Ontology type: schema:Chapter Open Access: True
2018
AUTHORSValentin Goede , Michael Hallek , Barbara Eichhorst
ABSTRACTBetroffene 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... »
PAGES249-260
Geriatrische Onkologie
ISBN
978-3-662-48726-6
978-3-662-48727-3
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DOIhttp://dx.doi.org/10.1007/978-3-662-48727-3_19
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