"Tato kazuistika popisuje 3let\u00E9 zku\u0161enosti s l\u00E9\u010Dbou pacienta, mu\u017Ee narozen\u00E9ho v roce 1961, u n\u011Bho\u017E byla diagnostikov\u00E1na multicentrick\u00E1 plazmocelul\u00E1rn\u00ED Castlemanova choroba (HIV a HHV-8 negativn\u00ED) s n\u00E1lezem generalizovan\u00E9 lymfadenopatie a splenomegalie. B\u011Bhem pod\u00E1v\u00E1n\u00ED l\u00E9\u010Dby prvn\u00ED linie (R-CHOP: rituximab, cyklofosfamid, doxorubicin, vinkristin, prednison, celkem 3 cykly, prosinec roku 2008\u2013\u00FAnor roku 2009) do\u0161lo k rozvoji oboustrann\u00E9ho otoku rukou a nohou s klinick\u00FDmi projevy vaskulitidy a restagingov\u00E9 vy\u0161et\u0159en\u00ED po\u010D\u00EDta\u010Dovou tomografi\u00ED (CT) uk\u00E1zalo nem\u011Bnn\u00FD rozsah lymfadenomegalie. V\u011Bt\u0161\u00EDch \u00FAsp\u011Bch\u016F bylo dosa\u017Eeno re\u017Eimem s thalidomidem (CTD: cyklofosfamid, thalidomid, dexametazon, 10 cykl\u016F, b\u0159ezen roku 2009\u2013leden roku 2010), kter\u00FD vedl k regresi velikosti (celkov\u011B t\u00E9m\u011B\u0159 o 50 %) i m\u00EDry akumulace radiofarmaka (fluorodeoxygluk\u00F3zy) hypervaskularizovan\u00FDch zv\u011Bt\u0161en\u00FDch lymfatick\u00FDch uzlin dle vy\u0161et\u0159en\u00ED pozitronovou emisn\u00ED tomografi\u00ED v kombinaci s v\u00FDpo\u010Detn\u00ED tomografi\u00ED (PET/CT). D\u00E1vky thalidomidu se pohybovaly mezi 100 a 200 mg denn\u011B. K re\u017Eimu CTD jsme se op\u011Bt vr\u00E1tili v dubnu roku 2010 po kr\u00E1tk\u00E9m obdob\u00ED l\u00E9\u010Dby monoklon\u00E1ln\u00ED protil\u00E1tkou tocilizumabem (400 mg i.v. ka\u017Ed\u00E9 2 t\u00FDdny, tedy redukce d\u00E1vky na 50 % vzhledem k omezen\u00E9mu mno\u017Estv\u00ED l\u00E9ku, celkem 5 d\u00E1vek), p\u0159i n\u00ED\u017E do\u0161lo k recidiv\u011B ed\u00E9m\u016F p\u0159i stacion\u00E1rn\u00EDm n\u00E1lezu lymfadenomegalie na CT vy\u0161et\u0159en\u00ED. Obnoven\u00FD re\u017Eim s thalidomidem byl v\u0161ak po 2,5 cyklech ukon\u010Den pro v\u00FDskyt ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F thalidomidu (neuropatie) i kortikoid\u016F (Cushing\u016Fv syndrom). V z\u00E1\u0159\u00ED roku 2010 jsme po registraci do programu CUP (Compassionate Use Program) firmy Celgene z\u00EDskali mo\u017Enost zah\u00E1jit u pacienta l\u00E9\u010Dbu s lenalidomidem, deriv\u00E1tem thalidomidu, v d\u00E1vkov\u00E1n\u00ED 25 mg ve dnech 1 a\u017E 21 v r\u00E1mci 28denn\u00EDho cyklu, celkem 15 cykl\u016F (\u0159\u00EDjen roku 2010\u2013prosinec roku 2011)."@cs . "\u0158eh\u00E1k, Zden\u011Bk" . . "The case report given here describes the 3-year experience with therapy in a patient, male born 1961, diagnosed with multicentric plasma-cell Castleman disease (HIV and HHV-8 negative) with the finding of generalized lymphadenopathy and splenomegaly. During first line treatment (R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone, 3 cycles in total, 12/2008\u20132/2009) the development of bilateral upper and lower limb edemas with clinical manifestation of vasculitis occurred and a restaging computed tomography (CT) examination revealed a stable finding of the lymphadenomegaly. Greater success was achieved with thalidomide regimen (CTD: cyclophosphamide, thalidomide, dexamethasone, 10 cycles, 3/2009\u20131/2010) leading to reduction in the size of the hypervascularized lymph nodes (almost by 50%) as well as their radiopharmaceutical (fluorodeoxyglucose) uptake as seen on a combined positron emission tomography and computed tomography (PET/CT) scan imaging. Thalidomide was given daily at doses between 100 and 200 mg. We returned to the CTD regimen again in April 2010 after a short period of monoclonal antibody tocilizumab treatment (400 mg intravenous in 2-week intervals with 50% dose reduction due to a limited supply of the drug, 5 doses in total) during which edemas reoccurred with a CT scan finding of stable lymphadenomegaly. However, the renewed regimen with thalidomide was stopped after 2.5 cycles due to adverse effects of thalidomide (neuropathy) and corticoids (Cushing syndrome). In September 2010, after enrollement in the Celgene\u2019s Compassionate Use Program we were able to start treating the patient with the derivative of thalidomide, lenalidomide, at a dosage of 25 mg on days 1\u201321 in a 28-day cycle, 15 cycles in total (10/2010\u201312/2011)."@en . . "Z(MZ0MOU2005)" . "RIV/00209805:_____/12:#0000390!RIV13-MZ0-00209805" . "Koukalov\u00E1, Renata" . "2"^^ . "Vnit\u0159n\u00ED l\u00E9ka\u0159stv\u00ED" . "86" . "Szturz, Petr" . . "Our experience in treatment of multicentric plasma-cell Castleman disease associated with vasculitis manifestations - case report and literature review"@en . "Na\u0161e zku\u0161enosti s l\u00E9\u010Dbou multicentrick\u00E9 plazmocelul\u00E1rn\u00ED Castelmanovy choroby s projevy vaskulitidy - popis p\u0159\u00EDpadu a p\u0159ehled literatury"@cs . "12"^^ . . "0042-773X" . . "Castleman disease; glucocorticoids; chemotherapy; rituximab; thalidomide; monoclonal antibody; tocilizumab; lenalidomide; positron emission tomography; computed tomography"@en . . "12"^^ . . . "http://www.prolekare.cz/vnitrni-lekarstvi-clanek/nase-zkusenosti-s-lecbou-multicentricke-plazmocelularni-castlemanovy-choroby-s-projevy-vaskulitidy-popis-pri-38877" . . . . . . "Na\u0161e zku\u0161enosti s l\u00E9\u010Dbou multicentrick\u00E9 plazmocelul\u00E1rn\u00ED Castelmanovy choroby s projevy vaskulitidy - popis p\u0159\u00EDpadu a p\u0159ehled literatury" . . . "9" . "153088" . . "RIV/00209805:_____/12:#0000390" . "Na\u0161e zku\u0161enosti s l\u00E9\u010Dbou multicentrick\u00E9 plazmocelul\u00E1rn\u00ED Castelmanovy choroby s projevy vaskulitidy - popis p\u0159\u00EDpadu a p\u0159ehled literatury" . "Na\u0161e zku\u0161enosti s l\u00E9\u010Dbou multicentrick\u00E9 plazmocelul\u00E1rn\u00ED Castelmanovy choroby s projevy vaskulitidy - popis p\u0159\u00EDpadu a p\u0159ehled literatury"@cs . . . . "[04D2F897101E]" . "Our experience in treatment of multicentric plasma-cell Castleman disease associated with vasculitis manifestations - case report and literature review"@en . . . . . . "Tato kazuistika popisuje 3let\u00E9 zku\u0161enosti s l\u00E9\u010Dbou pacienta, mu\u017Ee narozen\u00E9ho v roce 1961, u n\u011Bho\u017E byla diagnostikov\u00E1na multicentrick\u00E1 plazmocelul\u00E1rn\u00ED Castlemanova choroba (HIV a HHV-8 negativn\u00ED) s n\u00E1lezem generalizovan\u00E9 lymfadenopatie a splenomegalie. B\u011Bhem pod\u00E1v\u00E1n\u00ED l\u00E9\u010Dby prvn\u00ED linie (R-CHOP: rituximab, cyklofosfamid, doxorubicin, vinkristin, prednison, celkem 3 cykly, prosinec roku 2008\u2013\u00FAnor roku 2009) do\u0161lo k rozvoji oboustrann\u00E9ho otoku rukou a nohou s klinick\u00FDmi projevy vaskulitidy a restagingov\u00E9 vy\u0161et\u0159en\u00ED po\u010D\u00EDta\u010Dovou tomografi\u00ED (CT) uk\u00E1zalo nem\u011Bnn\u00FD rozsah lymfadenomegalie. V\u011Bt\u0161\u00EDch \u00FAsp\u011Bch\u016F bylo dosa\u017Eeno re\u017Eimem s thalidomidem (CTD: cyklofosfamid, thalidomid, dexametazon, 10 cykl\u016F, b\u0159ezen roku 2009\u2013leden roku 2010), kter\u00FD vedl k regresi velikosti (celkov\u011B t\u00E9m\u011B\u0159 o 50 %) i m\u00EDry akumulace radiofarmaka (fluorodeoxygluk\u00F3zy) hypervaskularizovan\u00FDch zv\u011Bt\u0161en\u00FDch lymfatick\u00FDch uzlin dle vy\u0161et\u0159en\u00ED pozitronovou emisn\u00ED tomografi\u00ED v kombinaci s v\u00FDpo\u010Detn\u00ED tomografi\u00ED (PET/CT). D\u00E1vky thalidomidu se pohybovaly mezi 100 a 200 mg denn\u011B. K re\u017Eimu CTD jsme se op\u011Bt vr\u00E1tili v dubnu roku 2010 po kr\u00E1tk\u00E9m obdob\u00ED l\u00E9\u010Dby monoklon\u00E1ln\u00ED protil\u00E1tkou tocilizumabem (400 mg i.v. ka\u017Ed\u00E9 2 t\u00FDdny, tedy redukce d\u00E1vky na 50 % vzhledem k omezen\u00E9mu mno\u017Estv\u00ED l\u00E9ku, celkem 5 d\u00E1vek), p\u0159i n\u00ED\u017E do\u0161lo k recidiv\u011B ed\u00E9m\u016F p\u0159i stacion\u00E1rn\u00EDm n\u00E1lezu lymfadenomegalie na CT vy\u0161et\u0159en\u00ED. Obnoven\u00FD re\u017Eim s thalidomidem byl v\u0161ak po 2,5 cyklech ukon\u010Den pro v\u00FDskyt ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F thalidomidu (neuropatie) i kortikoid\u016F (Cushing\u016Fv syndrom). V z\u00E1\u0159\u00ED roku 2010 jsme po registraci do programu CUP (Compassionate Use Program) firmy Celgene z\u00EDskali mo\u017Enost zah\u00E1jit u pacienta l\u00E9\u010Dbu s lenalidomidem, deriv\u00E1tem thalidomidu, v d\u00E1vkov\u00E1n\u00ED 25 mg ve dnech 1 a\u017E 21 v r\u00E1mci 28denn\u00EDho cyklu, celkem 15 cykl\u016F (\u0159\u00EDjen roku 2010\u2013prosinec roku 2011)." . "CZ - \u010Cesk\u00E1 republika" .