MMSL 2022, 91(1):29-36 | DOI: 10.31482/mmsl.2021.024

SUPPORTIVE CARE IN HEMATOONCOLOGYReview article

Tomáš Kupsa ORCID...1,2, Jan M. Horáček ORCID...1,2*, Martin Jakl ORCID...1,2, Pavel Skořepa ORCID...1, Martin Štajer1,2, Ladislav Jebavý ORCID...1,2, Pavel Žák ORCID...2
1 Katedra vojenského vnitřního lékařství a vojenské hygieny, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové, Česká republika
2 IV. interní hematologická klinika, Fakultní nemocnice Hradec Králové a Lékařská fakulta Univerzity Karlovy, Hradec Králové, Česká republika

V posledních letech byl díky zavedení nových léčebných postupů dosažen signifikantní pokrok v intenzivní léčbě mnoha hematoonkologických onemocnění. Se zavedením nových léčebných postupů přichází nové nároky na podpůrnou terapii. V tomto článku poskytujeme stručný přehled nejčastějších nároků na podpůrnou péči v modelové situaci autologních či alogenních transplantací krvetvorby a vysvětlujeme důvody a přínos aplikace konkrétních postupů. Vzhledem k podobnému orgánovému postižení při zevním ozáření a intenzivní chemoterapii popisujeme možnosti aplikace současných postupů podpůrné péče u nemocných s akutní nemocní z ozáření. Současně popisujeme nové nároky na podpůrnou terapii v hematologii. Cílem článku je popsat rizika a objasnit patologické mechanismy u imunosuprimovaných nemocných a zvýšit všeobecné povědomí o možnostech podpůrné péče, které lze aplikovat napříč interními i chirurgickými obory medicíny.

Keywords: podpůrná terapie; hematoonkologie; imunosuprese; pancytopenie; ozáření

Recently, a significant improvement in treatment outcomes throughout hematologic malignancies has been achieved. Innovative treatment approaches require new modalities of supportive care. In this article, we review common requirements on supportive care in oncology and hematopoietic cell transplantation and elucidate the reasoning of this treatment. Due to similar organ affection as in patients after high-dose chemotherapy, we also find possibilities of applying these procedures in patients after high-dose external irradiation. Further, we describe new requirements on supportive care in hematology. Our aim is to increase the general knowledge about severe immune suppression and specific complications in these patients, which can be useful throughout internal medicine and surgery disciplines.

Keywords: supportive care; hematooncology; immunosuppression; pancytopenia; irradiation

Received: June 30, 2021; Revised: August 2, 2021; Accepted: August 4, 2021; Prepublished online: August 10, 2021; Published: March 4, 2022  Show citation

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Kupsa, T., Horáček, J.M., Jakl, M., Skořepa, P., Štajer, M., Jebavý, L., & Žák, P. (2022). SUPPORTIVE CARE IN HEMATOONCOLOGY. MMSL, 91(1), 29-36. doi: 10.31482/mmsl.2021.024
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