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2008, vol. 15, br. 2, str. 41-45
Tromboza kod pacijenata sa akutnom promijelocitnom leukemijom tretiranih all-trans retinoičnom kiselinom (ATRA) - prospektivno ispitivanje
aKlinički centar Niš, Klinika za hematologiju i kliničku imunologiju
bKlinički centar Niš, Klinika za kardiovaskularne bolesti

e-adresagolubovicz@bankerinter.net
Ključne reči: akutna promijelocitna leukemija; ATRA (all-trans retinoična kiselina); ATRA sindrom; tromboza
Sažetak
Akutna promijelocitna leukemija (APL) se karakteriše klonalnom proliferacijom i akumulacijom promijelocita karakteristične morfologije, fibrinolizom, proteolizom i diseminovanom intravaskulnom koagulacijom. Opšte je prihvaćeno da se all-trans retinoična kiselina (ATRA), sama ili u kombinaciji sa citostaticima, koristi u indukciji lečenja APL-a, u APL rezistentnom na citostatike i u relapsu APL-a tretiranom citostaticima. Iako se dobro toleriše, ATRA može izazvati neke neželjene efekte, poznate kao ATRA sindrom. Duboka venska tromboza je retka komplikacija lečenja ATRA-om. Za četiri godine dugog prospektivnog istraživanja, utvrdili smo incidencu i rizik od tromboza kod APL bolesnika tretiranih ATRA-om. Studija je uključivala 12 APL bolesnika, oba pola, prosečnog uzrasta 48,7g. Svi pacijenti, primili su, 110995mg ATRA-e ukupno, 9246,25mg po osobi u proseku. Duboka venska tromboza razvila se kod jednog pacijenta (8,3%) posle primanja kumulativne doze od 2700mg ATRA-e. Lek je momentalno obustavljen i po izlečenju duboke venske tromboze ponovo uključen. Tromboza je verovatno izazvana tranzitornom hiperkoagulabilnošću krvi izazvane lekom. U sledeće tri godine ATRA tretmana, tromboza se više nije pojavljivala. Pacijent je još uvek u remisiji, iako je u poslednjih 12 meseci bez APL terapije. Neophodna je pažljiva opservacija svakog pacijenta tretiranog ATRA-om, kao i rana dijagnoza i adekvatno lečenje ATRA-om izazvane tromboze.
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O članku

jezik rada: engleski
vrsta rada: neklasifikovan
objavljen u SCIndeksu: 04.05.2010.