Deutsche medizinische Wochenschrift
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Our understanding of the molecular basis of the development and progression of malignant lymphoma has significantly improved over the last decades leading to the identification of genetic alterations with proven prognostic impact on the clinical course of the disease, such as TP53 mutations in MCL. This deepened molecular understanding sets the basis for the current rapid development regarding targeted and immuno-based therapies, offering individualized, risk-adapted treatment strategies in our near future with the potential to further improve patient care. ⋯ For such high-risk patients, further optimized and individualized therapeutic strategies are highly warranted. This article summarizes new findings regarding tumor biology and actual developments expanding the therapeutic landscape of DLBCL and MCL.
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Dtsch. Med. Wochenschr. · Nov 2022
[Seasonal Influenza - Update on Epidemiology, Prevention and Therapy].
Infection control measures and travel restrictions implemented during the COVID-19 pandemic have limited the transmission of seasonal influenza viruses as well. It must be assumed that after these public health measures have largely been lifted, influenza activity will sharply increase in the coming influenza season. Anticipating the potentially high number of cases, the co-circulation of influenza viruses and SARS-CoV-2, efforts to increase vaccination rates against both infectious diseases must be given more attention.
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Dtsch. Med. Wochenschr. · Nov 2022
[CAR-T cell therapy - personalized cellular immunotherapy in 2022].
Chimeric antigen receptor T cells (CAR T cells) are genetically modified autologous or allogeneic T lymphocytes that target specific antigens and can be used to combat tumor cells. The approval studies show a high response and remission rate in heavily pretreated patients with aggressive B-cell lymphoma, acute lymphoblastic leukemia or multiple myeloma. The article presents the indications for approval, the clinical implementation and the management of side effects of CAR cell therapy.
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Dtsch. Med. Wochenschr. · Nov 2022
[Cardiac amyloidosis - important differential diagnosis in heart failure].
The systemic disease amyloidosis is caused by deposits of misfolded proteins and can cause very different symptoms depending on the organ involvement. The two most common forms are AL amyloidosis and ATTR amyloidosis. The determination of light chains and bone scintigraphy have a high priority in the diagnostic algorithm. ⋯ The classic heart failure medication is often not well tolerated by patients with cardiac amyloidosis and must be adjusted in the presence of symptoms. This article shows which findings and symptom complexes should make you think of amyloidosis and how to arrive at the correct diagnosis in a targeted manner. Causal therapy options as well as special features of heart failure therapy in this patient collective are explained.
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A new classification of patients with diabetes mellitus into so-called clusters can be used to assess the risk of developing diabetic nephropathy. Up to date treatment of patients with diabetic nephropathy includes not only glycemic control, but focuses on a holistic approach with prevention of (progression of) secondary diabetic complications and reduction of the patient's cardiovascular mortality. ⋯ Adjustment of drug therapy is no longer based on antihyperglycemic effects alone, but takes into account inhibition of progression of nephropathy and cardiac risk, as well as support of body weight control. For this purpose, in addition to RAAS inhibitors from the field of antihypertensives, the antidiabetic classes of SGLT2 inhibitors and GLP-1 receptor agonists as well as the non-steroidal aldosterone antagonist finerenone are now available.