Nepoželjne popratne pojave imunoterapije tumora

Implementation of immunotherapy in many cancer types has achieved positive results in tumor control and cure. The concept of immunotherapy is diff erent in comparison with conventional tumor therapies. While chemotherapy, hormonal or biological therapies target tumor cells and mechanisms, immunotherapy targets host immune system. Amplifi cation of defending possibilities or unblocking the control of the immune reactions are used. Besides positive results in tumor control, enhancing immunogenicity can provoke harm to other tissues and systems in form of adverse reactions or unwanted side effects of therapy. Early recognition of side effects is of crucial importance and prompt care can diminish the harm and severity. Knowledge about side effects is needed, therefore good education of all medical personnel included in treatment as well as patient education must be assured prior and thorough the treatment. Writt en guidelines are provided and easy reachable and must be used.Provedba imunoterapije u mnogim vrstama karcinoma postigla je pozitivne rezultate u kontroli i liječenju tumora. Koncept imunoterapije razlikuje se u usporedbi s konvencionalnim terapijama tumora. Dok su kemoterapija, hormonska ili biološka terapija svojim djelovanjem usmjerena na uništenje tumorske stanice i mehanizama u tumoru, imunoterapija cilja imunološki sustav domaćina. Pri tome se jačaju obrambeni procesi i reakcije ili se korištenjem imunoterapije dovodi do deblokiranja procesa kontrole imunoloških reakcija. Osim pozitivnih rezultata u kontroli tumora, povećanje imunogenosti može izazvati štetu drugim tkivima i sustavima u obliku nuspojava ili neželjenih nuspojava terapije. Rano prepoznavanje nuspojava od presudne je važnosti, a pravodobno zbrinjavanje može smanjiti oštećenje i težinu popratne pojave. Znanje o mogućim nuspojavama je nužno osigurati kroz dobro i sveobuhvatno obrazovanje svih medicinskih djelatnika uključenih u liječenje, a jednako je tako važno podučiti i s popratnim pojavama upoznati i pacijenata prije liječenja. Pisane smjernice pružene su i lako dostupne i moraju se koristiti

Nepoželjne popratne pojave imunoterapije tumora

Implementation of immunotherapy in many cancer types has achieved positive results in tumor control and cure. The concept of immunotherapy is diff erent in comparison with conventional tumor therapies. While chemotherapy, hormonal or biological therapies target tumor cells and mechanisms, immunotherapy targets host immune system. Amplifi cation of defending possibilities or unblocking the control of the immune reactions are used. Besides positive results in tumor control, enhancing immunogenicity can provoke harm to other tissues and systems in form of adverse reactions or unwanted side effects of therapy. Early recognition of side effects is of crucial importance and prompt care can diminish the harm and severity. Knowledge about side effects is needed, therefore good education of all medical personnel included in treatment as well as patient education must be assured prior and thorough the treatment. Writt en guidelines are provided and easy reachable and must be used.Provedba imunoterapije u mnogim vrstama karcinoma postigla je pozitivne rezultate u kontroli i liječenju tumora. Koncept imunoterapije razlikuje se u usporedbi s konvencionalnim terapijama tumora. Dok su kemoterapija, hormonska ili biološka terapija svojim djelovanjem usmjerena na uništenje tumorske stanice i mehanizama u tumoru, imunoterapija cilja imunološki sustav domaćina. Pri tome se jačaju obrambeni procesi i reakcije ili se korištenjem imunoterapije dovodi do deblokiranja procesa kontrole imunoloških reakcija. Osim pozitivnih rezultata u kontroli tumora, povećanje imunogenosti može izazvati štetu drugim tkivima i sustavima u obliku nuspojava ili neželjenih nuspojava terapije. Rano prepoznavanje nuspojava od presudne je važnosti, a pravodobno zbrinjavanje može smanjiti oštećenje i težinu popratne pojave. Znanje o mogućim nuspojavama je nužno osigurati kroz dobro i sveobuhvatno obrazovanje svih medicinskih djelatnika uključenih u liječenje, a jednako je tako važno podučiti i s popratnim pojavama upoznati i pacijenata prije liječenja. Pisane smjernice pružene su i lako dostupne i moraju se koristiti

Imunoterapija karcinoma mokraćnog mjehura

Urothelial urinary bladder carcinoma represents 9th most common malignancy in the world. This disease is held responsable for more than 165000 deaths throughout the world. In the past 30 years there were no major advances in treatment of this tumor. Chemotherapy regimens used for treatment are based on platinum compounds. In a recent time a series of immune system modulating drugs have been developed. This drugs have achieved excellent results in the treatment of urinary bladder carcinoma.Karcinom mokraćnog mjehura je deveti najčešći maligni tumor u svijetu. Bolest je uzrok više od 165.000 smrtnih slučajeva. U posljednjih 30 godina nije bilo većih pomaka u mogućnostima liječenja ovoga tumora. Kemoterapijski protokoli za liječenje uznapredovale ili metastatske bolesti mokraćnog mjehura bazirani su uglavnom na spojevima platine. U posljednje vrijeme razvijen je niz novih lijekova koji moduliraju imunološki odgovor organizma na tumorske stanice i time omogućavaju uspješno liječenje karcinoma mokraćnog mjehura

Imunoterapija karcinoma mokraćnog mjehura

Urothelial urinary bladder carcinoma represents 9th most common malignancy in the world. This disease is held responsable for more than 165000 deaths throughout the world. In the past 30 years there were no major advances in treatment of this tumor. Chemotherapy regimens used for treatment are based on platinum compounds. In a recent time a series of immune system modulating drugs have been developed. This drugs have achieved excellent results in the treatment of urinary bladder carcinoma.Karcinom mokraćnog mjehura je deveti najčešći maligni tumor u svijetu. Bolest je uzrok više od 165.000 smrtnih slučajeva. U posljednjih 30 godina nije bilo većih pomaka u mogućnostima liječenja ovoga tumora. Kemoterapijski protokoli za liječenje uznapredovale ili metastatske bolesti mokraćnog mjehura bazirani su uglavnom na spojevima platine. U posljednje vrijeme razvijen je niz novih lijekova koji moduliraju imunološki odgovor organizma na tumorske stanice i time omogućavaju uspješno liječenje karcinoma mokraćnog mjehura

Imunoterapija karcinoma mokraćnog mjehura

Urothelial urinary bladder carcinoma represents 9th most common malignancy in the world. This disease is held responsable for more than 165000 deaths throughout the world. In the past 30 years there were no major advances in treatment of this tumor. Chemotherapy regimens used for treatment are based on platinum compounds. In a recent time a series of immune system modulating drugs have been developed. This drugs have achieved excellent results in the treatment of urinary bladder carcinoma.Karcinom mokraćnog mjehura je deveti najčešći maligni tumor u svijetu. Bolest je uzrok više od 165.000 smrtnih slučajeva. U posljednjih 30 godina nije bilo većih pomaka u mogućnostima liječenja ovoga tumora. Kemoterapijski protokoli za liječenje uznapredovale ili metastatske bolesti mokraćnog mjehura bazirani su uglavnom na spojevima platine. U posljednje vrijeme razvijen je niz novih lijekova koji moduliraju imunološki odgovor organizma na tumorske stanice i time omogućavaju uspješno liječenje karcinoma mokraćnog mjehura

Kognitivne sposobnosti mjerene Kompleksnim Reakciometrom Drenovac (CRD) u onkološko hematoloških bolesnika prije i poslije liječenja anemije

Anemia is commonly present in hematology and oncology patients and influence significantly their quality of life. The aim of this study was to evaluate the effect of anemia and malignant disease on cognitive functions in hematology- oncology patients. Four hundred patients were evaluated for cognitive functions and hemoglobin levels before and after correction of anemia in the Clinical Hospital Center of Rijeka, Croatia. The patients were divided in four groups (100 patients in each group): Experimental Group 1 – patients with malignancy plus anemia, and controls: Group 2 – patients with malignancy and without anemia, Group 3 – patients without malignancy but anemic and Group 4 – healthy controls without malignancy and without anemia. Cognitive functions were measured by Complex Reactiometer Drenovac (CRD) before and after therapy of anemia. Group 1 showed the worst cognitive achievement (p<0.001) compared with all other groups. After correction of anemia, cognition improved (except visual orientation and memory) but did not reach the results of other groups. Cognitive improvement was in correlation with hemoglobin levels. This study confirmed that anemia significantly influence cognitive functions in hematology-oncology patients and that cognitive functions could be improved by correction of anemia.Kognitivna disfunkcija uzorkovana anemijom vrlo je česta u onkoloških i hematoloških bolesnika te značajno utječe na njihovu kvalitetu života. Cilj ovog istraživanja bio je procijeniti u kolikoj se mjeri maligna bolest i anemija odražavaju na kognitivne sposobnosti onkološko-hematoloških bolesnika. Istraživanjem je obuhvaćen uzorak od 400 bolesnika liječenih u Kliničkom bolničkom centru Rijeka, koji su bili svrstani u 4 skupine izjednačene po spolu, dobi i stručnoj spremi (po 100 ispitanika u svakoj skupini). Skupina 1 bila je eksperimentalna (bolesnici sa zloćudnim tumorom koji pri postavljanju dijagnoze imaju i anemiju) dok su ostale skupine bile kontrolne: skupina 2 (bolesnici sa zloćudnim tumorom koji nemaju anemiju), skupina 3 (anemični bolesnici koji nemaju malignu bolest), skupina 4 (zdravi ispitanici koji nemaju ni malignu bolest niti anemiju). U svih bolesnika provedeno je psihometrijsko testiranje različitih kognitivnih funkcija pomoću kompjutoriziranih testova CRD-serije (Complex reactiometer Drenovac) prije i poslije liječenja anemije. U skupini 1 zabilježeni su lošiji rezultati na kognitivnim testovima (p<0,001) u odnosu na ostale skupine. Nakon korekcije anemije većina kognitivnih funkcija je bila poboljšana (osim vizualne orijentacije i memoriranja), ali nisu dostignuti rezultati ostalih skupina. Porast kognitivnih sposobnosti bio je proporcionalan razini hemoglobina. Rezultati istraživanja pokazuju da je anemija značajno utjecala na kognitivne funkcije onkološko-hematoloških bolesnika i da se liječenjem anemije može utjecati na poboljšanje kognitivnih sposobnosti

Predictive value of intraoperative sentinel lymph node imprint cytology analysis for metastasis in patients with melanoma

Since there are no standardized protocols regarding the detection of microscopic melanoma deposits in sentinel lymph nodes (SLN), the aim of this study was to present our experience with intraoperative cytological evaluation of SLN in patients with melanoma. The study included 475 SLN biopsies (SLNB) from 201 patients with primary cutaneous melanoma of intermediate thickness. Each lymph node was cut in half; touch imprint cytology (TIC) preparations of all cut surfaces were performed and stained according to a modified May-Grünwald-Giemsa method. The results were compared to definitive postoperative histology. Twenty of 25 SLNB positive on TIC proved to be metastatic when compared to definitive histology. Most of 32 SLN that were suspicious but not diagnostic on TIC were proven negative (23/32, 71.8%), while 7 nodes had metastases (one micrometastasis and one with isolated tumor cells only). The majority (94%) of SLNBs negative on TIC remained negative on final histology, while 6% or 25 nodes were positive, mostly with micrometastases or isolated tumor cells (17/25). In frozen sections performed in cases of suspicious or positive SLN cytology, metastasis was confirmed in 80% of positive and in 21.9% of suspicious TIC. Altogether, 49% (27/55) of positive SLNB were identified intraoperatively in 57% (24/42) of patients, and in those cases a complete regional lymph node dissection was performed in the first step. TIC assessment of SLNB with 99% specificity and 57% sensitivity for intraoperative identification of metastasis is useful and beneficial for avoiding a second operative procedure.  </p

The patterns of melanoma presentation

There is a global rising incidence of melanoma. For different reasons patterns of incidence, appearance, gender, anatomical distribution and outcome vary in different geographic area. Screening programs leaded to better early detection of melanoma in Australia and some world areas. National Cancer registry and practice data show incidence in Croatia is constantly rising. Despite public education programs about early discovery, in clinics we still see many new advanced stage melanoma.We analyzed data from 157 patients, cured and followed for 10 years for T1b-T4aN0 skin melanoma. There was a difference in anatomical distribution of melanoma lesions in correlation with patients age (ANOVA test, F=3.51, p=0,009). A higher prevalence of shoulder melanoma in young people was found, and head/neck in old (post-hoc Sheffe test, p=0.038).The T4 lesions were more found in men, and T1 mainly in women (Pearson c2 test, c2 =12.08, p=0.016). There was no difference in Clark level, but significantly higher Breslow stage was found in men (t=-2.52, p=0.013). Men were much prone to have head and neck, body, and shoulder melanoma; women had more melanoma on their legs and arms. Clark and Breslow level were strongly correlated in leg melanoma; head localization had no correlation at all. As conclusion, more attention should be devoted to improve results in melanoma detection in men, especially with the prevalence of body (back), head/neck localization, sometimes not prone to visual detection. Pattern of distribution show also the need for more attention to shoulder melanoma in younger people.</p