12.5.2.30 DHS rekommandationer for KMT 2011.pdf - e-Dok
12.5.2.30 DHS rekommandationer for KMT 2011.pdf - e-Dok
12.5.2.30 DHS rekommandationer for KMT 2011.pdf - e-Dok
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*) Specielt i denne gruppe gælder at stillingtagen til <strong>KMT</strong> må individualiseres.<br />
Der er ikke tilstrækkelige data til at vurdere hvilken rolle auto-<strong>KMT</strong> kan have. Auto-<strong>KMT</strong><br />
<strong>for</strong>udsætter opnåelse af CR og en vellykket stamcellehøst.<br />
Cytoreduktiv kemoterapi før allo-<strong>KMT</strong> af patienter med RAEB: Standard allogen <strong>KMT</strong>:<br />
Værdien er uafklaret. MINI-<strong>KMT</strong>: Cytoreduktiv behandling før mini-<strong>KMT</strong> gives <strong>for</strong> at vinde tid<br />
så GVL-effekten kan sætte ind.<br />
Standard versus mini allo-<strong>KMT</strong>: Comorbiditet taler <strong>for</strong> mini-<strong>KMT</strong>. Faktorer der indikerer<br />
øget relapsrisiko taler <strong>for</strong> standard allo-<strong>KMT</strong>.<br />
Aldersgrænser: Aldersgrænserne er vejledende. <strong>KMT</strong> vil ofte være eneste kurative<br />
mulighed. Hver patient må bedømmes individuelt. Et stærkt patientønske om <strong>KMT</strong> trods<br />
in<strong>for</strong>mation om høj TRM taler <strong>for</strong> <strong>KMT</strong>.<br />
Optimalt tidspunkt <strong>for</strong> <strong>KMT</strong>: Så snart beslutningen om <strong>KMT</strong> er truffet.<br />
Referencer vedrørende <strong>KMT</strong> af MDS<br />
Patogenese, cytogenetik klassifikation og prognose<br />
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