Mieczysław Komarnicki

Publications of Mieczysław Komarnicki

• Exercise capacity, arrhythmic risk profile, and pulmonary function is not influenced by intracoronary injection of Bone Marrow Stem Cells in patients with acute myocardial infarction.

  Authors: Ewa Straburzyńska-Migaj, Małgorzata Popiel, Stefan Grajek, Agnieszka Katarzyńska-Szymańska, Maciej Lesiak, Piotr Bręborowicz, Krzysztof Sawiński, Anna Czyż, Lidia Gil, Maria Kozłowska-Skrzypczak, Mieczysław Komarnicki

  International journal of cardiology. 03/2011;

  OBJECTIVES: To evaluate influence of Bone Marrow Stem Cells (BMSC) intracoronary infusion on exercise capacity, pulmonary function, heart rate recovery and SAECG in patients with AMI of anteriorOBJECTIVES: To evaluate influence of Bone Marrow Stem Cells (BMSC) intracoronary infusion on exercise capacity, pulmonary function, heart rate recovery and SAECG in patients with AMI of anterior wall, compared to control group - from baseline in the acute phase during 12months follow up. METHODS: Forty five patients were randomized 2:1 to BMSC group (n=31 pts) or to control group (n=14 pts). BMSC were administered into infarct related artery (IRA) at 4-6day after primary PCI. Patients were followed up with cardiopulmonary exercise testing. The QRS duration, QT and QTc interval were measured and signal averaged ECGs (SAECG) were performed to evaluate late potentials. RESULTS: There were no significant differences between both groups neither at peak VO(2) (190.7±7.4 at baseline; 24.2±5.2 at 6months; 22.2±7.4ml/kg/min at 12months vs 18.4±8.2 at baseline; 22.0±7.2 at 6months; 21.8±6.2ml/kg/min at 12months; BMSC vs control group respectively; p=ns), nor VO(2) at anaerobic threshold, nor in VE/VCO(2) slope, RER, and systolic blood pressure at peak exercise at baseline and any time point of follow-up. There were no significant differences between groups concerning HR peak, HRR1 and HRR2 at any time point and also QRS, QT parameters, and SAEKG. There were no significant differences between both groups at any time point (baseline, 6 and 12months) concerning FVC, FEV(1) and FVC/FEV(1) and % of their normal values. CONCLUSIONS: We did not find that BMSC therapy in patients with anterior wall myocardial infarction influences exercise capacity. We did not confirm it's potential proarrhythmogenic influence as assessed with SAECG and standard ECG analysis.

• Exudative pericarditis in a pregnant woman as the first sign of non-Hodgkin's lymphoma.

  Authors: Ewa Kaźmierczak, Monika Joks, Ewa Straburzyńska, Stefan Grajek, Anna Jabłecka, Mieczysław Komarnicki, Adrian Gwizdała

  Kardiologia polska. 01/2011; 69(8):825-6.

  This case report presents a 25 year-old pregnant female diagnosed with exudative pericarditis which was the first sign of cardiac lymphoma. Such a manifestation of this disease is rare and itThis case report presents a 25 year-old pregnant female diagnosed with exudative pericarditis which was the first sign of cardiac lymphoma. Such a manifestation of this disease is rare and it represents a significant diagnostic and therapeutic problem in pregnant women.

• Megakaryocytic blast crisis in a chronic myeloid leukemia patient with a rare variant of Philadelphia rearrangement t(9;22;22) and a constitutional translocation t(3;7).

  Authors: Małgorzata Jarmuz, Renata Kroll, Anna Przybyłowicz-Chalecka, Błazej Ratajczak, Michał Gniot, Krzysztof Szyfter, Mieczysław Komarnicki

  Cancer genetics and cytogenetics. 05/2010; 199(1):45-7.

  Megakaryocytic blast crisis occurs extremely rarely, accounting for <3% of cases of chronic myelogenous leukemia in blastic transformation. In chronic myeloid leukemia, a variant PhiladelphiaMegakaryocytic blast crisis occurs extremely rarely, accounting for <3% of cases of chronic myelogenous leukemia in blastic transformation. In chronic myeloid leukemia, a variant Philadelphia translocation is reported in 2-10% of cases. We report an unusual case of megakaryocytic blast crisis with the Philadelphia variant rearrangement t(9;22;22) and a constitutional translocation t(3;7). The breakpoint in the 22q13 region was involved in this translocation. The chromosome region 22q13 harbors MKL1 gene, which is engaged in a specific translocation associated with acute megakaryoblastic leukemia. Study of deregulation of these four genes could contribute to better understanding of the effects of the t(9;22;22) rearrangement in a megakaryocytic blast crisis.

• [Thrombotic complications of central venous catheters in hematooncological patients].

  Authors: Monika Joks, Renata Kroll, Mieczysław Komarnicki

  Przegla̧d lekarski. 01/2010; 67(3):217-21.

  Central venous catheters (CVC) are frequently used in patients with a hematological disorders in order to administer drugs, stem cell infusions, blood products, parenteral alimentation as well as forCentral venous catheters (CVC) are frequently used in patients with a hematological disorders in order to administer drugs, stem cell infusions, blood products, parenteral alimentation as well as for blood sampling. There are known mechanical, infectious and thrombotic complications of central venous catheters in hematological patients. Infectious and thrombotic complications have been considered as separate entities so far, but there are theory and accumulating evidence that they are interrelated. Since data on central venous catheters-related thrombosis in hematological patients have been obtained mainly from retrospective studies of small size, prospective randomized studies are warranted. In this review we present current opinions about epidemiology, pathogenesis, diagnosis of CVC-related thrombosis and also its correlations with infectious CVC-related complications.

• Frequency of BCR-ABL gene mutations in Polish patients with chronic myeloid leukemia treated with imatinib: a final report of the MAPTEST study.

  Authors: Krzysztof Lewandowski, Krzysztof Warzocha, Andrzej Hellmann, Aleksander Skotnicki, Witold Prejzner, Kajetana Foryciarz, Tomasz Sacha, Michał Gniot, Mirosław Majewski, Iwona Solarska, Grazyna Nowak, Bartosz Wasag, Mikołaj Kobelski, Cezary Scibiorski, Marek Siemiatkowski, Maria Lewandowska, Mieczysław Komarnicki

  Polskie archiwum medycyny wewnȩtrznej. 12/2009; 119(12):789-94.

  INTRODUCTION: The presence of BCR-ABL oncogene mutations in patients with chronic myeloid leukemia (CML) may be responsible for the failure of tyrosine kinase inhibitor treatment. OBJECTIVES: The aimINTRODUCTION: The presence of BCR-ABL oncogene mutations in patients with chronic myeloid leukemia (CML) may be responsible for the failure of tyrosine kinase inhibitor treatment. OBJECTIVES: The aim of the study was to evaluate the frequency of BCR-ABL gene mutations in patients with CML (the MAPTEST study) treated with imatinib (IM). PATIENTS AND METHODS: Direct sequencing analysis of BCR-ABL gene was performed in 92 patients treated with IM for more than 3 months. The mean time of IM treatment was 18 months. At the time of the analysis, 75 patients were in the first chronic phase (CP), 4 in the second CP, 5 in the acceleration and 8 in the blastic phase. Fifty-seven patients (62%) were treated with IM at a daily dose of 400 mg and 35 patients with higher doses (600 or 800 mg daily). Inclusion criteria were based on the European Leukemia Net definitions for failure and suboptimal response to IM. RESULTS: Twelve mutations were detected in 11 of 92 patients, including 4 mutations (36.7%) diagnosed during CP, 3 (27.3%) in acceleration, and 4 (36.7%) in blast crisis. In 1 patient with lymphoid blast crisis of CML coexisting F359V and Y253F mutations were detected. In the whole group mutations were detected in 2 of 5 patients (40%) with primary resistance (M351T, F359V + Y253F) and in 9 of 87 patients (10.3%) (E255K, T315I-3x, M351T, E355G, F359V-2x) with acquired resistance to IM. CONCLUSIONS: The study confirmed the usefulness of BCR-ABL gene mutation screening in patients with CML resistant to IM therapy.

• Dasatinib-induced complete molecular response after allogeneic hematopoietic stem cell transplantation in Philadelphia chromosome-positive acute lymphoblastic leukemia resistant to prior imatinib-containing regimen: a case report and discussion.

  Authors: Anna Czyz, Krzysztof Lewandowski, Renata Kroll, Mieczysław Komarnicki

  Medical oncology (Northwood, London, England). 11/2009;

  Presence of the Philadelphia chromosome in acute lymphoblastic leukemia is the single most adverse prognostic marker associated with high risk of disease relapse and poor prognosis. AllogeneicPresence of the Philadelphia chromosome in acute lymphoblastic leukemia is the single most adverse prognostic marker associated with high risk of disease relapse and poor prognosis. Allogeneic haematopoietic stem cell transplantation is considered as the only curative option in adults with Philadelphia-positive acute lymphoblastic leukemia, but relapse remains the main cause of treatment failure. Moreover, long-term survival rates are markedly decreased when transplanted patients are not in complete remission. Incorporation of tyrosine kinase inhibitors into transplantation strategy in patients with Philadelphia-positive acute lymphoblastic leukemia may improve prognosis of the disease. Imatinib combined with conventional chemotherapy and used in conjunction with allogeneic hematopoietic stem cell transplantation has improved long-term survival rates. The more potent multikinase inhibitor dasatinib has shown enhanced activity in Philadelphia-positive acute lymphoblastic leukemia and has been approved for the treatment of adults with resistance or intolerance to prior imatinib therapy. Here, we present a case of Philadelphia-positive acute lymphoblastic leukemia primary resistant to imatinib combined with chemotherapy. Subsequently, the patient underwent allogeneic hematopoietic stem cell transplantation as a salvage therapy. Clinical evaluation performed thereafter revealed complete hematologic remission, but with the presence of the minimal residual disease detected at molecular level. Due to imatinib resistance, the therapy with dasatinib was started and complete molecular response was obtained. The consecutive clinical evaluation performed every 3 months during the last 18 months confirmed the absence of molecular minimal residual disease. We believe that inclusion of dasatinib into transplantation strategy allows obtaining sustained molecular remission even in patients resistant to imatinib.

• [Autologous stem cell transplantation in the treatment of primary systemic amyloidosis]

  Authors: Lidia Gil, Mieczysław Komarnicki

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2009; 27(159):181-4.

  Primary systemic amyloidosis is a plasma cell dyscrasia resulting multiorgan failure and death. The optimal treatment method is unknown. Current status of therapy for primary amyloidosis based on hasPrimary systemic amyloidosis is a plasma cell dyscrasia resulting multiorgan failure and death. The optimal treatment method is unknown. Current status of therapy for primary amyloidosis based on has been publication analysis. Treatment options for primary amyloidosis are similar to multiple myleoma therapy. Treatment of primary amyloidosis should be based on risk factors analysis. In selected patients high-dose therapy and autologous stem cell transplantation has been associated with higher response rate than standard chemotherapy However, autologous transplantation for primary amyloidosis remains controversial because of high treatment-related mortality. Novel non-transplant methods for primary amyloidosis therapy are highly effective. Early and detailed diagnosis and treatment based on risk factors can influence survival in group of patients with systemic primary amyloidosis.

• Bortezomib in combination with thalidomide and dexamethasone--a successful treatment regimen in refractory extramedullary multiple myeloma.

  Authors: Dominik Dytfeld, Magdalena Matuszak, Krzysztof Lewandowski, Mieczysław Komarnicki

  Annals of hematology. 04/2008; 87(3):253-4.

• Dasatinib treatment can overcome imatinib and nilotinib resistance in CML patient carrying F359I mutation of BCR-ABL oncogene.

  Authors: Marta Barańska, Krzysztof Lewandowski, Michał Gniot, Małgorzata Iwoła, Maria Lewandowska, Mieczysław Komarnicki

  Journal of applied genetics. 02/2008; 49(2):201-3.

  Point mutations of bcr-abl tyrosine kinase are the most frequent causes of imatinib resistance in chronic myeloid leukaemia (CML) patients. In most CML cases with BCR-ABL mutations leading toPoint mutations of bcr-abl tyrosine kinase are the most frequent causes of imatinib resistance in chronic myeloid leukaemia (CML) patients. In most CML cases with BCR-ABL mutations leading to imatinib resistance the second generation of tyrosine kinase inhibitors (TKI- e.g. nilotinib or dasatinib) may be effective. Here, we report a case of a CML patient who during imatinib treatment did not obtain clinical and cytogenetic response within 12 months of therapy. The sequencing of BCR-ABL kinase domains was performed and revealed the presence of a F359I point mutation (TTC-to-ATC nucleotide change leading to Phe-to-Ile amino acid substitution). After 1 month of nilotinib therapy a rapid progression of clinical symptoms was observed. In the presence of the F359I point mutation only dasatinib treatment overcame imatinib and nilotinib resistance.

• [The role of bone marrow cells immunophenotypic study by flow cytometry in diagnosing myelodysplastic syndrome]

  Authors: Anna Czyz, Grzegorz Dworacki, Mieczysław Komarnicki

  Postȩpy higieny i medycyny doświadczalnej (Online). 02/2008; 62:354-63.

  Myelodysplastic syndromes are a heterogeneous group of clonal bone marrow disorders characterized by dysplasia, progressive bone marrow failure, and increased risk of transformation to acute myeloidMyelodysplastic syndromes are a heterogeneous group of clonal bone marrow disorders characterized by dysplasia, progressive bone marrow failure, and increased risk of transformation to acute myeloid leukemia. Although diagnostic criteria are well established, a diagnosis based on morphologic and cytogenetic findings is often difficult in a significant number of patients. Multiparametric flow cytometric immunophenotyping is a highly sensitive and specific method for quantitative and qualitative evaluation of hematopoietic cells. Flow cytometry is used to identify dysregulated antigen expression of myeloid cells, estimate the proportion of bone marrow blasts cells, and reveal their abnormal immunophenotype. Recent data suggest that flow cytometry adds important prognostic information to the widely accepted International Prognostic Scoring System.

• Cancer procoagulant in patients with adenocarcinomas.

  Authors: Maciej Kaźmierczak, Krzysztof Lewandowski, Marek Z Wojtukiewicz, Zofia Turowiecka, Edyta Kołacz, Anna Lojko, Elzbieta Skrzydlewska, Krystyna Zawilska, Mieczysław Komarnicki

  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 12/2005; 16(8):543-7.

  Cancer procoagulant (CP) is a cysteine proteinase that may be produced by malignant and foetal tissue. The possible role of CP in the pathogenesis of cancer-related thrombosis has been suggestedCancer procoagulant (CP) is a cysteine proteinase that may be produced by malignant and foetal tissue. The possible role of CP in the pathogenesis of cancer-related thrombosis has been suggested recently. The purpose of the study was to evaluate coagulation prothrombotic markers and their relation to CP concentration in the blood of patients with gastrointestinal adenocarcinomas (GIAC). The study group consisted of 45 patients with confirmed diagnosis of adenocarcinoma (stomach, 18 patients; colon, 27 patients) and without evident metastatic disease. In 24 patients further observation showed metastases. The control group for CP was composed of 10 healthy subjects. Blood samples were drawn on the admission day, before any treatment. Among 45 patients with GIAC, deep venous thrombosis was observed in two (4.4%). In all patients the CP activity in the serum was found, and the mean CP activity shortened the coagulation time almost three times compared with the healthy control group. Also, the mean thrombin-antithrombin complex concentration was above the normal range. A significant elevation of the mean prothrombin fragment 1+2 plasma content in this group of patients was noticed. Despite these observations, CP remained within the normal range and did not correlate with thrombin-antithrombin complex or prothrombin fragment 1+2 plasma concentrations. A positive correlation was observed between serum CP and fibrinogen concentration, and a negative correlation between CP and free protein S plasma content (P = 0.04 and P = 0.025, respectively). A negative correlation between activated protein C resistance ratio and protein C activity in the plasma was confirmed. Protein C activity in the plasma showed a correlation with free protein S plasma content. Analysis of factors influencing the activated partial thromboplastin time revealed the presence of antiphospholipid antibodies in seven persons from the study group (in three cases of IgG and in four cases of IgM class). Our data suggest that CP is a minor risk factor for deep venous thrombosis in GIAC patients. To confirm this, however, the number of patients and controls should be larger. After 3 years of observation, the follow-up in 10 living GIAC patients showed nobody with thromboembolic disease.

• [Suppressive effect of high-dose chemotherapy (HDC) on the clonal growth of grafted peripheral blood granulocyte progenitors is reduced 72 hours after completion of HDC]

  Authors: Maria Kozłowska-Skrzypczak, Janusz Hansz, Krzysztof Sawiński, Mieczysław Komarnicki

  Polskie archiwum medycyny wewnȩtrznej. 06/2005; 113(5):431-7.

  Hematopoietic stem cells (HSC) transplantations are usually performed 24-48 hours after the end od high-dose chemotherapy (HDC). It is possible, however, that at that time the transplanted HSC can beHematopoietic stem cells (HSC) transplantations are usually performed 24-48 hours after the end od high-dose chemotherapy (HDC). It is possible, however, that at that time the transplanted HSC can be affected by the administered drugs. We report the results obtained in 30 patients (pts) with hematological malignancies (multiple myeloma - 14, Hodgkin's disease -6, non-Hodgkin's lymphomas -4, chronic myeloid leukemia -6) treated with HDC with peripheral blood stem cell transplantation (PBSCT). The following HDC regimens were applied: melphalan - 14, Dexa-BEAM (dexamethasone, BCNU, etoposide, cytarabine, melphalan) - 10 and BuCy2 (busulfan, cyclophosphamide) - 6. To evaluate the impact of HDC on the growth ability of less /14/ and more /7/ mature CFU-GM, sera were taken directly before cytoreductive chemotherapy, on the last day of HDC (0 day) and on days 1, 2, 3, 4 and 5 after the end of HDC. After melphalan, for CFU-GM/14/ the following results were received: days 0 - 54 +/- 9, 1 - 55 +/- 9, 2 - 68 +/- 12, 3 - 82 +/- 10, 4 - 95 +/- 8,5 - 100 +/- 8% and for CFU-GM/7/: days 0 - 60 +/- 11, 1 - 59 +/- 8, 2 - 72 +/- 11, 3 - 80 +/- 7, 4 - 90 +/- 9, 5 - 105 +/- 7%, determined as a percentage of those obtained before HDC (100%). After Dexa-BEAM, for CFU-GM/14/: days 0 - 45 +/- 13, 1 - 49 +/- 8, 2 - 59 +/- 12, 3 - 85 +/- 15, 4 - 96 +/- 9, 5 - 106 +/- 11%, and for CFU-GM/7/: 0 - 43 +/- 15, 1 - 50 +/- 9, 2 - 63 +/- 11, 3 - 89 +/- 11, 4 - 98 +/- 11, 5 - 110 +/- 8%. In case of BuCy2, for CFU-GM/14/: days 0 - 55 +/- 13, 1 - 67 +/- 7, 2 - 69 +/- 15, 3 - 85 +/- 10, 4 - 103 +/- 12, 5 - 108 +/- 7% and for CFU-GM/7/: days 0 - 50 +/- 12, 1 - 71 +/- 6, 2 - 76 +/- 16, 3 - 98 +/- 9, 4 - 105 +/- 11, 5 - 101 +/- 8%. In all pts PBSCT were infused 72 hours after HDC. The median time to reach granulocytes > 0.5 G/l and >1.0 G/l was 12 (8-17) and 13 (9-18) days, respectively. The recovery of platelets >20.0 G/l and >50. 0 G/l occured after 17 (9-48) and 25 (11-54) days, respectively. We conclude that the suppressive effect of the sera taken on days 0-2 on the CFU-GM growth depends on the HDC-regimen. We have also shown that third day after completion of HDC is the optimal time for the infusion of HSC. The time of hematological reconstituton is related in all investigated pts and independently on the HDC-program (p>0.05).

• [Evaluation of a risk of a cross-reactivity with Echinococcus multilocularis-specific Em2plus antigen in patients with liver cancer]

  Authors: Małgorzata Paul, Jerzy Stefaniak, Witold Rychlicki, Elzbieta Kacprzak, Małgorzata Mazur-Roszak, Mieczysław Komarnicki

  Wiadomości parazytologiczne. 02/2004; 50(3):439-45.

  The incidence of non-specific reactions with E. multilocularis antigen in patients with liver malignancies, and the risk of a supradiagnosis of alveolar echinococcosis (AE) in space-occupying lesionsThe incidence of non-specific reactions with E. multilocularis antigen in patients with liver malignancies, and the risk of a supradiagnosis of alveolar echinococcosis (AE) in space-occupying lesions in the liver due to neoplastic proliferative diseases were studied. Analysis of specific IgG serum antibody against Em2plus antigenic complex was performed in 11 AE patients in comparison to 76 individuals with malignant neoplasms of abdominal or extra-hepatic location, including some patients with primary hepatocellular cancer or distant metastases to liver, and 42 patients with benign hepatic lesions. Only one false borderline result was reported in a case with colorectal cancer, and dissemination to liver. Low risk of false positive results with E. multilocularis-specific Em2plus antigen in patients with liver malignancies makes the test valuable for practical reasons in a differential diagnosis of irregular tumor masses visualized by imaging techniques.

• [Role of adhesion molecules in a determination of progression stages and clinical prognosis of patients with Echinococcus multilocularis]

  Authors: Małgorzata Paul, Jerzy Stefaniak, Witold Rychlicki, Mieczysław Komarnicki, Małgorzata Mazur-Roszak

  Wiadomości parazytologiczne. 02/2004; 50(3):483-9.

  Alveococcosis in humans is characterized by a tumor-like growth with a tendency to infiltration of neighbouring organs or metastases formation in the lungs and brain. The study aimed to improve onAlveococcosis in humans is characterized by a tumor-like growth with a tendency to infiltration of neighbouring organs or metastases formation in the lungs and brain. The study aimed to improve on the clinical evaluation of patients with alveolar echinococcosis (AE) and to determine the risk of metacestode spreading to adjacent tissues or distant organs by a detection of adhesion molecules involved in the tumorigenesis process. Serum concentrations of sPECAM-1, sVCAM-1 and sE-selectin adhesion molecules were studied in 8 AE patients in comparison to 75 cases with malignant neoplasms, including cases with tumors of hepatic and extra-hepatic location. The adhesion molecules were found to be early predictive markers of the active, tissue infiltrated alveococcosis with the risk of parasite spreading through the circulation. High serum levels of soluble PECAM-1 molecule were strongly related to the advanced, progressive disease and the fatality of patients' clinical prognosis.