Nilotinib in patients with chronic myelogenous leukemia with hepatotoxicity after imatinib

W leczeniu chorych na przewlekłą białaczkę szpikową (CML) stosuje się terapię celowaną inhibitorami kinaz tyrozynowych (TKI). Obecnie w leczeniu pierwszej linii możliwe jest zastosowanie jednego z trzech dostępnych TKI: imatynibu (IM), nilotynibu, dazatynibu. Najczęściej jednak nadal stosuje się IM. U niektórych pacjentów lek ten może być przyczyną ciężkiego uszkodzenia wątroby. Takie zdarzenie występuje u mniej niż 5% chorych. W pracy przedstawiono opisy 2 przypadków chorych z hepatotoksycznością po IM. U 2 pacjentek było to powodem przerwania leczenia IM. W dalszym leczeniu zastosowano nilotynib (NILO). Leczenie za pomocą NILO było dobrze tolerowane i nie obserwowano nawrotu hepatotoksyczności.In the treatment of patients with chronic myelogenous leukemia (CML) targeted therapy with tyrosine kinase inhibitors (TKI) is used. Presently, treatment of the fi rst line is based on the three available TKI, including imatinib, nilotinib or dasatynib. However, imatinib (IM) is the most widely used in this clinical setting. In some patients, it can cause severe liver damage. This event occurs in less than 5% of patients. This paper presents a description of 2 clinical cases of hepatotoxicity after IM. In 2 patients, this was the reason of withdrawing the drug and nilotinib was introduced. The therapy was well tolerated and there was no recurrence of hepatotoxicity

Small cell carcinoma with neuroendocrine differentiation of subglottic larynx- a case report

Small cell cancer (SCC) is a neuroendocrine neoplasm, which is most frequently found in the lungs. Extrapulmonary location of SCC is rare and may involve 2.5-5% of SCCs. We present a case of a 31-year-old male patient with an extremely uncommon subglottic SCC. The patient was qualified for a radical sequential chemoradiotherapy. After treatment, patient’s condition suggested complete remission. Recurrence was detected one year later, and the disease rapidly progressed, despite a second line chemotherapy. The patient died 29 months after initial diagnosis. This case aims to raise awareness on the aggressive laryngeal SCC and its good response to first line chemotherapy composed of cisplatin and etoposide, followed by radiotherapy

The management and outcome of essential thrombocythemia in pregnancy – single-center experience

Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by an increase in platelet (PLT > 450 000/μl) and a tendency for either thrombosis or hemorrhage. ET is often diagnosed in elderly life and is two times more frequent in females than in males. This is the most common myeloproliferative neoplasm in women of childbearing age. An increased risk of fetal and maternal complications has been demonstrated in patients with ET. Most of complications (particularly the case of spontaneous abortion) occurs during the first trimester of pregnancy. The paper presents four pregnancies in three patients with essential thrombocythemia who were treated in Department of Hematology Pomeranian Medical University. In the treatment of pregnant patients with essential thrombocythemia interferon alpha, acetylsalicylic acid (ASA) and low molecular weight heparin were used.Nadpłytkowość samoistna (ET) jest przewlekłym nowotworem mieloproliferacyjnym dotyczącym głównie linii megakariocytów, przebiegającym ze zwiększoną ponad 450 000/ul liczbą płytek krwi. Nadpłytkowość występuje przede wszystkim u ludzi starszych, dwukrotnie częściej u kobiet niż u mężczyzn. Jest jednym z najczęstszych nowotworów mieloproliferacyjnych występujących u młodych kobiet, będących w okresie rozrodczym. U pacjentek ciężarnych z ET stwierdza się zwiększone ryzyko powikłań w postaci wad płodu oraz powikłań u ciężarnej. Najczęściej powikłania występują w pierwszym trymestrze ciąży i są to samoistne poronienia. W pracy przedstawiono przebieg czterech ciąż u trzech pacjentek z ET leczonych w jednym ośrodku, zakończonych urodzeniem zdrowych dzieci. W leczeniu stosowano interferon α, heparynę drobnocząsteczkową oraz kwas acetylosalicylowy

Pleural effusion in patient with chronic myeloid leukemia treated with dasatinib – a case report

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with inherence of a cytogenetic abnormalities in the shape of translocation of gene ABL from chromosome 9 to chromosome 22, t(9,22)(q34;q11). Current standard therapy in CML, is made by the application of a medicine from tyrosine kinase inhibitors group (TKI) which means usage of: imatinib, dasatinib or nilotinib. Application of a tyrosine kinase inhibitors with their therapeutic effectiveness can cause a variety of undesirable side-effects. One of the essential nonhematologic complications made by the usage of dasatinib is the fluid retention which may manifest, among the others, of pleural effusion. Here is the case report of a patients with CML treated initially with imatinib and then due to intolerance (skin toxicity) with dasatinib. During dasatinib treatment a pleural effusion occurred, this caused periodic interruption in usage of dasatinib and implementation of appropriate conduct.Przewlekła białaczka szpikowa (CML, chronic myeloid leukemia) to nowotwór mieloproliferacyjny z obecnością zaburzeń cytogenetycznych pod postacią translokacji genu ABL z chromosomu 9 na chromosom 22: t(9;22)(q34;q11). Aktualnym standardem postępowania terapeutycznego w CML jest zastosowanie leków z grupy inhibitorów kinaz tyrozynowych: imatynibu, dazatynibu czy nilotynibu. Użycie inhibitorów kinaz tyrozynowych ma dużą skuteczność terapeutyczną, ale niesie za sobą ryzyko wystąpienia różnych działań niepożądanych. Jednym z istotnych pozahematologicznych powikłań po dazatynibie jest retencja płynów, objawiająca się m.in. wysiękiem opłucnowym. W pracy przedstawiono przypadek pacjentki z przewlekłą białaczką szpikową leczonej początkowo imatynibem, a następnie z uwagi na nietolerancję (toksyczność skórną) – dazatynibem. W trakcie terapii nim wystąpił wysięk opłucnowy, co było powodem czasowego jego przerwania i leczenia tego powikłania

Patient with disseminated malignant tumor of the pancreas. Application of liposomal irinotecan as a new option of palliative treatment

In palliative treatment of pancreatic neoplasms, chemotherapy regimens with gemcitabine, nab-paclitaxel, oxaliplatin, irinotecan, 5-fluorouracil or combinations of these drugs are used. The registration of liposomal irinotecan in the treatment of stage IV disease in patients with progression after gemcitabine creates new options for the treatment choice. The described case concerns a relatively young patient in whom the use of liposomal irinotecan in the registration indication turned out to be a safe and well-tolerated treatment

The Double-Edged Sword Role of Viruses in Gastric Cancer

Due to its high morbidity and mortality, gastric cancer is a topic of a great concern throughout the world. Major ways of treatment are gastrectomy and chemotherapy, unfortunately they are not always successful. In a search for more efficient therapy strategies, viruses and their potential seem to be an important issue. On one hand, several oncogenic viruses have been noticed in the case of gastric cancer, making the positive treatment even more advantageous, but on the other, viruses exist with a potential therapeutic role in this malignancy

Herpesviruses in Head and Neck Cancers

Head and neck cancers arise in the mucosa lining the oral cavity, oropharynx, hypopharynx, larynx, sinonasal tract, and nasopharynx. The etiology of head and neck cancers is complex and involves many factors, including the presence of oncogenic viruses. These types of cancers are among the most common cancers in the world. Thorough knowledge of the pathogenesis of viral infections is needed to fully understand their impact on cancer development

Chronic Lymphocytic Leukemia-Induced Humoral Immunosuppression: A Systematic Review

Secondary immunodeficiency is observed in all patients with chronic lymphocytic leukemia (CLL) in varying degrees. The aim of the study was to review the available literature data on patients with CLL, with particular regard to the pathogenesis of the disease and the impact of humoral immunity deficiency on the clinical and therapeutic approach. A systematic literature review was carried out by two independent authors who searched PubMed databases for studies published up to January 2020. Additionally, Google Scholar was used to evaluate search results and support manual research. The search resulted in 240 articles eligible for analysis. After all criteria and filters were applied, 22 studies were finally applied to the analysis. The data analysis showed that the clinical heterogeneity of CLL patients correlates with the diversity of molecular abnormalities determining the clinical picture of the disease, the analysis of which enables setting therapeutic targets. Additionally, in improving the therapeutic method, it is worth introducing supportive therapies with the use of vaccines, antibiotics and/or immunoglobins. Moreover, humoral immunodeficiency in CLL has a strong influence on the risk of infection in patients for whom infections are a major cause of morbidity and mortality

The Epidemiology and Clinical Presentations of Atopic Diseases in Selective IgA Deficiency

Selective IgA deficiency (sIgAD) is the most common primary immunodeficiency disease (PID), with an estimated occurrence from about 1:3000 to even 1:150, depending on population. sIgAD is diagnosed in adults and children after the 4th year of age, with immunoglobulin A level below 0.07 g/L and normal levels of IgM and IgG. Usually, the disease remains undiagnosed throughout the patient’s life, due to its frequent asymptomatic course. If symptomatic, sIgAD is connected to more frequent viral and bacterial infections of upper respiratory, urinary, and gastrointestinal tracts, as well as autoimmune and allergic diseases. Interestingly, it may also be associated with other PIDs, such as IgG subclasses deficiency or specific antibodies deficiency. Rarely sIgAD can evolve to common variable immunodeficiency disease (CVID). It should also be remembered that IgA deficiency may occur in the course of other conditions or result from their treatment. It is hypothesized that allergic diseases (e.g., eczema, rhinitis, asthma) are more common in patients diagnosed with this particular PID. Selective IgA deficiency, although usually mildly symptomatic, can be difficult for clinicians. The aim of the study is to summarize the connection between selective IgA deficiency and atopic diseases

Extremely Rare Pulmonary Metastases of Skin Basal Cell Carcinoma: Report of Two Cases with Clinicopathological Features

Basal cell carcinoma (BCC) is the most frequent human skin cancer, but metastasizing BCC (MBCC) is extremely rare, developing in approximately 0.0028% to 0.55% of BCC patients. Herein, we report two cases of pulmonary MBCC. The first one developed in a 72-year-old male who underwent surgical resection due to multiple recurrences and adjuvant radiotherapy. Immunohistochemistry showed that neoplastic cells expressed Ber-EP4, CK5/6, p63, EMA (focally), BCL-2, and CD10, but were negative for CK7, CK20, S100, estrogen and progesterone receptors, and TTF-1. The second case is a 64-year-old female treated with vismodegib. Clinicopathological features and differential diagnoses are described