Schmidt Christian, Fingerle-Rowson Guenter, Boehme Angelika, Brendel Kurt, Fischer Richard, Gonnermann Michael, Höhler Thomas, Kegel Thomas, Kellermann Lenka, Nusch Arndt, Pönisch Wolfram, Wendtner Clemens, Dreyling Martin
University Hospital Grosshadern, Ludwig Maximilians University , Munich , Germany.
Leuk Lymphoma. 2015 Mar;56(3):694-702. doi: 10.3109/10428194.2014.928935. Epub 2014 Aug 19.
Today's treatment options for indolent lymphoma and chronic lymphocytic leukemia (CLL) range from watch & wait, immunochemotherapy up to allogeneic transplantation. We describe changes in the diagnosis and treatment of indolent lymphoma and CLL in Germany between 2006 and 2009. Two nation-wide surveys in the fourth quarter of 2006 and 2009 included patients with indolent lymphoma and CLL. Data from 576 patients from 46 centers in Q4/2006 were compared with data from 521 patients from 57 centers in Q4/2009. The subpopulation of patients ≥ 70 years of age and the number of patients with comorbidities increased from 39% to 55% and 47% to 55%, respectively. Both in indolent lymphoma and CLL, Rituximab and R-based immunochemotherapy (50.6% vs. 64.4%) as well as bendamustine (4.8 % vs. 24%) were much more frequently applied. In contrast, high dose chemotherapy consolidation was almost abandoned in first line treatment. Supportive care is given more frequently, with exception of erythropoietin and immunoglobulins. Our national survey confirmed that scientific results were rapidly transferred into clinical care of indolent lymphoma.
目前针对惰性淋巴瘤和慢性淋巴细胞白血病（CLL）的治疗方案包括观察等待、免疫化疗直至异体移植。我们描述了2006年至2009年间德国惰性淋巴瘤和CLL的诊断与治疗变化。2006年第四季度和2009年进行的两项全国性调查纳入了惰性淋巴瘤和CLL患者。将2006年第四季度来自46个中心的576例患者的数据与2009年第四季度来自57个中心的521例患者的数据进行了比较。年龄≥70岁的患者亚群以及合并症患者数量分别从39%增至55%和从47%增至55%。在惰性淋巴瘤和CLL中，利妥昔单抗和基于利妥昔单抗的免疫化疗（50.6%对64.4%）以及苯达莫司汀（4.8%对24%）的应用频率都显著更高。相比之下，一线治疗中高剂量化疗巩固几乎被摒弃。除了促红细胞生成素和免疫球蛋白外，支持性治疗的应用更为频繁。我们的全国性调查证实，科学成果迅速转化为了惰性淋巴瘤的临床治疗。
