Yazarlar : Pfreundschuh M.

Yayın : Blood

Yayın Yılı : 2010

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/20805363

Konu : Lenfoma

Literatür İçeriği :

Abstract

Enormous progress has been made in the treatment of diffuse large B-Cell lymphoma (DLBCL), mostly due to the anti-CD20 antibody rituximab (R). More than 50% of elderly DLBCL patients up to 80 years of age can be expected to be cured by modern immuno-chemotherapy. The standard chemotherapy partner of rituximab is the CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen. Results from recently closed trials will determine if the 2-week (R-CHOP-14) regimen is superior to the 3-week application (R-CHOP-21) or might be more appropriate for specific subpopulations of patients with DLBCL. Elderly patients need particular attention and thorough evaluation if they are suited for the standard treatment or if they are candidates for palliative treatment. Rigorous supportive care including anti-infectious prophylaxis and growth factor support are mandatory. Whether there is still a role of additive radiotherapy in the R-CHOP era is under debate. While further intensificiation of chemotherapy might hardly be feasible in elderly patients, dose and schedule of rituximab appear to be optimizable. Patients failing after R-CHOP are a particular challenge as are frail patients who are not fit enough for R-CHOP. Further progress on the road to cure of DLBCL in elderly patients can be expected from novel antibodies and small molecules that interfere with signal transductiosn pathways that are essential for the survival of the lymphoma cell.. To achieve this goal, prospective trials with large numbers of patients are necessary for which the continuous commitment of patients and physicians is indispensable

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