Dtsch Med Wochenschr 2015; 140(20): 1501-1506
DOI: 10.1055/s-0041-103336
Klinischer Fortschritt
Hämatologie und Onkologie
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und Therapie der Polycythaemia vera im Jahre 2015

Diagnosis and treatment of polycythemia vera in the year 2015
Eva Lengfelder
1   III. Medizinische Klinik, Hämatologie und Onkologie, Universitätsmedizin Mannheim
,
Martin Griesshammer
2   Klinik für Hämatologie, Onkologie, Hämostaseologie und Palliativmedizin, Johannes Wesling Klinikum Minden
,
Steffen Koschmieder
3   Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, RWTH Uniklinik Aachen
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
07. Oktober 2015 (online)

Was ist neu?
  • Neue Entwicklungen bei Diagnosesicherung und Pathogenese: Hauptkriterien der zur Zeit noch aktuellen WHO-Klassifikation der Polycythaemia vera (PV) sind eine gesteigerte Erythrozytenmasse und der Nachweis eines klonalen Markers (JAK2-Mutation).

  • Klinische Symptome: Der Schweregrad der PV-Symptome ist häufig moderat, jedoch leiden viele Patienten an mehreren Symptomen, wodurch die Lebensqualität eingeschränkt ist.

  • Therapieziele und Risikostratifizierung: Bei in der Regel guter Überlebensprognose ist die Reduktion der potenziell bedrohlichen thromboembolischen Komplikationen primäres Therapieziel. Das Überleben wird signifikant von der Anzahl der vorliegenden Risikofaktoren beeinflusst.

  • Therapie: Aderlass, ASS und zytoreduktive Therapie (Hydroxyurea bzw. Interferon-alpha) sind die Eckpfeiler der Therapie. Der Tyrosinkinase-Inhibitor Ruxolitinib erweitert die Therapiemöglichkeiten bei einer Resistenz und Intoleranz gegenüber Hydroxyurea.

 
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