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Hämostasedefekte durch Umsatzstörungen bei soliden Tumoren und malignen hämatologischen Systemerkrankungen

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Part of the Handbuch der Inneren Medizin book series (INNEREN, volume 2 / 9)

Zusammenfassung

Maligne Erkrankungen sind in ihrer Initialphase und in ihrem Verlauf regelmäßig durch labordiagnostische und häufig durch klinische Zeichen der Dysregulation des Hämostasesystems gekennzeichnet. Isolierte oder generalisierte Thrombosierungen insbesondere der venösen Strombahnen finden sich gehäuft bei Patienten mit soliden Tumoren, während bei hämatologischen Systemerkrankungen und insbesondere bei den verschiedenen Formen der Leukämie Blutungen im Vordergrund stehen. In Kenntnis dieser Zusammenhänge ist es gerechtfertigt, hämorrhagische und thrombophile Diathesen bei Malignompatienten in den Formenkreis der paraneoplastischen Syndrome einzuordnen. Marx (1971, 1976) hat für das Spezialgebiet den Begriff „Onkohämostaseologie“geprägt und hierzu folgende Definition vorgelegt: Es handelt sich um die Wissenschaft von den Zusammenhängen der relativ häufigen Tumorkomplikationen (Thromboembolien, Blutungen, mikroangiopathisch-hämolytische Anämie, Mikrozirkulationsstörungen), der Tumormetastasierung und dem Tumorwachstum einerseits mit dem Gerinnungssystem, dem Fibrinolysesystem und den Plättchenfunktionen andererseits sowie der speziellen Diagnostik und Therapie der Tumoren und der genannten Komplikationen.

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