u0161\u00ed pravd\u011bpodobnost na \u00faplnou shodu v\u0161ech kl\u00ed\u010dov\u00fdch znak\u016f maj\u00ed b\u011blo\u0161i, kter\u00fdch je v registrech nejv\u00edc. Podle v\u00fdzkumu je to a\u017e p\u011btasedmdes\u00e1tiprocentn\u00ed \u0161ance. Naopak nejh\u016f\u0159 se d\u00e1rci hledaj\u00ed mezi Afri\u010dany a Afroameri\u010dany. \u00daplnou genetickou shodu najde m\u00ed\u0148 ne\u017e p\u011btina pacient\u016f. Nov\u00fdm d\u00e1rcem kostn\u00ed d\u0159en\u011b se m\u016f\u017ee st\u00e1t kdokoliv mezi 18 a 40 lety. V registrech jsou veden\u00ed a\u017e do 55 let. D\u016fle\u017eit\u00fd je v\u00fdborn\u00fd zdravotn\u00ed stav bez trval\u00e9 l\u00e9\u010dby, anebo bez dlouhodob\u00e9ho u\u017e\u00edv\u00e1n\u00ed\u00a0l\u00e9ku<\/strong>. V Ud\u00e1lostech, koment\u00e1\u0159\u00edch d\u011btsk\u00fd hematolog, onkolog, emeritn\u00ed p\u0159ednosta\u00a0kliniky<\/strong>\u00a0d\u011btsk\u00e9 hematologie a onkologie 2. l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy a Fakultn\u00ed\u00a0nemocnice<\/strong>\u00a0Motol Jan Star\u00fd. Pane profesore, dobr\u00fd ve\u010der. D\u00edky, \u017ee jste dorazil. \u00da\u010dast lid\u00ed je skv\u011bl\u00e1 samoz\u0159ejm\u011b, kolik lid\u00ed se p\u0159i\u0161lo p\u0159ihl\u00e1sit, jsem \u0159\u00edkal, 120 000 zhruba jich tam je, jenom, ale 1 % nakonec skute\u010dn\u011b daruje, pokud jsou ty informace spr\u00e1vn\u00e9. Ka\u017ed\u00fd zachr\u00e1n\u011bn\u00fd \u017eivot nebo ka\u017ed\u00e9 zachr\u00e1n\u011bn\u00e9 zdrav\u00ed ur\u010dit\u011b m\u00e1 smysl, ale pro\u010d je to tak m\u00e1lo, jak to, kdy\u017e je tam tolik lid\u00ed?
Jan Star\u00fd, d\u011btsk\u00fd hematolog a onkolog, emeritn\u00ed p\u0159ednosta\u00a0Kliniky<\/strong>\u00a0d\u011btsk\u00e9 hematologie a onkologie, 2. LF UK a FN Motol
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No, tak to v genetice chod\u00ed. Ale v\u00edte, \u010desk\u00e9 d\u011bti, \u010de\u0161t\u00ed pacienti maj\u00ed relativn\u011b \u0161t\u011bst\u00ed, proto\u017ee oni pat\u0159\u00ed mezi ty, kter\u00e9 jste uvedl, mezi tu b\u00edlou rasu, kter\u00e1 m\u00e1 \u0161anci vlastn\u011b velikou. Tak\u017ee z tohoto pohledu i Madlenka m\u00e1 \u0161anci zna\u010dnou a my jsme p\u0159esv\u011bd\u010deni, \u017ee pro ni d\u00e1rce najdeme.
Daniel Tak\u00e1\u010d, moder\u00e1tor
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Jak komplikovan\u00e9 je to rozhodov\u00e1n\u00ed o tom, jestli n\u011bkdo vhodn\u00fd d\u00e1rce je nebo nen\u00ed?
Jan Star\u00fd,
Ono to m\u00e1 n\u011bkolik stadi\u00ed a prvn\u00ed je to, co zazn\u011blo, to jsou ty znaky, kter\u00fdch na krvink\u00e1ch, na bu\u0148k\u00e1ch, kter\u00e9 hodnot\u00edme, t\u011bch je 10 a optim\u00e1ln\u00ed shoda je v\u0161ech 10 shodn\u00fdch mezi d\u00e1rcem a pacientem, co\u017e se n\u00e1m relativn\u011b ne tak vz\u00e1cn\u011b da\u0159\u00ed a dal\u0161\u00ed akceptovateln\u00e1 shoda je 9 z 10. To si mysl\u00edm, \u017ee by m\u011bl b\u00fdt p\u0159\u00edpad Madlenky, \u017ee najdeme pro ni takov\u00e9ho d\u00e1rce, to je po\u0159\u00e1d je\u0161t\u011b d\u00e1rce, kter\u00fd je pro n\u00e1s pln\u011b akceptovateln\u00fd a kter\u00e9ho b\u011b\u017en\u011b pou\u017e\u00edv\u00e1me jako d\u00e1rce kostn\u00ed d\u0159en\u011b.
Daniel Tak\u00e1\u010d, moder\u00e1tor
——————–
Najdete tady v \u010cesk\u00e9 republice, tady doma, nebo d\u016fle\u017eit\u00e1 je ta mezin\u00e1rodn\u00ed propojenost?
Jan Star\u00fd,
Mezin\u00e1rodn\u00ed propojenost je z\u00e1sadn\u00ed. My d\u00e1rce nej\u010dast\u011bji nach\u00e1z\u00edme ve st\u0159edn\u00ed Evrop\u011b, melting pod st\u0159edn\u00ed Evropy umo\u017e\u0148uje, \u017ee to m\u00edsen\u00ed generac\u00ed, ty d\u00e1rce nach\u00e1z\u00edme v N\u011bmecku, Rakousku, v Polsku. Pro n\u00e1s je samoz\u0159ejm\u011b \u010desk\u00fd registr dar z nebes, kdy\u017e najdeme d\u00e1rce, proto\u017ee je to operativn\u00ed a flexibiln\u00ed a m\u016f\u017eeme velmi rychle transplantaci zorganizovat, proto\u017ee n\u011bkdy ho\u0159\u00ed a my hled\u00e1me prost\u011b co nejrychleji, ale samoz\u0159ejm\u011b jsme vd\u011b\u010dn\u00ed za d\u00e1rce jak\u00e9hokoliv, kdy\u017e je pro ty na\u0161e pacienty optim\u00e1ln\u00ed, krom\u011b toho, \u017ee by m\u011bl m\u00edt tu shodu v t\u011bch z\u00e1kladn\u00edch znac\u00edch, tak v\u00edt\u00e1me mlad\u0161\u00ed lidi. A hraje roli dal\u0161\u00ed je\u0161t\u011b v\u011bc, jako t\u0159eba ur\u010dit\u00e9 virov\u00e9 infekce, kter\u00fdmi je \u010dlov\u011bk nosi\u010dem, a to v\u0161echno zohled\u0148ujeme, dokonce i pohlav\u00ed mezi d\u00e1rcema, p\u0159\u00edjemcem, i to hraje roli, \u010dili je to pom\u011brn\u011b sofistikovan\u00e1 z\u00e1le\u017eitost.
Daniel Tak\u00e1\u010d, moder\u00e1tor
——————–
\u010cili to je zva\u017eov\u00e1n\u00ed, to nen\u00ed n\u011bjak\u00e1 vypln\u011bn\u00e1 tabulka.
Jan Star\u00fd,
Je to zva\u017eov\u00e1n\u00ed. V\u00edte, n\u011bkdy si m\u016f\u017eeme vyb\u00edrat a m\u00e1me d\u00e1rc\u016f des\u00edtky potenci\u00e1ln\u00edch a n\u011bkdy m\u00e1me jednoho a nevyb\u00edr\u00e1me si a jsme \u0161\u0165astn\u00ed, \u017ee ho m\u00e1me.
Daniel Tak\u00e1\u010d, moder\u00e1tor
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No mimochodem \u0159\u00edk\u00e1te, registr je dar z nebes, jak\u00fd by byl vlastn\u011b ide\u00e1ln\u00ed stav, proto\u017ee pokud se nem\u00fdl\u00edm, tak v N\u011bmecku, kter\u00e9 jste zm\u00ednil, mimochodem tam v tom registru je asi 8\u20139 % populace, co\u017e u n\u00e1s nen\u00ed tedy, tak\u017ee ta desetina populace, kdybyste ji m\u011bli k dispozici v t\u011bch \/nesrozumiteln\u00e9\/, tak to by bylo skv\u011bl\u00e9.
Jan Star\u00fd,
Jasn\u011b. Tak\u017ee v\u00edt\u00e1me to, v\u00edt\u00e1me to.
moder\u00e1tor
——————–
Ne, tak n\u011bkte\u0159\u00ed lid\u00e9 se boj\u00ed t\u0159eba, \u017ee to bol\u00ed, \u017ee to d\u00e1rcovstv\u00ed, te\u010f mysl\u00edm.
Jan Star\u00fd,
D\u00e1rcovstv\u00ed m\u00e1 dv\u011b roviny. Za prv\u00e9, jak u\u017e tady zazn\u011blo, ta pravd\u011bpodobnost, \u017ee \u010dlov\u011bk se stane d\u00e1rcem, je mal\u00e1. Druh\u00e1 v\u011bc je, \u017ee bu\u010f odeb\u00edr\u00e1me kostn\u00ed d\u0159e\u0148, co\u017e je teda ta nark\u00f3za a n\u011bco, co potom tro\u0161ku je \u010dlov\u011bk jako rozl\u00e1man\u00fd. Krvetvorba se mu obnov\u00ed, tak\u017ee to nen\u00ed, \u017ee bysme mu vzali n\u011bco, co prost\u011b u\u017e nedoroste. \u010c\u00edm d\u00e1l t\u00edm v\u00edce pou\u017e\u00edv\u00e1me variantu, \u017ee pomoc\u00ed\u00a0l\u00e9k\u016f<\/strong>\u00a0vyplav\u00edme z kostn\u00ed d\u0159en\u011b d\u00e1rce krvinky, kter\u00e9 nasb\u00edr\u00e1me, ty nezral\u00e9 krvinky, kter\u00e9 nasb\u00edr\u00e1me na ur\u010dit\u00e9m p\u0159\u00edstroji, kter\u00e9mu se \u0159\u00edk\u00e1 separ\u00e1tor, a pod\u00e1me pacientovi, \u010dili je mnoho variant a jako ned\u00e1 se \u0159\u00edct, \u017ee by to bylo bolestn\u00e1 z\u00e1le\u017eitost, ale jist\u011b v\u0161ichni d\u00e1rci maj\u00ed m\u016fj nekone\u010dn\u00fd obdiv, proto\u017ee to je n\u011bco, co by nemuseli a jist\u011b nen\u00ed to \u00fapln\u011b p\u0159\u00edjemn\u00e1 v\u011bc. Tak\u017ee …
Daniel Tak\u00e1\u010d, moder\u00e1tor
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A ten vlastn\u00ed test, to za\u0159azen\u00ed do toho registru, to tak\u00e9 nen\u00ed \u00fapln\u011b p\u0159\u00edjemn\u00e1 v\u011bc, nebo to je skute\u010dn\u011b …
Jan Star\u00fd,
Ne, ne, ne, to se nabere zkumavka krve, vy\u0161et\u0159\u00ed se na b\u00edl\u00fdch krvink\u00e1ch ty z\u00e1kladn\u00ed znaky, ud\u011bl\u00e1 se takov\u00e9to z\u00e1kladn\u00ed vy\u0161et\u0159en\u00ed, kter\u00e9 pot\u0159ebujeme, krevn\u00ed skupina, stav ur\u010dit\u00fdch vir\u016f v organismu, a to v\u0161echno se ulo\u017e\u00ed do datab\u00e1ze a tam je to ulo\u017eeno. A pak jako na koho to slovo padne.
Daniel Tak\u00e1\u010d, moder\u00e1tor
——————–
Jak je to vlastn\u011b mo\u017en\u00e9, \u017ee ani v rodin\u011b ta mo\u017enost darovat nen\u00ed v podstat\u011b stoprocentn\u011b? Laik by si \u0159ekl, no, tak jestli\u017ee je to biologick\u00e1 rodina, pochopiteln\u011b, jak to, \u017ee to nejde?
Jan Star\u00fd,
To, co tady zazn\u011blo, t\u011bch 25 %, je, \u017ee prost\u011b a jasn\u011b se ty znaky d\u011bd\u00ed v ur\u010dit\u00fdch sad\u00e1ch, tomu \u0159\u00edk\u00e1me haplotypy a ty p\u0159ed\u00e1vaj\u00ed ty rodi\u010de oba a tak ty se r\u016fzn\u011b kombinuj\u00ed, tak\u017ee to d\u00edt\u011b od t\u011bch rodi\u010d\u016f zd\u011bd\u00ed jednu tu sadu znak\u016f a druhou sadu znak\u016f zd\u011bd\u00ed od toho druh\u00e9ho rodi\u010de a pak je v\u011bc t\u00e9 n\u00e1hody a t\u00e9 genetiky, jestli teda ty sady jsou u t\u011bch d\u011bt\u00ed shodn\u00e9, anebo nejsou, samoz\u0159ejm\u011b ten rodi\u010d m\u00e1 1\/2 znaku s t\u00edm d\u00edt\u011btem shodnou a my v situaci, kde nenajdeme \u017e\u00e1dn\u00e9ho jin\u00e9ho d\u00e1rce, tak m\u016f\u017eeme transplantovat s ur\u010dit\u00fdmi takov\u00fdmi technick\u00fdmi vychyt\u00e1vkami i kostn\u00ed d\u0159e\u0148 nebo krvetvorbu od toho rodi\u010de, \u010dili i to je mo\u017enost pro n\u00e1s dnes, v dne\u0161n\u00edm stavu medic\u00edny.
Daniel Tak\u00e1\u010d, moder\u00e1tor
——————–
Bav\u00edme se o hodn\u011b sofistikovan\u00e9 v\u011bci, kam postoupila za posledn\u00edch, nev\u00edm, n\u011bkolik let v\u011bda v tom smyslu, jestli ten proces nem\u016f\u017ee b\u00fdt jednak jednodu\u0161\u0161\u00ed a jednak tedy \u00fa\u010dinn\u011bj\u0161\u00ed a samoz\u0159ejm\u011b m\u00ed\u0159\u00edm k \u00fapln\u00e9mu vyl\u00e9\u010den\u00ed \u00fapln\u011b v\u0161ech, co\u017e samoz\u0159ejm\u011b v\u00edm, \u017ee je ta limitn\u00ed z\u00e1le\u017eitost, ale postupuje v\u011bda?
Jan Star\u00fd,
V\u011bda postoupila ne \u00fapln\u011b pro to onemocn\u011bn\u00ed, co m\u00e1 Madlenka, ona nem\u00e1 leuk\u00e9mii, ona m\u00e1 selh\u00e1n\u00ed kostn\u00ed d\u0159en\u011b, tzv. aplastickou an\u00e9mii, kter\u00e1 m\u00e1 dv\u011b l\u00e9\u010debn\u00e9 mo\u017enosti, transplantaci kostn\u00ed d\u0159en\u011b je jedna z nich. To, co podstupuje te\u010f ona, ta l\u00e9\u010dba, to je druh\u00e1 mo\u017enost, ale t\u0159eba u leuk\u00e9mi\u00ed to, co je pro n\u00e1s nej\u010dast\u011bj\u0161\u00ed indikace k transplantaci, tam v\u011bda postoupila. M\u00e1me genovou l\u00e9\u010dbu, kdy opravujeme b\u00edl\u00e9 krvinky nebo ne my, ale kolegov\u00e9 v laborato\u0159\u00edch b\u00edl\u00e9 krvinky toho nemocn\u00e9ho \u010dlov\u011bka, tak aby se nau\u010dily nach\u00e1zet ty leuk\u00e9mick\u00e9 bu\u0148ky a ni\u010dit je, tomu se \u0159\u00edk\u00e1 l\u00e9\u010dba chimerick\u00fdm antigenn\u00edm receptorem b\u00edl\u00fdch krvinek a je to situace, kter\u00e1 dok\u00e1\u017ee v \u0159ad\u011b p\u0159\u00edpad\u016f, mo\u017en\u00e1 v polovin\u011b, nahradit transplantaci kostn\u00ed d\u0159en\u011b, m\u00e1 m\u00e9n\u011b vedlej\u0161\u00edch \u00fa\u010dink\u016f, m\u00e9n\u011b pozdn\u00edch n\u00e1sledk\u016f, co\u017e pro ty d\u011bti je d\u016fle\u017eit\u00e9 a je to ur\u010dit\u011b l\u00e9\u010dba budoucnosti..
Daniel Tak\u00e1\u010d, moder\u00e1tor
——————–
Tedy m\u00ed\u0159\u00edme k tomu, \u017ee vezmeme si pilulku a nemoc se vyl\u00e9\u010d\u00ed?
Jan Star\u00fd,
No tak my vyl\u00e9\u010d\u00edme nemoce pilulkami u\u017e l\u00e9ta, kdy\u017e jsme za\u010dali s chemoterapi\u00ed p\u0159ed 60 lety, tak\u017ee ano, my l\u00e9\u010d\u00edme pilulkami \u017eivot ohro\u017euj\u00edc\u00ed nemoci, ale ne v\u017edy se n\u00e1m to poda\u0159\u00ed.
Daniel Tak\u00e1\u010d, moder\u00e1tor
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Tak, pane profesore, d\u011bkuju, \u017ee jste p\u0159i\u0161el do Ud\u00e1lost\u00ed, koment\u00e1\u0159\u016f a d\u011bkuju za va\u0161i pr\u00e1ci, na shledanou.
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