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01.07.2010 | Außer der Reihe

Empfehlungen zur Verlaufskontrolle und Zweitlinientherapie bei der chronischen myeloischen Leukämie (CML)

verfasst von: Prof. Dr. A. Hochhaus, F. Overkamp, T. Lange, A. Mohr, O. Ottmann, P. Coutre, T. Haferlach

Erschienen in: Die Onkologie | Ausgabe 7/2010

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Zusammenfassung

Die Prognose der Patienten mit chronischer myeloischer Leukämie (CML) hängt in erster Linie vom im Therapieintervall erreichten Remissionsgrad ab. Die Behandlung der CML erfordert deshalb systematische Verlaufskontrollen, um ein suboptimales Ansprechen oder ein Therapieversagen frühzeitig zu erkennen und um therapeutische Maßnahmen einleiten zu können. Trotz der beeindruckenden Wirksamkeit von Imatinib benötigen einige Patienten in chronischer Phase im Verlauf der Behandlung eine alternative Therapie. Als Zweitlinientherapie bei Imatinib-Versagen oder -Unverträglichkeit stehen die Tyrosinkinasehemmer Nilotinib und Dasatinib zur Verfügung. Beide Substanzen zeigen eine hohe Wirksamkeit. Welches der beiden Medikamente im individuellen Fall als Zweitlinientherapie bevorzugt werden sollte, kann anhand des individuellen Patientenstatus, der Nebenwirkungsprofile und der unterschiedlichen Wirksamkeit von Nilotinib und Dasatinib bei bestimmten BCR-ABL-Mutationen entschieden werden. Die Indikation zur allogenen Stammzelltransplantation sollte bei Imatinib-Versagen in jedem Fall geprüft werden. In dieser Publikation werden aktuelle Empfehlungen zur Methodik und Frequenz von Verlaufsanalysen bei CML diskutiert und Unterschiede zwischen Nilotinib und Dasatinib aufgezeigt, die als Entscheidungsgrundlage für eine optimale Therapiewahl dienen können.
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Metadaten
Titel
Empfehlungen zur Verlaufskontrolle und Zweitlinientherapie bei der chronischen myeloischen Leukämie (CML)
verfasst von
Prof. Dr. A. Hochhaus
F. Overkamp
T. Lange
A. Mohr
O. Ottmann
P. Coutre
T. Haferlach
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 7/2010
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-010-1894-7

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