RSS-Feed abonnieren
DOI: 10.1055/s-2004-831853
© Georg Thieme Verlag Stuttgart · New York
Neue Diagnostik- und Therapiestrategien bei aggressiven Lymphomen
Novel diagnostic and therapeutic strategies in aggressive lymphomasPublikationsverlauf
eingereicht: 20.8.2004
akzeptiert: 8.9.2004
Publikationsdatum:
28. September 2004 (online)

Die Non-Hodgkin-Lymphome (NHL) umfassen eine klinisch, biologisch und pathohistologisch heterogene Gruppe von Erkrankungen, deren gemeinsames Merkmal die Abstammung von Zellen des lymphatischen Systems ist. Etwa 40 % aller Lymphome gehören zur klinisch und histopathologisch heterogenen Gruppe der sog. aggressiven Lymphome [2], die durch ein äußerst rasches Wachstum und eine hohe Proliferationsrate gekennzeichnet - aber gerade wegen dieser Eigenschaft durch optimierte Chemotherapieregimes heilbar sind.
Wesentliche, in den letzten 5 Jahren erreichte Neuerungen in Diagnostik und Therapie dieser Lymphome betreffen
die Einführung einer biologisch fundierten, weltweit akzeptierten Klassifikation der Lymphome durch die Weltgesundheitsorganisation WHO 31, die Identifikation der genetischen Basis der Heterogenität durch die Genexpressionsanalyse mit genomweiten Chip-Analysen 25, die signifikante Verbesserung der Heilungsrate durch dosisdichte Chemotherapieschemata 21, die signifikante Verbesserung der Heilungsrate durch die kombinierte Chemo-Immuntherapie mit monoklonalen Antikörpern 6.
Literatur
- 1
Alizadeh A A, Eisen M B, Davis R E. et al .
Distinct types of diffuse large B-cell lymphoma identified by gene expression
profiling.
Nature.
2000;
403
503-511
MissingFormLabel
- 2
Anderson J R, Armitage J O, Weisenburger D D.
Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes
differ by geographic locations. Non-Hodgkin’s Lymphoma Classification Project.
Ann Oncol.
1998;
9
717-720
MissingFormLabel
- 3
Armitage J O, Weisenburger D D.
New approach to classifying non-Hodgkin’s lymphomas: clinical features of the
major histologic subtypes. Non-Hodgkin’s Lymphoma Classification Project.
J Clin Oncol.
1998;
16
2780-2795
MissingFormLabel
- 4
Canellos G P, Skarin A T, Klatt M M. et al .
The m-BACOD combination chemotherapy regimen in the treatment of diffuse large
cell lymphoma.
Semin Hematol.
1987;
24
2-7
MissingFormLabel
- 5
Coiffier B, Ferme F, Hermine O. et al .
Rituximab plus CHOP (CHOP-R) in the treatment of elderly patients with diffuse
large B-cell lymphoma. An update of the GELA study (abstract).
Blood.
2001;
97
405
MissingFormLabel
- 6
Coiffier B, Lepage E, Briere J. et al .
CHOP chemotherapy plus rituximab compared with CHOP Alone in elderly patients
with diffuse large-B-cell lymphoma.
N Engl J Med.
2002;
346
235-242
MissingFormLabel
- 7
Fisher R I, Gaynor E R, Dahlberg S. et al .
Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens
for advanced non-Hodgkin’s lymphoma.
New Engl Journ Med.
1993;
328
1002-1006
MissingFormLabel
- 8
Fisher R I, Longo D L, DeVita V T. et al .
Long-term follow up of ProMACE-CytaBOM in non-Hodgkin’s lymphomas.
Ann Oncol.
1991;
2
S33-S35
MissingFormLabel
- 9
Gianni A M, Bregni M, Siena S. et al .
High-dose chemotherapy and autologous bone marrow transplantation compared with
MACOP-B in aggressive B-cell lymphoma.
N Engl J Med.
1997;
336
1290-1297
MissingFormLabel
- 10
Glass B, Kloess M, Engert A. et al .
Dose escalated CHOP + etoposide and repetitive autologous stem cell transplantation
(Mega-CHOEP) in primary treatment of aggressive lymphoma: Dose intensity count
(Abstract).
Bone Marrow Transpl.
2004;
(Suppl 1)
O103s
MissingFormLabel
- 11
Habermann T M, Weller E, Horning S J.
Rituximab-CHOP vs CHOP with a second randomization to maintenance rituximab
or observation in patients > 60 years with diffuse large B-cell lymphoma (DLBCL)
(abstract).
Blood.
2004;
102
233
MissingFormLabel
- 12
Haioun C, Lepage E, Gisselbrecht C. et al .
Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin’s
lymphoma: final analysis of the prospective LNH87 - 2 protocol - a Groupe d’Etude
des Lymphomes de l’Adulte study.
J Clin Oncol.
2000;
18
3025-3030
MissingFormLabel
- 13
Hans C P, Weisenburger D D, Greiner T C. et al .
Confirmation of the molecular classification of diffuse large B-cell lymphoma
by immunohistochemistry using a tissue microarray.
Blood.
2004;
103
275-282
MissingFormLabel
- 14
Kaiser U, Uebelacker I, Abel U. et al .
Randomized study to evaluate the use of high-dose therapy as part of primary
treatment for „aggressive” lymphoma.
J Clin Oncol.
2002;
20
4413-4419
MissingFormLabel
- 15
Klimo P, Connors J M.
Updated clinical experience with MACOP-B.
Semin Hematol.
1987;
24
26-34
MissingFormLabel
- 16
Kluin-Nelemans H C, Zagonel V, Anastasopoulou A. et al .
Standard chemotherapy with or without high-dose chemotherapy for aggressive
non-Hodgkin’s lymphoma: randomized phase III EORTC study.
J Nat Cancer Inst.
2001;
93
22-30
MissingFormLabel
- 17
McKelvey E M, Gottlieb J A, Wilson H E.
Hydroxydaunomycin (adriamycin) combination chemotherapy in malignant lymphomas.
Cancer.
1976;
38
1484-1493
MissingFormLabel
- 18
Milpied N, Deconinck E, Gaillard F. et al .
Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous
stem-cell support.
N Engl J Med.
2004;
350
1287-1295
MissingFormLabel
- 19
Mounier N, Briere J, Gisselbrecht C. et al .
Rituximab plus CHOP (R-CHOP) overcomes bcl-2-associated resistance to chemotherapy
in elderly patients with diffuse large B-cell lymphoma (DLBCL).
Blood.
2003;
101
4279-4284
MissingFormLabel
- 20
Pfreundschuh M, Trumper L, Kloess M. et al .
Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment
of young patients with good-prognosis (normal LDH) aggressive lymphomas: results
of the NHL-B1 trial of the DSHNHL.
Blood.
2004;
104
626-633
MissingFormLabel
- 21
Pfreundschuh M, Trumper L, Kloess M. et al .
Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment
of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of
the DSHNHL.
Blood.
2004;
104
634-641
MissingFormLabel
- 22
Pfreundschuh M, Trümper L, Ma D. et al .
Randomized intergroup trial of first line treatment for patients below 60 years
with diffuse large B-cell lymphoma with a CHOP-like regimen with or without
the anti-CD 20 antibody rituximab - early stopping after the first interim analysis
(abstract).
J Clin Oncol.
2004;
23
556
MissingFormLabel
- 23
Philip T, Guglielmi C, Somers R. et al .
Autologous bone marrow transplantation as compared with salvage chemotherapy
in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma [abstract].
New Engl Journ Med.
1995;
333
1540-1545
MissingFormLabel
- 24
Reyes F, Lepage E, Munck J N. et al .
Superiority of the ACVBP regimen over a combined treatment with three cycles
of CHOP followed by involved field radiotherapy in patients with low risk localized
agressive non-Hodgkin’s lymphoma: Results of the LNH93 - 1 study (abstract).
Blood.
2000;
96
532a
MissingFormLabel
- 25
Rosenwald A, Wright G, Chan W C. et al .
The use of molecular profiling to predict survival after chemotherapy for diffuse
large-B-cell lymphoma.
N Engl J Med.
2002;
346
1937-1947
MissingFormLabel
- 26
Santini G, Salvagno L, Leoni P. et al .
VACOP-B versus VACOP-B plus autologous bone marrow transplantation for advanced
diffuse non-Hodgkin’s lymphoma: results of a prospective randomized trial by
the non-Hodgkin’s Lymphoma Cooperative Study Group.
J Clin Oncol.
1998;
16
2796-2802
MissingFormLabel
- 27
Shipp M A, Harrington D P. et al .
The International Non-Hodgkin’s Lymphoma Prognostic Factors Project: A predictive
model for aggressive non-Hodgkin’s lymphoma.
New Engl J Med.
1993;
329
987-994
MissingFormLabel
- 28
Shipp M A, Ross K N, Tamayo P. et al .
Diffuse large B-cell lymphoma outcome prediction by gene-expression profiling
and supervised machine learning.
Nat Med.
2002;
8
68-74
MissingFormLabel
- 29
Stansfield A G, Diebold J, Noel H. et al .
Kiel Classification.
Lancet.
1988;
1
292-293
MissingFormLabel
- 30
Verdonck L F, van Putten W L, Hagenbeek A. et al .
Comparison of CHOP chemotherapy with autologous bone marrow transplantation
for slowly responding patients with aggressive non-Hodgkin’s lymphoma.
N Engl J Med.
1995;
332
1045-1051
MissingFormLabel
- 31 WHO .Tumours of Haemotopoietic and Lymphoid Tissue. 1 ed Lyon: IARC Press 2001
MissingFormLabel
Prof. Dr. med. Lorenz Trümper
Abteilung Hämatologie und Onkologie, Klinikum der Georg-August-Universität Göttingen
37099 Göttingen
Telefon: 0551/398535
Fax: 0551/398587
eMail: lorenz.truemper@med.uni-goettingen.de