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Dtsch Med Wochenschr 2001; 126(39): 1073-1079
DOI: 10.1055/s-2001-17496
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© Georg Thieme Verlag Stuttgart · New York

Aktuelle Therapiekonzepte bei akuter Promyelozytenleukämie

Current therapeutic concept of acute promyelocytic leukaemiaE. Lengfelder1 , R. Hehlmann1 , Th Büchner2
  • 1III. Medizinische Universitätsklinik Mannheim (Direktor: Prof. Dr. R. Hehlmann), Universität Heidelberg
  • 2Medizinische Universitätsklinik A (Direktor Prof. Dr. W. Berdel), Universität Münster
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Publication Date:
27 September 2001 (online)

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Die herkömmliche Strategie zur Behandlung akuter Leukämien beruht auf dem Prinzip, den leukämischen Klon mit Hilfe einer intensiven Chemotherapie möglichst vollständig zu eradizieren und dadurch eine Heilung zu erzielen. Hauptansatzpunkt der Zytostatika ist die Blockierung zentraler Mechanismen der Zellreplikation. Die Grenzen dieser Therapie liegen in der unspezifischen, oft unzureichenden Wirkung und der hohen Toxizität. Ein neuerer Ansatz, der diese Probleme zu umgehen versucht, beruht auf einer selektiv auf die Leukämiezelle gerichteten, gezielt am Pathomechanismus des Leukämietyps angreifenden Therapie.

Bei der akuten Promyelozytenleukämie (APL), einem Subtyp der akuten myeloischen Leukämie (AML-M3), hat ein solches Therapieprinzip in Form einer APL-spezifischen differenzierenden Therapie mit dem Vitamin-A-Säurederivat All-trans-Retinsäure (ATRA) bereits seit Ende der 80er Jahre Eingang in die klinische Praxis gefunden. Die APL war die erste Leukämieform bei der eine spezifisch wirksame Substanz verfügbar war. Außerdem sind die therapeutisch relevanten molekularen Aberrationen bekannt. Die APL kann deshalb als Modellkrankheit für Fortschritte durch die Anwendung einer Pathogenese-orientierten Therapie bei akuter Leukämie angesehen werden.

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Korrespondenz

PD Dr. Eva Lengfelder

III. Med. Klinik Mannheim

Wiesbadenerstraße 7-11

68305 Mannheim

Phone: 0621/383-4110

Fax: 0621/383-4201