Liječenje refraktornih hematoloških bolesti alogeničnom transplantacijom krvotvornih matičnih stanica u Kliničkom bolničkom centru Zagreb

master's thesis

• Title (english): Treatment of refractory hematological diseases with allogeneic transplantation of hematopoetic stem cell at the University Hospital Center Zagreb
• Author: Tomislav Taboršak
• Mentor: Zinaida Perić (mentor)
• Committee member: Nadira Duraković (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Zinaida Perić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Alogenična TKMS je terapijska metoda koja pruža mogućnost izliječenja brojnih malignih i nemalignih hematoloških bolesti, a danas ima sve veću ulogu i u liječenju kongenitalnih imunodeficijencija, genetski uvjetovanih autoimunih i metaboličkih bolesti te drugih oboljenja. Cilj ovog retrospektivnog istraživanja bio je procijeniti učinkovitost alogenične TKMS u liječenju naše populacije od 306 bolesnika s refraktornim i relapsnim hematološkim bolestima, koji su transplantirani u KBC-u Zagreb u razdoblju između 19.01.2011. i 19.12.2017., prema parametrima poput ukupnog preživljenja, akutnog i kroničnog GvHD-a te relapsa bolesti.
Rezultati su pokazali da je alogenična TKMS vrlo učinkovita u liječenju naših bolesnika; ukupno preživljenje svih 306 bolesnika na 42 mjeseca od transplantacije iznosilo je 52%. Ukupno preživljenje na 42 mjeseca od transplantacije bilo je najbolje u skupini bolesnika s CML-om i HL-om; 71% i 76%. Skupine bolesnika s MDS-om i mijelofibrozom imale su ukupno preživljenje na 42 mjeseca od transplantacije 56%, dok je skupina bolesnika s akutnim leukemijama imala ukupno preživljenje na 42 mjeseca od transplantacije 52%. Ukupno preživljenje bolesnika s refraktornim i relapsnim akutnim leukemijama na 36 mjeseci od alogenične TKMS bilo je 31%, dok su bolesnici s NHL-om na 24 mjeseca od transplantacije imali najlošije ukupno preživljenje koje je iznosilo 29%. Incidencija akutnog GvHD-a bila je najveća u skupini bolesnika s NHL-om te je iznosila 58%. Kronični GvHD je najčešće dijagnosticiran u skupini bolesnika s mijelofibrozom, u njih 57%. Do relapsa bolesti je najčešće došlo u skupini bolesnika s HL-om, kod njih 36%. Naši podaci pokazuju da je alogenična TKMS učinkovita metoda liječenja refraktornih hematoloških bolesti, koja, s razvojem novih lijekova te novih pristupa transplantaciji, još ima prostora za napredak.

Abstract (english)

Allogeneic SCT is a therapeutic method that provides the possibility of curing many malignant and non-malignant hematological diseases, and today it has increasing power in the treatment of congenital immunodeficiencies, genetically conditioned autoimmune and metabolic diseases and other diseases. The aim of this retrospective study was to evaluate the effectiveness of allogeneic SCT in the treatment of our population of 306 patients with refractory and relapsed hematological diseases, who were transplanted at the UHC Zagreb in the period between 19.01.2011. and 19.12.2017, according to the parameters like overall survival, acute and chronic GvHD and relapse of the disease. The results showed that allogeneic SCT is very useful in the treatment of our patients; the overall survival of all 306 patients at 42 months post-transplantation was 52%. Overall survival at 42 months post-transplantation was best in the group of patients with CML and HL; 71% and 76%. The group of patients with MDS and myelofibrosis had an overall survival at 42 months post-transplantation of 56%, whereas the group of patients with acute leukemias had overall survival of 52% at 42 months post-transplantation. Overall survival of patients with refractory and relapsing acute leukemias at 36 months post-allogeneic SCT was 31%, whereas patients with NHL at 24 months post-transplantation had overall survival of 29%. The incidence of acute GvHD was the highest in the NHL group and was 58%. Chronic GvHD was most commonly diagnosed in the group of patients with myelofibrosis; in 57% of them. Relapse of the disease was most common in the group of patients with HL; in 36% of them. Our data show that allogeneic SCT is an useful method of treating refractory hematological diseases, but, with the development of new drugs and new approaches to the transplantation, there is still room for improvement.

• Keywords: alogenična transplantacija; refraktorne hematološke bolesti; ukupno preživljenje
• Keywords (english): allogeneic transplantation; refractory haematological diseases; overall survival
• Language: croatian
• URN:NBN: urn:nbn:hr:105:529021
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-08-16 12:19:35