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Analýza minimální reziduální nemoci u mnohočetného myelomu pomocí multiparametrické průtokové cytometrie


: L. Rihova 1;  P. Vsianska 1;  R. Bezdekova 1;  R. Kralova 1;  M. Penka 1;  M. Krejci 2;  L. Pour 2;  R. Hájek 1,3
: Department of Hematology, University Hospital Brno, Czech Republic 1;  Department of Internal Medicine – Haematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic 2;  Department of Haematooncology, University Hospital Ostrava, Czech Republic 3
: Klin Onkol 2017; 30(Supplementum2): 21-28
: Review
prolekare.web.journal.doi_sk: https://doi.org/10.14735/amko20172S21

Východiska:
Díky pokrokům v léčbě mnohočetného myelomu se značně zvýšil počet pacientů dosahujících remise onemocnění, a tedy detekce minimální reziduální choroby (minimal residual disease – MRD) se stala nepostradatelnou ke zhodnocení účinnosti léčby a k posouzení hloubky kompletní léčebné odpovědi. Multiparametrická průtoková cytometrie (multiparametric flow cytometry – MFC) je v současnosti nejpoužívanější metodou pro stanovení a monitorování přítomnosti MRD v kostní dřeni pacientů s mnohočetným myelomem, nicméně mohou být využity také metody na molekulární úrovni. Je zřejmé, že protokol použitý pro stanovení MFC-MRD může významně ovlivnit získané výsledky, přičemž standardizovaný a vysoce senzitivní přístup „next generation flow” je již dostupný. Přínos stanovení MRD pro predikci přežití bez progrese onemocnění a celkového přežití je znám, nicméně nedávné výzkumy ukazují, že MRD negativita dokonce překonává prognostickou hodnotu dosažení kompletní léčebné odpovědi pro přežití bez progrese a celkové přežití.

Cíl:
Souhrnný článek je zaměřen na využití MFC v analýze MRD u mnohočetného myelomu. Zmíněny jsou také technické aspekty a zhodnocení klinického přínosu tohoto stanovení.

Závěr:
Informace o hladině MRD stanovené pomocí vysoce senzitivní a reprodukovatelné MFC může být využita jako biomarker k hodnocení účinnosti rozdílných léčebných přístupů, k rozhodování o vhodnosti léčby, ale také může sloužit jako parametr nahrazující celkové přežití u pacientů s mnohočetným myelomem.

Klíčová slova:
mnohočetný myelom – minimální reziduální nemoc – průtoková cytometrie – plazmatické buňky

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Obdrženo:
25. 6. 2017

Přijato:
29. 6. 2017


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