Leukämien und myelodysplastische Syndrome – Altersadaptierte Therapie bei älteren Patienten

Maligne Knochenmarkerkrankungen wie akute myeloische Leukämien und myelodysplastische Syndrome sind klassische Alterserkrankungen mit einem Altersmedian um 70 Jahre. Die Auswahl der Therapieverfahren, wie intensive Chemotherapie, allogene Blutstammzell-Transplantation, epigenetische und supportive Therapie, sollte nicht nur am kalendarischen Alter festgemacht werden. Vielmehr müssen Begleiterkrankungen, die im Kontext einer Therapie relevante Probleme bereiten können, berücksichtigt werden. Gute Instrumente zur Abschätzung der Relevanz von Begleiterkrankungen sind Komorbiditäts-Scores, von denen 2 mittlerweile gut etabliert und validiert sind.

Bone marrow disease like Acute Myeloid Leukemia and Myelodysplastic syndromes are diseases of the elderly with a median age at diagnosis of about 70 years. The choice of treatment should not primarily be based on the age, but rather on the presence of concomitant disease. Valuable instruments to describe concomitant diseases and their impact on prognosis and outcome after treatment are Comorbidity Scores, which should be used in clinical decision making in day-to day practice.

Key words

Acute Leukemia - Myelodysplastic Syndromes - Comorbidity Score - Stem cell transplantation

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