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Dtsch Med Wochenschr 2004; 129(45): 2429-2433
DOI: 10.1055/s-2004-835284
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Hämatologie/Onkologie
© Georg Thieme Verlag Stuttgart · New York

Aktuelle Therapiestrategien beim fortgeschrittenen Mantelzell-Lymphom

Current strategies in the treatment of advanced stage mantle cell lymphomaG. Lenz1 , M. Dreyling1 , M. Unterhalt1 , W. Hiddemann1
  • 1Medizinische Klinik III, Klinikum der Ludwig Maximilians-Universität, München.
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Publication History

eingereicht: 3.6.2004

akzeptiert: 8.9.2004

Publication Date:
04 November 2004 (online)

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Zusammenfassung

Mit einem medianen Überleben von nur 3 Jahren weisen fortgeschrittene Mantelzell-Lymphome die schlechteste Langzeitprognose aller Lymphomsubtypen auf und sind mittels konventioneller Chemotherapie nicht heilbar. Zwei aktuelle Studien der Deutschen Studiengruppe für niedrig-maligne Lymphome (GLSG) zeigen den Vorteil einer kombinierten Immunochemotherapie mit dem Anti-CD20-Antikörper Rituximab sowohl in der Primärtherapie (R-CHOP) als auch im Rezidiv (R-FCM). Zusätzlich konnte in einer multizentrischen Studie des Europäischen Mantelzell-Lymphom-Netzwerkes durch eine konsolidierende Hochdosistherapie mit nachfolgender autologer Stammzelltransplantation das progressionsfreie Überleben bei Patienten unter 66 Jahren signifikant verlängert werden. Trotzdem erleidet ein Großteil der Patienten mit Mantelzell-Lymphom auch nach einer solchen dosisgesteigerten Therapie ein Rezidiv. Daher ist die Erprobung neuer Strategien wie die allogene Stammzelltransplantation nach Dosis-reduzierter Konditionierung und die Entwicklung neuer Substanzen (z. B. Proteosomeninhibitoren oder Radioimmunotherapie) dringend erforderlich, um die Langzeitprognose des Mantelzell-Lymphoms weiter zu verbessern.

Summary

Advanced stage mantle cell lymphoma (MCL) with a median survival of only three years and virtually no long-term survivors represents the lymphoma subtype with the poorest prognosis and remains incurable with conventional chemotherapy. Recently two randomized trials of the German Low Grade Lymphoma Study Group (GLSG) demonstrated the superiority of a combined immunochemotherapy with the anti-CD20 antibody rituximab in first-line therapy (R-CHOP) as well as in relapsed disease (R-FCM). In addition, in a trial of the European MCL Network, intensified-consolidation with high-dose radiochemotherapy followed by autologous stem cell transplantation significantly improved the progression-free survival in patients up to 65 years of age. However, the vast majority of patients with MCL will eventually relapse. Thus, new strategies such as allogenic transplantation after dose-reduced conditioning or novel molecular targeting agents (e. g. proteasome inhibitors or radiolabeled antibodies) are urgently warranted to further improve the long-term outcome of MCL.

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Dr. Georg Lenz

Medizinische Klinik III, Klinikum der Ludwig-Maximilians Universität München

Marchioninistraße 15

81377 München

Phone: 089/70950

Fax: 089/70955550

Email: georg.lenz@med.uni-muenchen.de