Chronische lymphatische Leukämie beim alten und geriatrischen Patienten View Full Text


Ontology type: schema:Chapter      Open Access: True


Chapter Info

DATE

2018

AUTHORS

Valentin Goede , Michael Hallek , Barbara Eichhorst

ABSTRACT

Betroffene mit CLL sind häufig alt. Bei Vorliegen einer Behandlungspflichtigkeit sollte im Rahmen der Therapieplanung neben der molekularen Charakterisierung der CLL (17p-Deletion und TP53-Mutation) auch die gesundheitliche Fitness des Betroffenen sorgfältig beurteilt werden. Neben einer umfassenden Anamnese und körperlichen Untersuchung sind dabei Komorbiditäts-Scores und geriatrische Assessments informativ. Therapiestandard für die unvorbehandelte CLL ohne 17p-Deletion bzw. TP53-Mutation ist bei älteren Patienten die Immunchemotherapie, wobei sich die Auswahl der Chemokomponente (Fludarabin, Bendamustin, Chlorambucil) und des Antikörpers (Rituximab, Ofatumumab, Obinutuzumab) nach der gesundheitlichen Fitness richtet. Die unvorbehandelte CLL mit 17p-Deletion oder TP53-Mutation wird bevorzugt mit dem Kinaseinhibitor Ibrutinib behandelt. Ältere Patienten mit Frührezidiv erhalten Ibrutinib, Idelalisib plus Rituximab oder Venetoclax. Spätrezidive können erneut immunchemotherapiert werden. More... »

PAGES

249-260

Book

TITLE

Geriatrische Onkologie

ISBN

978-3-662-48726-6
978-3-662-48727-3

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-662-48727-3_19

DOI

http://dx.doi.org/10.1007/978-3-662-48727-3_19

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1101884262


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