Author/Editor     Černelč, Peter
Title     Zdravljenje primarne plazmacelične levkemije
Translated title     Treatment of primary plasma cell leukemia
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 72, št. 4
Publication year     2003
Volume     str. 201-4
Language     slo
Abstract     Background. The author describes long-term survival in 3 patients with primary plasma cell leukaemia (PL) after different therapeutic regimen and maintenance treatment with interferon alpha (INF). Patients and treatment. In a 52 year-old male patient, a partial remission of PL was achieved after 6 months of treatment with melphalan and prednisone. The patient did not consent to stem cell transplantation (SCT). An 86 year-old female patient with PL achieved a complete remission after 6 months of treatment with vincristine, doxorubicin and dexamethasone. A 31 year-old male patient experienced a complete remission of PL after 6 months of treatment with cyclophosphamide, vincristine, doxorubicin, methilprednisone, followed by autologous SCT. All three patients were placed on maintenance therapy with INF-2b(IntronA)3 X 106IU given subcutaneously on two days per week. In the 52 year-old man, the remission lasted 9 months and in the woman 23 months, where upon they developed a relapse with signs of disseminated plasmacytoma. In both patients the former chemotherapy was applied again, resulting in a slight improvement. The man died 37 months and the woman 43 months after the diagnosis of PL, while the youngest patient has been in complete remission for 82 months. Conclusions. Long remission achieved in ourpatients confirmed the favourable effect of INF in terms of prolongation of the remission duration in this patients. The effect of maintenance treatment with INF is usually directly dependent on the degree of remission induced by different therapeutic regimen.
Summary     Izhodišča. Avtor opisuje dolge remisije bolezni po različnih načinih zdravljenja s citostatiki in enakim vzdrževalnim zdravljenjem z interferonom alfa-2b (INF) pri treh bolnikih s primarno plazmacelično levkemijo (PL). Bolniki in zdravljenje. Pri 52-letnem bolniku smo po šestih krogih zdravljenja z melfalanom in prednizonom dosegli delno remisijo bolezni. Za presaditev krvotvornih matičnih celic (KMC) se bolnik ni odločil. Pri 86-letni bolnici smo dosegli popolno remisijo bolezni po šestih krogih zdravljenja z vinkristinom, doksorubicinom in deksametazonom. Pri 31-letnem bolniku smo dosegli popolno remisijo bolezni po šestih krogih zdravljenja s ciklofosfamidom, vinkristinom, Adriablastinom in metilprednizolonom, ki mu je sledila avtologna presaditev KMC. Vzdrževalno zdravljenje smo pri vseh treh nadaljevali z INF 3 X 106 IE dvakrat na teden. Pri 52-letnem bolniku smo ugotovili po devetih, pri bolnici pa po 23 mesecih poslabšanje bolezni. Pri obeh bolnikih smo z enako kombinacijo citostatikov dosegli kratkotrajno delno izboljšanje bolezni. Bolnik je umrl 37 mesecev, bolnica pa 43 mesecev po ugotovitvi bolezni, medtem ko je najmlajši bolnik 82 mesecev v popolni remisiji bolezni. Zaključki. Vzdrževalno zdravljenje z INF podaljša remisijo PL. Trajanje remisije je sorazmerno s stopnjo dosežene remisije po zdravljenju s citostatiki.
Descriptors     LEUKEMIA, PLASMACYTIC
ANTINEOPLASTIC AGENTS, COMBINED
ADULT
INTERFERON-ALPHA
VINCRISTINE
DEXAMETHASONE
BONE MARROW TRANSPLANTATION