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Multiples Myelom beim alten und geriatrischen Patienten

  • Christoph Kahl
Chapter
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Das Multiple Myelom (MM) ist eine maligne Plasmazellerkrankung. Das mediane Erkrankungsalter liegt bei über 70 Jahren. Die moderne Risikostratifikation erfolgt nach der R-ISS Klassifikation, in der neben klassischen Parametern wie dem beta-2 Mikroglobulin und dem Albumin auch die LDH und zytogenetische Befunde berücksichtigt werden. Für eine differenzierte Entscheidung für oder gegen eine Therapie und die Therapieintensität bei alten und/oder gebrechlichen Myelompatienten sollte der Frailty Score der International Myeloma Working Group herangezogen werden. Grundsätzlich besteht die Therapie des MM aus einer Induktionstherapie mit einer anschließenden Hochdosistherapie mit autologem Stammzellsupport. Obwohl ältere Patienten nicht per se davon ausgeschlossen sind, ist die Indikation für diese Therapieoption auf Grund der Komorbiditäten mit Sorgfalt durchzuführen. In der Regel besteht die Therapie bei dieser Patientenpopulation aus einer Dreifachkombination mit Melphalan, Prednisolon und einem Medikament aus einer neuen Substanzklasse mit einer anschließenden Erhaltungstherapie. Myelompatienten sind auf Grund von krankheitsassoziierten Symptomen wie Schmerzen bei Osteolysen und Anämie in ihrer Lebensqualität deutlich beeinträchtigt. Diese Symptome müssen durch eine Supportivtherapie adressiert werden.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Hämatologie, Onkologie und PalliativmedizinKlinikum Magdeburg gGmbHMagdeburgDeutschland

Section editors and affiliations

  • Ulrich Wedding
    • 1
  1. 1.Abteilung für PalliativmedizinUniversitätsklinikum Jena, Klinik für Innere Medizin IIJenaDeutschland

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