Myelodysplastische Syndrome

Zusammenfassung

Myelodysplastische Syndrome (MDS) sind Knochenmarkerkrankungen einer klonal entarteten hämatopoietischen Stamm- oder Progenitorzelle, die zu einer ineffektiven Hämatopoiese führen und mit einem erhöhten Risiko für einen Übergang in eine akute myeloische Leukämie einhergehen. MDS treten meist im höheren Lebensalter auf und haben einen individuell sehr unterschiedlichen Krankheitsverlauf. Mittels einer zytologischen, zytogenetischen und histologischen Untersuchung des Knochenmarks wird die Diagnose gestellt. Patienten mit Niedrigrisiko erhalten in palliativer Intention unter anderem Transfusionen mit Blutprodukten, ggf. eine Eisenchelation, Erythropoetin bei niedrigem endogenen Erythropoetin-Spiegel und Lenalidomid beim Vorliegen einer 5q- Deletion. Demgegenüber kommt für Patienten mit Hochrisiko-Konstellation in einem Alter von 65–70 Jahren ohne relevante Komorbidität eine allogene Blutstammzelltransplantation in kurativer Intention in Frage. Patienten die nicht für eine Transplantation in Frage kommen, können in palliativer Intention mit der hypomethylierenden Substanz 5-Azacitidine behandelt werden.

• Literatur

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