TumorDiagnostik & Therapie 2019; 40(01): 43-49
DOI: 10.1055/a-0829-2400
Thieme Onkologie aktuell
© Georg Thieme Verlag KG Stuttgart · New York

Chronische Myeloische Leukämie

Chronic Myelogenous Leukemia
Andreas Hochhaus
1   Klinik für Innere Medizin II, Universitätsklinikum Jena
2   UniversitätsTumorCentrum, Universitätsklinikum Jena
,
Ekkehard Eigendorff
2   UniversitätsTumorCentrum, Universitätsklinikum Jena
,
Thomas Ernst
2   Konservative Tagesklinik, Universitätsklinikum Jena
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
04. Februar 2019 (online)

Zusammenfassung

Vom fachlichen Standpunkt aus gesehen, stellt die chronische myeloische Leukämie (CML) eine Modellerkrankung für Diagnostik und Therapie neoplastischer Erkrankungen dar. Die zugrundeliegende zytogenetische Aberration, das Philadelphia-Chromosom mit der Genfusion sowie der mehrstufige Verlauf ermöglichen es, molekular-zytogenetische Erkenntnisse auf die klinische Anwendung zu übertragen. Dabei spielen nicht nur „Meilensteine“ eine Rolle.

Abstract

The advent of tyrosine kinase inhibitors (TKI) has improved prognosis and outcome of patients with chronic myelogenous leukemia (CML) considerably. In comparison to imatinib, first line use of second generation inhibitors nilotinib, dasatinib and bosutinib lead to faster and deeper molecular remissions accompanied by a novel adverse event profile. Essential part of the management of CML patients is a consequent use of cytogenetic and molecular follow up with standardized methods to regularly assess the remission status. Long lasting remission without treatment in an important minority of patients prompted the hope for curability of CML. The use of interferon alpha in parallel with or after TKI therapy is associated with the induction of an immune response against the leukemic clone with further improved remission rate. The cooperative management of CML patients permits the early use of novel treatment options in patients at risk.

 
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