Zusammenfassung
Die Myeloproliferativen Neoplasien sind eine heterogene Gruppe von Stammzellerkrankungen mit Proliferation mindestens einer Zellreihe, die gehäuft beim älteren Menschen vorkommen. Klinisch manifestieren sich oft eine ausgeprägte B-Symptomatik, Juckreiz, Schmerzen im Bereich der Milz bei Splenomegalie und Mikrozirkulationsstörungen. In letzter Zeit wurden neben den bekannten genetischen Aberrationen (z. B. JAK2 V617F oder BCR-ABL1) weitere Mutationen identifiziert, welche z. T. prognostische Relevanz haben. Auch das Alter bei Diagnosestellung hat eine negativ prognostische Bedeutung. Mit Tyrosinkinaseinhibitoren und dem zytoreduktiv wirkenden Hydroxyurea stehen jedoch aufgrund der guten Verträglichkeit für alle Altersgruppen anwendbare medikamentöse Therapien zur Verfügung, die die Lebenserwartung z. T. signifikant verlängern (z. B. bei der chronischen myeloischen Leukämie). Die allogene Stammzelltransplantation dagegen, stellt eine Therapiealternative für eher jüngere Patienten dar.
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Schwaab, J., Saußele, S., Metzgeroth, G., Reiter, A. (2018). Myeloproliferative Syndrome und chronisch myeloische Leukämie beim alten und geriatrischen Patienten. In: Ebert, M., Härtel, N., Wedding, U. (eds) Geriatrische Onkologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48727-3_15
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