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Current Hematologic Malignancy Reports
Erschienen in:

01.12.2014 | Myeloproliferative Disorders (C Harrison, Section Editor)

Chronic Myelomonocytic Leukemia Prognostic Classification and Management: Evidence Base and Current Practice

verfasst von: Dorothée Selimoglu-Buet, Eric Solary

Erschienen in: Current Hematologic Malignancy Reports | Ausgabe 4/2014

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Abstract

Chronic myelomonocytic leukemia is a clonal malignancy of the ageing hematopoietic stem cell characterized by a biased differentiation leading to persistent monocytosis and inconstant hypersensitivity of myeloid progenitors to granulo-monocyte colony-stimulating factor (GM-CSF). Cytogenetic abnormalities identified in 30–40 % of patients and gene mutations detected in every patient can be used to stratify patients into risk groups that guide the therapeutic choices. TET2, SRSF2, ASXL1, and genes of the Ras pathway are the most frequently mutated genes, with ASXL1 mutations negatively affecting the disease outcome. Allogeneic stem cell transplantation is the first option to consider, especially in younger patients with poor prognostic factors. There is no firm clinical guideline in transplant-ineligible patients, but hypomethylating agents might be an interesting option. A consensus prognostic scoring system and specific response criteria are now required to facilitate the evaluation of new therapeutic strategies in clinical trials specifically dedicated to this disease.
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Metadaten
Titel
Chronic Myelomonocytic Leukemia Prognostic Classification and Management: Evidence Base and Current Practice
verfasst von
Dorothée Selimoglu-Buet
Eric Solary
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Current Hematologic Malignancy Reports / Ausgabe 4/2014
Print ISSN: 1558-8211
Elektronische ISSN: 1558-822X
DOI
https://doi.org/10.1007/s11899-014-0225-2

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Die erste Phase-3-Studie zum Nutzen von ASS in der adjuvanten Therapie des kolorektalen Karzinoms ist negativ verlaufen. Das abschließende Urteil über eine Sekundärprävention mit ASS ist trotzdem noch nicht gefallen.

Frühe CLL-Therapie: BTK-Hemmer verlängert EFS und PFS, aber nicht OS

Auch nach sechs Jahren ergibt sich kein Überlebensvorteil einer Therapie mit dem BTK-Hemmer Ibrutinib für Menschen mit frühem CLL-Stadium und erhöhtem Progressionsrisiko. Die Progressionsrate wird mit der Behandlung jedoch um über 80% gesenkt.

Adjuvantes Atezolizumab ohne Nutzen bei frühem TNBC

Patientinnen mit frühem triple-negativem Brustkrebs profitieren nach der Operation offenbar nicht von einer Zugabe des PD-L1-Hemmers Atezolizumab zur adjuvanten Standardchemotherapie. Die Studie, die das untersucht hat, wurde vorzeitig abgebrochen. Was könnte die schlechte Wirksamkeit erklären?

Update Onkologie

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