Abstract
Because of the excellent prognosis in early asymptomatic stage of the disease all
patients outside clinical trial should undergo “watch & wait” independently of their
individual risk profile. Prognostic markers and scoring systems, as the CLL international
prognostic index (CLL-IPI), help predicting the individual prognosis. In advanced
stage disease standard frontline therapy in patients without high risk factors is
still the combination of chemotherapy and CD20-antibody. However, particularly elderly
patients with unfavorable prognostic factors may alternatively be treated with the
Btk-inhibitor. Novel targeted agents are the treatment of choice in presence of high
risk prognostic factors as well as in most relapsed situations. They are currently
tested in currently ongoing trials in frontline.
Die Prognose der CLL ist ziemlich heterogen; dennoch erreichen viele Patienten ein
sehr langes krankheitsfreies Überleben. Mittlerweile lässt sich der individuelle Krankheitsverlauf
durch Prognosefaktoren besser einschätzen, vor allem durch nachgewiesene genetische
Veränderungen der CLL-Zellen. Der Beitrag stellt bewährte sowie vielversprechende
alternative Behandlungskonzepte vor, die sich durch die Zulassung neuer zielgerichteter
Substanzen ergeben.
Schlüsselwörter
Chronische lymphatische Leukämie (CLL) - Chemo-Immuntherapie - zielgerichtete Substanzen
Key words
chronic lymphocytic leukemia (CLL) - chemoimmunotherapy - targeted drugs