@article{RauSchmittBergetal.2018,
  author    = {Rau, Monika and Schmitt, Johannes and Berg, Thomas and Kremer, Andreas E. and Stieger, Bruno and Spanaus, Katharina and Bengsch, Bertram and Romero, Marta R. and Marin, Jose J. and Keitel, Verena and Klinker, Hartwig and Tony, Hans-Peter and M{\"u}llhaupt, Beat and Geier, Andreas},
  title     = {Serum IP-10 levels and increased DPPIV activity are linked to circulating CXCR3+ T cells in cholestatic HCV patients},
  series = {PLoS ONE},
  volume    = {13},
  journal   = {PLoS ONE},
  number    = {12},
  doi       = {10.1371/journal.pone.0208225},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177674},
  pages     = {e0208225},
  year      = {2018},
  abstract  = {Background \& aims Serum interferon-gamma-inducible protein-10 (IP-10) is elevated in cholestatic liver diseases and predicts response to antiviral therapy in patients with chronic hepatitis C virus (HCV) infection. Dipeptidylpeptidase 4 (DPPIV) cleaves active IP-10 into an inactive form, which inhibits recruitment of CXCR3+ T cells to the liver. In this study the link between IP-10 levels, DPPIV activity in serum and CXCR3+ T cells is analysed in cholestatic and non-cholestatic liver patients. Methods In serum DPPIV activity (by enzymatic assay), IP-10 (by ELISA) and bile acids (BA) (by enzymatic assay) were analysed in 229 naive HCV genotype (GT) 1 patients and in 16 patients with cholestatic liver disease. In a prospective follow-up (FU) cohort of 27 HCV GT 1 patients peripheral CD3+CXCR3+, CD4+CXCR3+ and CD8+CXCR3+ cells were measured by FACS. Results In 229 HCV patients serum IP-10 levels correlated positively to DPPIV serum activity. Higher IP-10 levels and DPPIV activity were detected in cholestatic and in cirrhotic HCV patients. Increased IP-10 serum levels were associated with therapeutic non-response to antiviral treatment with pegylated-interferon and ribavirin. In the HCV FU cohort elevated IP-10 serum levels and increased BA were associated with higher frequencies of peripheral CD3+CXCR3+, CD4+CXCR3+ and CD8+CXCR3+ T cells. Positive correlation between serum IP-10 levels and DPPIV activity was likewise validated in patients with cholestatic liver diseases. Conclusions A strong correlation between elevated serum levels of IP-10 and DPPIV activity was seen in different cholestatic patient groups. Furthermore, in cholestatic HCV patients a functional link to increased numbers of peripheral CXCR3+ immune cells could be observed. The source of DPPIV release in cholestatic patients remains open.},
  language  = {en}
}
@article{RiegerLissMellinghoffetal.2018,
  author    = {Rieger, C. T. and Liss, B. and Mellinghoff, S. and Buchheidt, D. and Cornely, O. A. and Egerer, G. and Heinz, W. J. and Hentrich, M. and Maschmeyer, G. and Mayer, K. and Sandherr, M. and Silling, G. and Ullmann, A. and Vehreschild, M. J. G. T. and von Lilienfeld-Toal, M. and Wolf, H. H. and Lehners, N.},
  title     = {Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO)},
  series = {Annals of Oncology},
  volume    = {29},
  journal   = {Annals of Oncology},
  number    = {6},
  doi       = {10.1093/annonc/mdy117},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226196},
  pages     = {1354-1365},
  year      = {2018},
  abstract  = {Infectious complications are a significant cause of morbidity and mortality in patients with malignancies specifically when receiving anticancer treatments. Prevention of infection through vaccines is an important aspect of clinical care of cancer patients. Immunocompromising effects of the underlying disease as well as of antineoplastic therapies need to be considered when devising vaccination strategies. This guideline provides clinical recommendations on vaccine use in cancer patients including autologous stem cell transplant recipients, while allogeneic stem cell transplantation is subject of a separate guideline. The document was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) by reviewing currently available data and applying evidence-based medicine criteria.},
  language  = {en}
}
@article{RinaldettiPfirrmannManzetal.2018,
  author    = {Rinaldetti, S{\´e}bastien and Pfirrmann, Markus and Manz, Kirsi and Guilhot, Joelle and Dietz, Christian and Panagiotidis, Panayiotidis and Spiess, Birgit and Seifarth, Wolfgang and Fabarius, Alice and M{\"u}ller, Martin and Pagoni, Maria and Dimou, Maria and Dengler, Jolanta and Waller, Cornelius F. and Br{\"u}mmendorf, Tim H. and Herbst, Regina and Burchert, Andreas and Janßen, Carsten and Goebeler, Maria Elisabeth and Jost, Philipp J. and Hanzel, Stefan and Schafhausen, Philippe and Prange-Krex, Gabriele and Illmer, Thomas and Janzen, Viktor and Klausmann, Martine and Eckert, Robert and B{\"u}schel, Gerd and Kiani, Alexander and Hofmann, Wolf-Karsten and Mahon, Fran{\c{c}}ois-Xavier and Saussele, Susanne},
  title     = {Effect of ABCG2, OCT1, and ABCB1 (MDR1) Gene Expression on Treatment-Free Remission in a EURO-SKI Subtrial},
  series = {Clinical Lymphoma, Myeloma \& Leukemia},
  volume    = {18},
  journal   = {Clinical Lymphoma, Myeloma \& Leukemia},
  number    = {4},
  doi       = {10.1016/j.clml.2018.02.004},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226281},
  pages     = {266-271},
  year      = {2018},
  abstract  = {Within the EURO-SKI trial, 132 chronic phase CML patients discontinued imatinib treatment. RNA was isolated from peripheral blood in order to analyze the expression of MDR1, ABCG2 and OCT1. ABCG2 was predictive for treatment-free remission in Cox regression analysis. High transcript levels of the ABCG2 efflux transporter (>4.5 parts per thousand) were associated with a twofold higher risk of relapse. Introduction: Tyrosine kinase inhibitors (TKIs) can safely be discontinued in chronic myeloid leukemia (CML) patients with sustained deep molecular response. ABCG2 (breast cancer resistance protein), OCT1 (organic cation transporter 1), and ABCB1 (multidrug resistance protein 1) gene products are known to play a crucial role in acquired pharmacogenetic TKI resistance. Their influence on treatment-free remission (TFR) has not yet been investigated. Materials and Methods: RNA was isolated on the last day of TKI intake from peripheral blood leukocytes of 132 chronic phase CML patients who discontinued TKI treatment within the European Stop Tyrosine Kinase Inhibitor Study trial. Plasmid standards were designed including subgenic inserts of OCT1, ABCG2, and ABCB1 together with GUSB as reference gene. For expression analyses, quantitative real-time polymerase chain reaction was used. Multiple Cox regression analysis was performed. In addition, gene expression cutoffs for patient risk stratification were investigated. Results: The TFR rate of 132 patients, 12 months after TKI discontinuation, was 54\% (95\% confidence interval [CI], 46\%-62\%). ABCG2 expression (parts per thousand) was retained as the only significant variable (P=.02; hazard ratio, 1.04; 95\% CI, 1.01-1.07) in multiple Cox regression analysis. Only for the ABCG2 efflux transporter, a significant cutoff was found (P=.04). Patients with an ABCG2/GUSB transcript level >4.5 parts per thousand (n=93) showed a 12-month TFR rate of 47\% (95\% CI, 37\%-57\%), whereas patients with low ABCG2 expression (<= 4.5 parts per thousand; n=39) had a 12-month TFR rate of 72\% (95\% CI, 55\%-82\%). Conclusion: In this study, we investigated the effect of pharmacogenetics in the context of a CML treatment discontinuation trial. The transcript levels of the efflux transporter ABCG2 predicted TFR after TKI discontinuation. (C) 2018 The Authors. Published by Elsevier Inc.},
  language  = {en}
}
@article{RolveringZimmerGinolhacetal.2018,
  author    = {Rolvering, Catherine and Zimmer, Andreas D. and Ginolhac, Aur{\´e}lien and Margue, Christiane and Kirchmeyer, M{\´e}lanie and Servais, Florence and Hermanns, Heike M. and Hergovits, Sabine and Nazarov, Petr V. and Nicot, Nathalie and Kreis, Stephanie and Haan, Serge and Behrmann, Iris and Haan, Claude},
  title     = {The PD-L1-and IL6-mediated dampening of the IL27/STAT1 anticancer responses are prevented by alpha-PD-L1 or alpha-IL6 antibodies},
  series = {Journal of Leukocyte Biology},
  volume    = {104},
  journal   = {Journal of Leukocyte Biology},
  number    = {5},
  doi       = {10.1002/JLB.MA1217-495R},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226974},
  pages     = {969-985},
  year      = {2018},
  abstract  = {Interleukin-27 (IL27) is a type-I cytokine of the IL6/IL12 family and is predominantly secreted by activated macrophages and dendritic cells. We show that IL27 induces STAT factor phosphorylation in cancerous cell lines of different tissue origin. IL27 leads to STAT1 phosphorylation and recapitulates an IFN--like response in the microarray analyses, with up-regulation of genes involved in antiviral defense, antigen presentation, and immune suppression. Like IFN-, IL27 leads to an up-regulation of TAP2 and MHC-I proteins, which mediate increased tumor immune clearance. However, both cytokines also upregulate proteins such as PD-L1 (CD274) and IDO-1, which are associated with immune escape of cancer. Interestingly, differential expression of these genes was observed within the different cell lines and when comparing IL27 to IFN-. In coculture experiments of hepatocellular carcinoma (HCC) cells with peripheral blood mononuclear cells, pre-treatment of the HCC cells with IL27 resulted in lowered IL2 production by anti-CD3/-CD28 activated T-lymphocytes. Addition of anti-PD-L1 antibody, however, restored IL2 secretion. The levels of other T(H)1 cytokines were also enhanced or restored upon administration of anti-PD-L1. In addition, we show that the suppression of IL27 signaling by IL6-type cytokine pre-stimulationmimicking a situation occurring, for example, in IL6-secreting tumors or in tumor inflammation-induced cachexiacan be antagonized by antibodies against IL6-type cytokines or their receptors. Therapeutically, the antitumor effects of IL27 (mediated, e.g., by increased antigen presentation) might thus be increased by combining IL27 with blocking antibodies against PD-L1 or/and IL6-type cytokines.},
  language  = {en}
}
@article{RuizHerediaSanchezVegaOnechaetal.2018,
  author    = {Ruiz-Heredia, Yanira and S{\´a}nchez-Vega, Beatriz and Onecha, Esther and Barrio, Santiago and Alonso, Rafael and Carlos Mart{\´i}nez-Avila, Jose and Cuenca, Isabel and Agirre, Xabier and Braggio, Esteban and Hern{\´a}ndez, Miguel-T. and Mart{\´i}nez, Rafael and Rosi{\~n}ol, Laura and Gutierrez, Norma and Martin-Ramos, Marisa and Ocio, Enrique M. and Echeveste, Mar{\´i}a-Asunci{\´o}n and P{\´e}rez de Oteyza, Jaime and Oriol, Albert and Bargay, Joan and Gironella, Mercedes and Ayala, Rosa and Blad{\´e}, Joan and Mateos, Mar{\´i}a-Victoria and Kortum, Klaus M. and Stewart, Keith and Garc{\´i}a-Sanz, Ram{\´o}n and San Miguel, Jes{\´u}s and Jos{\´e} Lahuerta, Juan and Martinez-Lopez, Joaqu{\´i}n},
  title     = {Mutational screening of newly diagnosed multiple myeloma patients by deep targeted sequencing},
  series = {Haematologica},
  volume    = {103},
  journal   = {Haematologica},
  number    = {11},
  doi       = {10.3324/haematol.2018.188839},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227151},
  pages     = {e544-e548},
  year      = {2018},
  abstract  = {no abstract available},
  language  = {en}
}
@article{RoelligKramerGabrechtetal.2018,
  author    = {R{\"o}llig, C. and Kramer, M. and Gabrecht, M. and H{\"a}nel, M. and Herbst, R. and Kaiser, U. and Schmitz, N. and Kullmer, J. and Fetscher, S. and Link, H. and Mantovani-L{\"o}ffler, L. and Kr{\"u}mpelmann, U. and Neuhaus, T. and Heits, F. and Einsele, H. and Ritter, B. and Bornh{\"a}user, M. and Schetelig, J. and Thiede, C. and Mohr, B. and Schaich, M. and Platzbecker, U. and Sch{\"a}fer-Eckart, K. and Kr{\"a}mer, A. and Berdel, W. E. and Serve, H. and Ehninger, G. and Schuler, U. S.},
  title     = {Intermediate-dose cytarabine plus mitoxantrone versus standard-dose cytarabine plus daunorubicin for acute myeloid leukemia in elderly patients},
  series = {Annals of Oncology},
  volume    = {29},
  journal   = {Annals of Oncology},
  number    = {4},
  doi       = {doi:10.1093/annonc/mdy030},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226473},
  pages     = {973-978},
  year      = {2018},
  abstract  = {Background: The combination of intermediate-dose cytarabine plus mitoxantrone (IMA) can induce high complete remission rates with acceptable toxicity in elderly patients with acute myeloid leukemia (AML). We present the final results of a randomized-controlled trial comparing IMA with the standard 7+3 induction regimen consisting of continuous infusion cytarabine plus daunorubicin (DA). Patients and methods: Patients with newly diagnosed AML>60 years were randomized to receive either intermediate-dose cytarabine (1000 mg/m(2) twice daily on days 1, 3, 5, 7) plus mitoxantrone (10 mg/m(2) days 1-3) (IMA) or standard induction therapy with cytarabine (100 mg/m(2) continuously days 1-7) plus daunorubicin (45 mg/m(2) days 3-5) (DA). Patients in complete remission after DA received intermediate-dose cytarabine plus amsacrine as consolidation treatment, whereas patients after IMA were consolidated with standard-dose cytarabine plus mitoxantrone. Results: Between February 2005 and October 2009, 485 patients were randomized; 241 for treatment arm DA and 244 for IMA; 76\% of patients were >65 years. The complete response rate after DA was 39\% [95\% confidence interval (95\% CI): 33-45] versus 55\% (95\% CI: 49-61) after IMA (odds ratio 1.89, P = 0.001). The 6-week early-death rate was 14\% in both arms. Relapse-free survival curves were superimposable in the first year, but separated afterwards, resulting in 3-year relapse-free survival rates of 29\% versus 14\% in the DA versus IMA arms, respectively (P = 0.042). The median overall survival was 10 months in both arms (P = 0.513). Conclusion: The dose escalation of cytarabine in induction therapy lead to improved remission rates in the elderly AML patients. This did not translate into a survival advantage, most likely due to differences in consolidation treatment. Thus, effective consolidation strategies need to be further explored. In combination with an effective consolidation strategy, the use of intermediate-dose cytarabine in induction may improve curative treatment for elderly AML patients.},
  language  = {en}
}
@article{SantoroLabopinGiannottietal.2018,
  author    = {Santoro, Nicole and Labopin, Myriam and Giannotti, Federica and Ehninger, Gerard and Niederwieser, Dietger and Brecht, Arne and Stelljes, Matthias and Kr{\"o}ger, Nicolaus and Einsele, Herman and Eder, Matthias and Hallek, Michael and Glass, Bertram and Finke, J{\"u}rgen and Ciceri, Fabio and Mohty, Mohamad and Ruggeri, Annalisa and Nagler, Arnon},
  title     = {Unmanipulated haploidentical in comparison with matched unrelated donor stem cell transplantation in patients 60 years and older with acute myeloid leukemia: a comparative study on behalf of the ALWP of the EBMT},
  series = {Journal of Hematology \& Oncology},
  volume    = {11},
  journal   = {Journal of Hematology \& Oncology},
  doi       = {10.1186/s13045-018-0598-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227315},
  pages     = {55, 1-10},
  year      = {2018},
  abstract  = {Background: Acute myeloid leukemia (AML) is both more common and with more biologically aggressive phenotype in the elderly. Allogenic stem cell transplantation (allo-SCT) is the best treatment option in fit patients. Either HLA-matched unrelated donor (MUD) or haploidentical (Haplo) donor are possible alternative for patients in need. Methods: We retrospectively compared non-T-cell-depleted Haplo (n = 250) to 10/10 MUD (n = 2589) in AML patients >= 60 years. Results: Median follow-up was 23 months. Disease status at transplant differs significantly between the two groups (p < 10(-4)). Reduced intensity conditioning (RIC) was administrated to 73 and 77\% of Haplo and MUD, respectively (p = 0.23). Stem cell source was the bone marrow (BM) in 52\% of the Haplo and 6\% of MUD (p < 10(-4)). Anti-thymocyte globulin (ATG) was most frequently used in MUD (p < 10(-4)) while post-Tx cyclophosphamide (PT-Cy) was given in 62\% of Haplo. Engraftment was achieved in 90\% of the Haplo vs 97\% of MUD (p < 10(-4)). In multivariate analysis, no significant difference was found between Haplo and MUD for acute (a) graft versus host disease (GVHD) grade II-IV, relapse incidence (RI), non-relapse mortality (NRM), leukemia free survival (LFS), graft-versus-host-free-relapse free survival (GRFS), and overall survival (OS). Extensive chronic (c) GVHD was significantly higher for MUD as compared to Haplo (HR 2, p = 0.01, 95\% CI 1.17-3.47). A propensity score analysis confirmed the higher risk of extensive cGVHD for MUD without differences for other outcomes. Conclusions: Allo-SCT from both Haplo and MUD are valid option for AML patients >= 60 years of age with similar results. Transplantation from MUD was associated with higher extensive cGVHD. Our findings suggest that Haplo is a suitable and attractive graft source for patients >= 60 with AML in need of allo-SCT.},
  language  = {en}
}
@article{SausseleHehlmannFabariusetal.2018,
  author    = {Saussele, Susanne and Hehlmann, Ruediger and Fabarius, Alice and Jeromin, Sabine and Proetel, Ulrike and Rinaldetti, Sebastien and Kohlbrenner, Katharina and Einsele, Hermann and Falge, Christine and Kanz, Lothar and Neubauer, Andreas and Kneba, Michael and Stegelmann, Frank and Pfreundschuh, Michael and Waller, Cornelius F. and Oppliger Leibundgut, Elisabeth and Heim, Dominik and Krause, Stefan W. and Hofmann, Wolf-Karsten and Hasford, Joerg and Pfirrmann, Markus and M{\"u}ller, Martin C. and Hochhaus, Andreas and Lauseker, Michael},
  title     = {Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV},
  series = {Leukemia},
  volume    = {32},
  journal   = {Leukemia},
  number    = {5},
  doi       = {10.1038/s41375-018-0055-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227528},
  pages     = {1222-1228},
  year      = {2018},
  abstract  = {Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1\% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later.},
  language  = {en}
}
@phdthesis{Strifler2018,
  author    = {Strifler, Susanne},
  title     = {Eine sp{\"a}te, dritte Hochdosis-Chemotherapie als wirksame Rezidivbehandlung des fortgeschrittenen multiplen Myeloms},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149373},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Das multiple Myelom muss trotz aller Therapierfolge in den letzten drei Jahrzehnten seit Einf{\"u}hrung der Melphalan-basierten Hochdosistherapie mit autologer Stammzell-Transplantation als eine unheilbare maligne h{\"a}matologische Systemerkrankung angesehen werden. Trotz einer großen Anzahl vielversprechender neuer Therapieoptionen im Bereich von IMiDs, PIs und g{\"a}nzlich neuer immuntherapeutischer Behandlungsans{\"a}tze stellt dabei die Behandlung eines Myelom-Patienten im sp{\"a}ten Krankheitsrezidiv nach Versagen von Lenalidomid und Bortezomib eine therapeutische Herausforderung dar. Daneben erweisen sich dabei im klinischen Alltag mit zunehmender Zahl an Vortherapien insbesondere auch Behandlungs-assoziierte Toxizit{\"a}ten als den Behandlungserfolg limitierende Faktoren. Diese retrospektive Analyse zeigt, dass eine dritte Melphalan-Hochdosistherapie mit anschließender autologer Stammzelltransplantation in dieser Situation eine wirkungsvolle Therapieoption darstellt, die zum einen ein {\"u}berzeugendes Ansprechen (ORR 59 \%) bewirkt, und {\"u}ber diese unmittelbare Wirksamkeit hinaus zu einem Zugewinn Progressions-freier {\"U}berlebenszeit von im Mittel 9 Monaten f{\"u}hrt. Zudem kann insbesondere auch die neuerliche autologe Transplantation durch eine Verbesserung der h{\"a}ufig Therapie-assoziiert ersch{\"o}pften h{\"a}matopoetischen Funktion dazu beitragen, dass Patienten im nahezu unweigerlich auftretenden neuerlichen Rezidiv durch bessere Therapieadh{\"a}renz und h{\"o}here Therapieintensit{\"a}t maximal von Folgetherapien profitieren. Dieser Effekt spiegelt sich in einem gemessen an einem trotz intensiv vortherapierter Patienten langen mittleren {\"U}berlebens von 26 Monaten wider. Trotz hoher Therapieeffektivit{\"a}t zeigt sich dabei ein g{\"u}nstiges Sicherheitsprofil mit einer Therapie-assoziierten Mortalit{\"a}t von 4,9 \%. Daneben konnte diese Arbeit in einer großen Kohorte best{\"a}tigen, dass eine lange Kryokonservierung autologer Stammzellen nicht nur in vitro sondern auch in vivo nicht zu einem Qualit{\"a}tsverlust und somit beeintr{\"a}chtigtem Stammzell-Engraftment f{\"u}hrt. Insgesamt kann sich die ASCT3 im sp{\"a}ten Krankheitsrezidiv in ihrer Wirksamkeit und Sicherheit in refrakt{\"a}ren/relabierten F{\"a}llen mit Proteasomen-Inhibitoren sowie immunmodulatorischen Substanzen der zweiten bzw. dritten Generation messen lassen, ist jedoch ebenso wenig wie diese im alleinigen Einsatz in der Lage, den negativ-prognostischen Einfluss einer Doppel-Refrakt{\"a}rit{\"a}t bzw. einer Hochrisiko-Zytogenetik vollst{\"a}ndig zu {\"u}berwinden. Hieraus ergeben sich neue Ans{\"a}tze f{\"u}r Therapiekonzepte, die beispielsweise immunmodulatorische Substanzen sowie Proteasomen-Inhibitoren der neueren und neuesten Generation ebenso wie Antik{\"o}rper-basierte Therapien im Rahmen einer prospektiven Studie mit einer dritten Hochdosistherapie und anschließender autologer Stammzelltransplantation kombinieren k{\"o}nnten, um das Gesamt{\"u}berleben von Myelom-Patienten weiter zu verl{\"a}ngern.},
  subject      = {Plasmozytom},
  language  = {de}
}
@phdthesis{WebergebSpalek2018,
  author    = {Weber [geb. Spalek], Evelyn},
  title     = {Poststation{\"a}res Management Helicobacter pylori positiver Patienten im Raum Aschaffenburg},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156634},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {2009 wurde die deutsche S3-Leitlinie „Helicobacter pylori und gastroduodenale Ulkuskrankheit" publiziert, in der klare Empfehlungen f{\"u}r die Diagnostik, die Indikationen f{\"u}r eine Eradikation, die Therapie und das Follow-Up beschrieben sind. Das Management der H. pylori Infektion im praktischen Alltag zeigt nach dieser Arbeit indessen ein anderes Bild. Ein Optimierungsbedarf f{\"u}r die Zukunft kann daraus abgeleitet werden. Diese Arbeit besch{\"a}ftigt sich mit dem poststation{\"a}ren Management von Patienten mit einer H. pylori Infektion im Raum Aschaffenburg. Hierzu wurden 199 Patienten identifiziert, bei denen im Rahmen eines station{\"a}ren Aufenthaltes im Klinikum Aschaffenburg im Jahr 2011 eine H. pylori Infektion diagnostiziert worden war. Aus den Patientenakten wurden alle relevanten Daten entnommen, wie zum Beispiel Diagnose, Indikation zur H. pylori Eradikation und deren station{\"a}re Initiierung beziehungsweise Empfehlung an den Hausarzt. Nachfolgend wurden die 97 Haus{\"a}rzte der 199 Patienten angeschrieben und um das ausf{\"u}llen eines Fragebogens gebeten. Dieser enthielt sechs Fragen zum poststation{\"a}ren Management der Patienten mit H. pylori Infektion. W{\"a}hrend des station{\"a}ren Aufenthaltes war bei 88/199 Patienten (44,2\%) die Eradikationstherapie begonnen und bei 24 von ihnen (12,1\%) bereits abgeschlossen worden. Bei den anderen 64 Patienten sollte die Medikation ambulant fortgef{\"u}hrt werden. Bei 77 Patienten (38,7\%) wurde dem Hausarzt die Einleitung einer ambulanten Eradikationsbehandlung empfohlen. 34 Patienten verließen das Krankenhaus ohne Therapie und auch ohne entsprechende Therapieempfehlung. Die R{\"u}cklaufquote der Frageb{\"o}gen betrug 46,2\% (92 von 199 Patienten). Die nachfolgenden Ergebnisse beziehen sich auf diese 92 Patienten (entspricht 100\%). Zwei Drittel der Patienten (n=61) stellten sich direkt im Anschluss an die Entlassung aus station{\"a}rer Behandlung ihrem Hausarzt vor. Bei 30 Patienten f{\"u}hrte der Hausarzt die station{\"a}re begonnene Eradikationstherapie fort (32,6\%) oder initiierte sie bei 28 Patienten selbst (30,4\%). 17 Patienten erhielten keine Eradikation (18,5\%). Die Gr{\"u}nde hierf{\"u}r waren unterschiedlich, am h{\"a}ufigsten lag ein Informationsdefizit zwischen Klinik und Hausarzt vor. Die franz{\"o}sische Triple-Therapie wurde mit 39 mal am h{\"a}ufigsten verordnet, die italienische Triple-Therapie wurde 20 Patienten verschrieben. Andere Behandlungsprotokolle fanden nur vereinzelt Anwendung. Eine Kontrolle des Eradikationserfolges wurde bei 35 Patienten (38\%) vorgenommen. Bezieht man die Eradikationskontrolle ausschließlich auf die therapierten Patienten erfolgte diese in der H{\"a}lfte der F{\"a}lle (49,3\%). Von den Patienten mit H. pylori Eradikation und Kontrolle des Eradikationserfolges (n=35) konnten 31 (88,6\%) erfolgreich behandelt werden. Die Vorgehensweise nach erfolgloser H. pylori Eradikation umfasste den Versuch einer Zweitlinientherapie, die {\"U}berweisung zum Gastroenterologen und den Verzicht auf weitere Maßnahmen. Zusammenfassend zeigt diese Erhebung, dass es einen klaren Optimierungsbedarf in der Anwendung der Empfehlungen aus der Leitlinie bedarf. Dieser Aspekt sollte zuk{\"u}nftig vermehrt Ber{\"u}cksichtigung finden, nicht zuletzt in der Aktualisierung der Leitlinie 2016.},
  subject      = {Ambulante Behandlung},
  language  = {de}
}