best practice onkologie

, 3:26

Chronische lymphatische Leukämie

Welche Behandlungsoptionen gibt es?
TOPIC 2 · chronische lymphatische leukämie
  • 84 Downloads

Die chronische lymphatische Leukämie vom B-Zell-Typ ist eine Erkrankung des höheren Lebensalters mit stadienhaftem Verlauf und individuell unterschiedlicher Prognose. Die dynamische klinische Forschung zu dieser Erkrankung hat in den letzten zehn Jahren neue Werkzeuge zur Prognoseabschätzung und deutlich effektivere Therapien zur Verfügung gestellt.

Literatur

  1. 1.
    Mauro FR, Foa R, Giannarelli D et al. (1999) Clinical characteristics and outcome of young chronic lymphocytic leukemia patients: a single institution study of 204 cases. Blood 94: 448–454PubMedGoogle Scholar
  2. 2.
    Hamblin TJ, Davis Z, Gardiner A et al. (1999) Unmutated Ig V(H) genes are associated with a more aggressive form of chronic lymphocytic leukemia. Blood 94: 1848–1854PubMedGoogle Scholar
  3. 3.
    Döhner H, Stilgenbauer S, Benner A et al. (2000) Genomic Aberrations and Survival in Chronic Lymphocytic Leukemia. N Engl J Med 343: 1910–1916PubMedCrossRefGoogle Scholar
  4. 4.
    Montserrat E, Vinolas N, Reverter JC, Rozman C (1988) Natural history of chronic lymphocytic leukemia: on the progression and prognosis of early clinical stages. Nouv Rev Fr Hematol 30: 359–361PubMedGoogle Scholar
  5. 5.
    Hallek M, Langenmayer I, Nerl C et al. (1999) Elevated serum thymidine kinase levels identify a subgroup at high risk of disease-progression in early, non-smoldering chronic lymphocytic leukemia. Blood 93: 1732–1737PubMedGoogle Scholar
  6. 6.
    Ibrahim S, Keating M, Do KA et al. (2001) CD38 expression as an important prognostic factor in B-cell chronic lymphocytic leukemia. Blood 98: 181–186PubMedCrossRefGoogle Scholar
  7. 7.
    Crespo M, Bosch F, Villamor N et al. (2003) ZAP-70 expression as a surrogate for immunoglobulin-variable-region mutations in chronic lymphocytic leukemia. N Engl J Med 348: 1764–1775PubMedCrossRefGoogle Scholar
  8. 8.
    Rassenti LZ, Huynh L, Toy TL et al. (2004) ZAP-70 compared with immunoglobulin heavy-chain gene mutation status as a predictor of disease progression in chronic lymphocytic leukemia. N Engl J Med 351: 893–901PubMedCrossRefGoogle Scholar
  9. 9.
    Binet JL, Caligaris-Cappio F, Catovsky D et al. (2006) Perspectives on the use of new diagnostic tools in the treatment of chronic lymphocytic leukemia. Blood 107: 859–861PubMedCrossRefGoogle Scholar
  10. 10.
    Hallek M, Cheson BD, Catovsky D et al.; International Workshop on Chronic Lymphocytic Leukemia (2008) Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute- Working Group 1996 guidelines. Blood 111: 5446–5456PubMedCrossRefGoogle Scholar
  11. 11.
    Moreau EJ, Matutes E, A’Hern RP et al. (1997) Improvement of the chronic lymphocytic leukemia scoring system with the monoclonal antibody SN8 (CD79b). Am J Clin Pathol 108: 378–382PubMedGoogle Scholar
  12. 12.
    Ginaldi L, De Martinis M, Matutes E et al. (1998) Levels of expression of CD19 and CD20 in chronic B cell leukaemias. J Clin Pathol 51: 364–369PubMedCrossRefGoogle Scholar
  13. 13.
    Catovsky D, Müller-Hermelink HK, Montserrat E, Harris NL (2001) B-cell prolymphocytic leukaemia. In: Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) World Health Organization Classification of Tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. IARC Press, Lyon pp 131–132Google Scholar
  14. 14.
    Bergmann MA, Eichhorst BF, Busch R et al. (2007) Prospective Evaluation of prognostic parameters in early stage chronic lymphocytic leukemia (CLL): Results of the CLL1-Protocol of the German CLL Study Group (GCLLSG). Blood (ASH Annual Meeting Abstracts) 110: 625Google Scholar
  15. 15.
    Eichhorst BF, Busch R, Hopfinger G et al. (2006) Fludarabine plus cyclophosphamide versus fludarabine alone in first line therapy of younger patients with chronic lymphocytic leukemia. Blood 107: 885–891PubMedCrossRefGoogle Scholar
  16. 16.
    Dearden C, Wade R, Else M et al. (2008) The prognostic significance of a positive direct antiglobulin test in chronic lymphocytic leukemia - a beneficial effect of the combination of fludarabine and cyclophosphamide on the incidence of hemolytic anemia. Blood 111: 1820–1826PubMedCrossRefGoogle Scholar
  17. 17.
    Cheson BD, Bennett JM, Grever M et al. (1996) National Cancer Institute-Sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment. Blood 87: 4990–4997PubMedGoogle Scholar
  18. 18.
    Ludwig H, Rai K, Blade J et al. (2002) Management of disease-related anemia in patients with multiple myeloma or chronic lymphocytic leukemia: epoetin treatment recommendations. Hematol J 3: 121-130PubMedCrossRefGoogle Scholar
  19. 19.
    Rai KR, Peterson BL, Appelbaum FR et al. (2000) Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia. N Engl J Med 343: 1750–1757PubMedCrossRefGoogle Scholar
  20. 20.
    Catovsky D, Richards S, Matutes E et al. (2007) Assessment of fludarabine plus cyclophosphamide for patients with chronic lymphocytic leukaemia (the LRF CLL4 Trial): a randomised controlled trial. Lancet 370: 230–239PubMedCrossRefGoogle Scholar
  21. 21.
    Johnson S, Smith AG, Loffler H et al. (1996) Multicentre prospective randomised trial of fludarabine versus cyclophosphamide, doxorubicin, and prednisone (CAP) for treatment of advanced-stage chronic lymphocytic leukaemia. The French Cooperative Group on CLL. Lancet 347: 1432–1438PubMedGoogle Scholar
  22. 22.
    Leporrier M, Chevret S, Cazin B et al. (2001) Randomized comparison of fludarabine, CAP, and ChOP in 938 previously untreated stage B and C chronic lymphocytic leukemia patients. Blood 98: 2319–2325PubMedCrossRefGoogle Scholar
  23. 23.
    Steurer M, Pall G, Richards S et al. (2006) Purine antagonists for chronic lymphocytic leukaemia. Cochrane Database Syst Rev 3: CD004270Google Scholar
  24. 24.
    Eichhorst BF, Busch R, Stauch M et al. (2007) No significant clinical benefit of first line therapy with fludarabine (F) in comparison to chlorambucil (Clb) in elderly patients (pts) with advanced chronic lymphocytic leukemia (CLL): results of a phase III study of the German CLL Study Group (GCLLSG). Blood (ASH Annual Meeting Abstracts) 110: 629Google Scholar
  25. 25.
    Knauf WU, Lissichkov T, Aldaoud A et al. (2007) Bendamustine versus chlorambucil in treatment-naive patients with B-cell chronic lymphocytic leukemia (B-CLL): results of an international phase III study. Blood (ASH Annual Meeting Abstracts) 110: 2043Google Scholar
  26. 26.
    Fischer K, Stilgenbauer S, Schweighofer CD et al. (2007) Bendamustine in combination with rituximab (BR) for patients with relapsed chronic lymphocytic leukemia (CLL): a multicentre phase II trial of the German CLL Study Group (GCLLSG). Blood (ASH Annual Meeting Abstracts) 110: 3106Google Scholar
  27. 27.
    Bergmann MA, Goebeler ME, Herold M et al. (2005) Efficacy of bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia: results of a phase I/II study of the German CLL Study Group. Haematologica 90: 1357–1364PubMedGoogle Scholar
  28. 28.
    Hillmen P, Skotnicki AB, Robak T et al. (2007) Alemtuzumab compared with chlorambucil as first-line therapy for chronic lymphocytic leukemia. J Clin Oncol 25: 5616–5623PubMedCrossRefGoogle Scholar
  29. 29.
    Hallek M, Schmitt B, Wilhelm M et al. (2001) Fludarabine plus cyclophosphamide for the treatment of chronic lymphocytic leukemia: Results of a phase II study (CLL2 protocol) of the German CLL Study Group (GCLLSG). Br J Haematol 114: 342–348PubMedCrossRefGoogle Scholar
  30. 30.
    O’Brien S, Kantarjian H, Cortes J et al. (2001) Results of the fludarabine and cyclophosphamide combination regimen in chronic lymphocytic leukemia. J Clin Oncol 19: 1414–1420PubMedGoogle Scholar
  31. 31.
    Bosch F, Ferrer A, Lopez-Guillermo A et al. (2002) Fludarabine, cyclophosphamide and mitoxantrone in the treatment of resistant or relapsed chronic lymphocytic leukaemia. Br J Haematol 119: 976–984PubMedCrossRefGoogle Scholar
  32. 32.
    Flinn IW, Neuberg DS, Grever MR et al. (2007) Phase III trial of fludarabine plus cyclophosphamide compared with fludarabine for patients with previously untreated chronic lymphocytic leukemia: US Intergroup Trial E2997. J Clin Oncol 25: 793–798PubMedCrossRefGoogle Scholar
  33. 33.
    Byrd JC, Rai K, Peterson BL et al. (2005) Addition of rituximab to fludarabine may prolong progression-free survival and overall survival in patients with previously untreated chronic lymphocytic leukemia: an updated retrospective comparative analysis of CALGB 9712 and CALGB 9011. Blood 105: 49–53PubMedCrossRefGoogle Scholar
  34. 34.
    Keating MJ, O’Brien S, Albitar M et al. (2005) Early results of a chemoimmunotherapy regimen of fludarabine, cyclophosphamide, and rituximab as initial therapy for chronic lymphocytic leukemia. J Clin Oncol 23: 4079-4088PubMedCrossRefGoogle Scholar
  35. 35.
    Wierda W, O’Brien S, Wen S et al. (2005) Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab for relapsed and refractory chronic lymphocytic leukemia. J Clin Oncol 23: 4070–4078PubMedCrossRefGoogle Scholar
  36. 36.
    Elter T, Borchmann P, Schulz H et al. (2005) Fludarabine in combination with alemtuzumab is effective and feasible in patients with relapsed or refractory B-cell chronic lymphocytic leukemia: results of a phase II trial. J Clin Oncol 23: 7024-7031PubMedCrossRefGoogle Scholar
  37. 37.
    Dreger P, Brand R, Milligan D et al. (2005) Reduced-intensity conditioning lowers treatment-related mortality of allogeneic stem cell transplantation for chronic lymphocytic leukemia: a population-matched analysis. Leukemia 19: 1029–1033PubMedCrossRefGoogle Scholar
  38. 38.
    Dreger P, Corradini P, Kimby E et al. (2007) Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus. Leukemia 21: 12–17PubMedCrossRefGoogle Scholar
  39. 39.
    Binet JL, Auquier A, Dighiero G et al. (1981) A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analyses. Cancer 48: 198–206PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Klinik I für Innere MedizinUniversität zu KölnKölnGermany
  2. 2.Klinik I für Innere MedizinUniversität zu KölnKölnGermany
  3. 3.Klinik I für Innere MedizinUniversität zu KölnKölnGermany

Personalised recommendations