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Antikörpertherapie maligner Lymphome

Monoclonal antibodies in the treatment of malignant lymphoma

  • Schwerpunkt: Was ist gesichert in der Therapie?
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Zusammenfassung

In den letzten Jahren ist der Einsatz monoklonaler Antikörper bei Patienten mit malignen B-Zelllymphomen zu einem festen Bestandteil therapeutischer Strategien geworden. Die Antikörpertherapie zeichnet sich durch einen zur Chemotherapie unterschiedlichen Wirkungsmechanismus aus und eröffnet neue therapeutische Möglichkeiten. Monoklonale Antikörper können über einen direkten Antilymphomeffekt bzw. als Träger für zytototoxische Substanzen oder Radioisotope wirksam werden. Zu den direkt wirksamen Antikörpern gehört der Anti-CD20-Antikörper Rituximab, der sich sowohl bei indolenten als auch aggressiven Lymphomen vor allem in Kombination mit einer Chemotherapie als hoch effektiv erwiesen hat. Der Anti-CD52-Antikörper Alemtuzumab ist dagegen bei der chronischen lymphatischen Leukämie effektiv. Auch für die Kopplung von Radioisotopen an monoklonale Antikörper liegen ermutigende Daten für den an 131Jod gekoppelten CD20-Antikörper Tositumomab sowie für den an 90Yttrium gekoppelten CD20-Antikörper Ibritumomab Tiuxetan vor.

Abstract

In the last years monoclonal antibodies directed against B-cell associated epitopes have enriched our armentarium of therapeutic strategies against malignant B-cell lymphoma. Monoclonal antibodies are characterized by a different mode of action compared to chemotherapy, thereby opening new avenues in lymphoma treatment. These monoclonal antibodies can exert their anti-lymphoma activity directly by an intrinsic cytotoxic effect or indirectly as a carrier of cytotoxic drugs or radioisotopes. Rituximab, an anti-CD20 monoclonal antibody, was proven to be highly active in indolent as well as aggressive lymphoma, in particular when combined with chemotherapy. The anti-CD52 antibody alemtuzumab was shown to induce remissions in high risk CLL. Furthermore, clinical trials have demonstrated promising activity of monoclonal antibodies conjugated to radioisotopes such as the 131iodine anti-CD20 antibody tositumomab or the 90yttrium anti-CD20 antibody ibritumomab tiuxetan.

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Authors and Affiliations

  1. Medizinische Klinik III, Klinikum Großhadern der Ludwig Maximilians Universität München

    C. Buske, M. Dreyling, M. Unterhalt & W. Hiddemann

  2. Medizinische Klinik III, Klinikum Großhadern, Marchioninistraße 15, 81377, München

    C. Buske

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  1. C. Buske
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  2. M. Dreyling
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  3. M. Unterhalt
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  4. W. Hiddemann
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Correspondence to C. Buske.

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Buske, C., Dreyling, M., Unterhalt, M. et al. Antikörpertherapie maligner Lymphome. Internist 45, 1370–1377 (2004). https://doi.org/10.1007/s00108-004-1299-z

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  • DOI: https://doi.org/10.1007/s00108-004-1299-z

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