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01.09.2011 | Leitthema

Therapie von ZNS-Lymphomen

verfasst von: PD Dr. Agnieszka Korfel

Erschienen in: Die Onkologie | Ausgabe 9/2011

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Zusammenfassung

Das seltene primäre ZNS-Lymphom (PZNSL) unterscheidet sich von nodalen Lymphomen mit der gleichen Histologie – zumeist handelt es sich um ein diffuses großzelliges B-Zell-Lymphom – durch starke Bindung an das ZNS, sehr aggressiven Verlauf und ungewöhnliche Empfindlichkeit auf Hochdosis-Methotrexat (HDMTX). Die Primärtherapie des PZNSL basiert daher heutzutage auf HDMTX, wobei das optimale Protokoll bisher aufgrund der Seltenheit der Erkrankung nicht etabliert werden konnte. Bei jüngeren Patienten sollte eine Heilung angestrebt und daher ein intensiviertes Chemotherapieprotokoll erwogen werden. Die Ganzhirnbestrahlung verlängert nicht das Gesamtüberleben und sollte daher nicht routinemäßig in der Primärtherapie verwendet werden. Das ebenfalls seltene sekundäre ZNS-Lymphom – definiert als eine ZNS-Beteiligung eines systemischen Lymphoms – hat ebenfalls eine sehr ungünstige Prognose. Die wenigen verfügbaren Daten sprechen für eine Verlängerung des Überlebens durch HDMTX-basierte systemische Chemotherapie und Hochdosischemotherapie, gefolgt von Stammzelltransplantation. Ein wichtiges Therapieziel bei allen Patienten mit einem ZNS-Lymphom ist die Vermeidung einer späten Neurotoxizität.
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Metadaten
Titel
Therapie von ZNS-Lymphomen
verfasst von
PD Dr. Agnieszka Korfel
Publikationsdatum
01.09.2011
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 9/2011
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-011-2131-8

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