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Leczenie celowane przewlekłej białaczki szpikowej a układ sercowo-naczyniowy

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Szmit S., Jędrzejczak W. W., Torbicki A.
OncoReview
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2013
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vol. 3
|
issue 3
149-162; 163-176
EN
Morbidity of chronic myeloid leukemia is recorded in elderly population, in patients with coexisting significant risk factors for atherosclerosis and heart diseases. Molecularly targeted therapy, imatinib, dasatinib and nilotinib, improve significantly the prognosis. However, the similar molecular targets in the form of different kinases are essential for cardiovascular system and blocking their pathways may have adverse effects. There is evidence about risk of systolic heart failure related to imatinib, pulmonary arterial hypertension induced by dasatinib and ischemic events associated with peripheral arterial disease and observed during nilotinib therapy. Some groups of patients with defined risk factors need appropriate cardiac monitoring.
PL
Zachorowania na przewlekłą białaczkę szpikową dotykają głównie osób starszych, u których występują istotne czynniki ryzyka miażdżycy, a często również organiczne choroby serca. Leki ukierunkowane molekularnie, takie jak imatynib, dazatynib i nilotynib, bardzo istotnie poprawiają rokowanie tej grupy chorych. Jednak podobne cele molekularne w postaci kinaz tyrozynowych są także istotne dla prawidłowej funkcji układu sercowo-naczyniowego i ich blokowanie może mieć niekorzystne skutki w tym układzie. Efektami klinicznymi są skurczowa niewydolność serca związana z terapią imatynibem, tętnicze nadciśnienie płucne związane z terapią dazatynibem oraz niedokrwienie kończyn związane z miażdżycą tętnic obwodowych obserwowane podczas terapii nilotynibem. Podkreśla się rolę odpowiedniego monitoringu kardiologicznego, zwłaszcza w podgrupach ze zdefiniowanymi czynnikami ryzyka powikłań.
2
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Idiopathic venous thromboembolism or occult cancer?

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Darocha S., Florczyk M., Torbicki A.
OncoReview
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2014
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vol. 4
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issue 1
A5-10
EN
The relationship between cancer and an increased incidence of venous thromboembolism (VTE) is well documented. VTE is a common complication of cancer, which usually occurs in the advanced stages of the disease. It often manifests itself before the cancer has been diagnosed and frequently is the first symptom of malignancy. In particular, pulmonary embolism is a major epidemiological problem because of its prevalence and high mortality. This article contains a review of the literature on VTE and occult cancer. It indicates the problem of a lack of an effective diagnostic strategy for malignancy in patients with idiopathic venous thromboembolism.
3
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Should a diagnosis of cancer impact the anticoagulant therapy in patients with recurrent thromboembolic disease?

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Wieteska M., Kurzyna M., Szmit S., Torbicki A.
OncoReview
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2015
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vol. 5
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issue 2
A62-66
EN
Venous thromboembolism often coexists with cancer, deteriorating patient prognosis. The diagnosis of cancer in patients who suffer from venous thromboembolism may lead to changes in the anticoagulant therapy administered. We present a case report involving a 72-year-old patient with recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension in whom the diagnosis of colorectal cancer resulted in the need for modification of the anticoagulant therapy. Oral anticoagulant was replaced with low molecular weight heparin and an inferior vena cava filter was implanted due to active bleeding from the anus, high perioperative risk of bleeding, which caused the need for a temporary interruption of anticoagulant therapy.
4
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Zastosowanie echokardiografii w onkologii – uwagi praktyczne

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Mańczak R., Szmit S., Torbicki A.
OncoReview
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2012
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vol. 2
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issue 3
183-192
EN
The paper presents the contemporary use of echocardiography in diagnosis of primary and metastatic tumors of the heart as well as in assessment of cardiovascular risk related to medical and interventional oncological therapy. Authors described the role of echocardiography in qualification for pericardiocentesis, cancer surgery and chemotherapy. The accuracy of echocardiography in evaluation of cardiac function was discussed in the context of recognizing cardiotoxicity of anticancer therapy. The historical and current definitions of iatrogenic myocardial damage and dysfunction were summarized. Finally, key recommendations derived from polish and foreign clinical guidelines for the use of echocardiography in patients with cancer were presented.
PL
Artykuł przedstawia współczesne zastosowanie echokardiografii w wykrywaniu pierwotnych i przerzutowych nowotworów serca oraz w ocenie ryzyka sercowo-naczyniowego związanego z farmakologicznym i zabiegowym leczeniem nowotworów. Omówiono w nim rolę echokardiografii w kwalifikacji do perikardiocentezy, onkologicznych zabiegów operacyjnych oraz chemioterapii. Krytycznie przedstawiono dokładność echokardiograficznej oceny funkcji mięśnia sercowego w kontekście rozpoznawania kardiotoksyczności leczenia przeciwnowotworowego. Zestawiono historyczne i obowiązujące definicje jatrogennej dysfunkcji skurczowej serca. Przedstawiono obecnie obowiązujące polskie i zagraniczne rekomendacje dotyczące zastosowań echokardiografii u chorych z nowotworami.
5
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Myocardial dysfunction related to trastuzumab therapy – is effective treatment always possible?

100%
Szmit S., Kownacki Ł., Torbicki A.
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EN
Left ventricle systolic dysfunction manifesting during trastuzumab treatment is defined as cardiotoxicity type II. It is characterized by full reversibility after discontinuation of trastuzumab and cardiological pharmacological treatment. In a group of patients, however, systolic cardiac function does not fully recover. The reasons of this unfavorable prognosis are subject of heated discussion.
6
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Percutaneous retrieval of a fractured portacath fragment in two patients undergoing long-term chemotherapy

64%
Norwa J., Darocha S., Dobosiewicz A., Koteja A., Pietrasik A., Pietura R., Torbicki A., Szmit S., Kurzyna M.
OncoReview
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2016
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vol. 6
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issue 2
A57-61
EN
The paper discusses two clinical cases of cancer patients undergoing chemotherapy, in whom fractured and displaced tips of portacath catheters were revealed based on plain chest imaging. In the first case, the portacath fragment migrated to the left pulmonary artery, with the missing catheter tip revealed during the procedure of port removal due to its occlusion, with no other prior clinical symptoms. In the second case, the catheter broke off at the level of its entry into the subclavian vein, and migrated into the right cardiac ventricle, which was accompanied by mild pain and oedema in the subclavicular region. Both patients underwent successful procedures of percutaneous foreign body retrieval with the use of endovascular snares. The procedures were performed via femoral vein access, with no complications.
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