Der Onkologe

, Volume 12, Issue 10, pp 1030–1038 | Cite as

Chronische lymphatische Leukämie

Neue diagnostische und therapeutische Konzepte
Leitthema

Zusammenfassung

Die chronische lymphatische Leukämie vom B-Zell-Typ (B-CLL) ist die häufigste Leukämie der westlichen Welt. In den letzten 15 Jahren haben sich die Konzepte zur Pathogenese, Diagnose und Therapie der CLL erheblich geändert. Diese Entwicklungen führten zu einer neuen Bewertung der therapeutischen Ziele und damit zu einer veränderten Führung insbesondere der körperlich fitten Patienten ohne wesentliche Komorbidität. Durch den Einsatz von Purinanaloga und Antikörpern in der Behandlung der CLL können länger anhaltende Remissionen erreicht werden. Mit der Einführung der allogenen Stammzelltransplantation stehen erste kurative Therapieansätze zur Verfügung. Anhand neuer diagnostischer Möglichkeiten, die eine bessere Risikoabschätzung der CLL ermöglichen, ist in zunehmenden Maß eine risikoadaptierte Behandlung möglich. Die neuen Therapieansätze werden durch die Deutsche CLL-Studiengruppe (DCLLSG) in kontrollierten Studien geprüft mit dem Ziel, durch den komorbiditäts-, stadien- und risikoadaptierten Einsatz der verschiedenen Therapiemodalitäten die Behandlung der CLL in den nächsten Jahren kontinuierlich zu optimieren.

Schlüsselwörter

Chronische lymphatische Leukämie Neue Prognosefaktoren Fludarabin-basierte Chemotherapie Antikörper Stammzelltransplantation 

Chronic lymphocytic leukemia

New diagnostic and therapeutic concepts

Abstract

Chronic lymphocytic leukemia of the B-cell type (B-CLL) is the most common type of leukemia in the western hemisphere. Concepts of pathogenesis, diagnostic procedures and therapy of CLL have changed tremendously over the past 15 years. These developments have called for a reassessment of therapeutic goals and clinical management, particularly of physically fit patients without relevant comorbidity. Since purine analogous and humanized antibodies were introduced into CLL therapy, longer lasting remissions become achievable. With the introduction of allogeneic stem cell transplantation, first curative approaches are available now have become available. New diagnostic tools improved risk stratification in CLL patients facilitating the implementation of risk-adapted therapeutic strategies. New therapeutic options are being evaluated within study protocols by the German CLL Study Group (GCLLSG). The aim of these studies is to optimize CLL therapy continuously by the comorbidity, stage and risk-adapted use of different treatment modalities.

Keywords

Chronic lymphocytic leukemia (CLL) New prognostic factors Fludarabine based chemotherapy Antibodies Stem cell transplantation 

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Klinik I für Innere MedizinUniversität zu KölnKöln

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