Léčba pacientů s Hodgkinovým lymfomem po relapsu nebo progresi onemocnění – chemosenzitivita, transplantace a cílená léčba

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Autoři: O. Novosad; T. Rudiuk
Působiště autorů: Oncohaematology Department, National Cancer Institute, Kyiv, Ukraine
Vyšlo v časopise: Transfuze Hematol. dnes,29, 2023, No. 2, p. 100-105.
Kategorie: Souhrnné/edukační práce
doi: https://doi.org/10.48095/cctahd2023prolekare.cz8

Souhrn

Dnes se Hodgkinův lymfom (HL) považuje za vyléčitelnou nemoc, protože až 90 % pacientů v časném stadiu a 70–80 % v pokročilých stadiích onemocnění dosáhne po léčbě první linie dlouhodobé remise. Přibližně 15–25 % pacientů s HL má primárně refrakterní nemoc nebo zrelabuje poté, co dosáhne odpověď po léčbě první linie. Přibližně polovina těchto nemocných je chemozenzitivních a/nebo zrelabuje po transplantaci. Vysocedávkovaná chemoterapie s autologní transplantací kmenových buněk má u pacientů s refrakterním onemocněním nebo relapsem vysokou účinnost a přispívá k dlouhodobému přežívání u významného počtu nemocných. Pacienti s vysoce rizikovým onemocněním, kteří byli léčeni načas a nedosáhli dostatečnou odpověď po standardní léčbě první linie nebo pacienti s chemozenzitivním relapsem mají dobrou prognózu. Na druhé straně, vysocedávkovaná chemoterapie následovaná autologní transplantací kmenových buněk není optimální možností u pacientů s primárně refrakterním onemocněním nebo s chemorezistentním relapsem. Alogenní transplantace krvetvorných buněk a/nebo cílená imunoterapie reprezentují léčebné možnosti pro tuto skupinu nemocných.

Klíčová slova:

transplantace – Hodgkinův lymfom – relaps – cílená léčba – chemosensitivita

Zdroje

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