Immunsuppressive Therapie bei Tumoranamnese

Abstract

▼As far as the question is concerned whether immunosuppressive therapy is feasible and safe in a patient with a history of malignoma, only fairly insuffi cient data is available. Nevertheless, the Société Francaise de Rhumatologie, the Canadian Rheumatology Association, and the American College of Rheumatology have tried to make recommendations for this delicate topic. Direct evidence mainly originates from data of 3 national registries which suggest that treatment with traditional disease-modifying anti-rheumatic drugs (DMARDs) and biologics seems safe for carefully selected patients. Furthermore, conclusions can be drawn from the experience with immunosuppressive medication in the transplant setting. With the exception of cyclophosphamide in a high cumulative dosage, for which an increased risk of malignoma is evident, all traditional DMARDs, all immunosuppressants and all biologics available probably do not lead to an increased risk of de novo malignancy in spite of sometimes confl icting data. The current data for each drug of interest is presented. Finally, an algorithm for treating patients with a history of malignoma with immunosuppressive drugs is suggested.Heruntergeladen von: Rutgers University. Urheberrechtlich geschützt.

B-Zell-Therapie mit Rituximab bei rheumatoider Arthritis

“…Von besonderem Interesse ist die Frage, ob eine immunsuppressive Therapie bei Patienten mit Malignomanamnese möglicherweise mit einem erhöh-ten Tumorrezidivrisiko assoziiert ist [23]. Die dazu bisher nur begrenzte Datenlage legt den Schluss nahe, dass eine Behandlung mit traditionellen Basistherapeutika oder Biologika bei der üblichen vorsichtigen Vorauswahl der Patienten mit Malignomanamnese möglich erscheint.…”