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
