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DOI: 10.1055/a-2160-5267
Neue Klassifikationen maligner Lymphome – Welche Änderungen sind für die Praxis relevant?
New classifications of malignant lymphomas – What changes are relevant for practice?
Für die Vergleichbarkeit klinischer Studien ist eine international einheitliche Lymphom-Klassifikation von grundlegender Bedeutung. Aktuell gibt es 2 parallele Klassifikationen: die „International Consensus Classification“ und die WHO-Klassifikation. Neben vielen Gemeinsamkeiten gibt es auch einige Unterschiede, wobei die traditionelle Unterteilung in indolente und aggressive B-Zell-Lymphome, Hodgkin-Lymphome und T-Zell-Lymphome weiter besteht.
Abstract
An internationally uniform lymphoma classification is of fundamental importance for the comparability of clinical studies. There are currently 2 parallel classifications: the “International Consensus Classification” and the WHO-classification. Follicular lymphoma 3B is classified separately as follicular large cell lymphoma in WHO-HAEM5. The diagnostic criteria of lymphoplasmocytic lymphoma (LPL) have been adjusted, both classifications recommend molecular testing for MYD88 and CXCR4 mutations. There are no significant diagnostic changes in aggressive B-cell lymphomas. The ICC classify NLPBL and THRLBCL into the group of large B-cell lymphomas (LBCL). NLPHL/NLPBL-specific therapy must be considered, which differs greatly from the therapy of DLBCL, especially in the early stages. Peripheral T-cell lymphomas are a group of nodal T-cell lymphomas with a TFH phenotype and frequent mutations; peripheral T-cell lymphoma (NOS) is therefore a diagnosis of exclusion. Indolent T-cell lymphomas/lymphoproliferations of the GI tract are rare but must be differentiated from aggressive T-cell lymphomas. The WHO-HAEM5 also includes reactive/non-neoplastic lymph node lesions classified according to B or T cell predominance.
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Kürzlich sind 2 neue Klassifikationen für lymphatische Neoplasien erschienen, die überwiegend Gemeinsamkeiten, aber auch kleinere Unterschiede aufweisen.
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Es ist notwendig, beide Klassifikationen zu kennen, um eine korrekte Diagnose und eine adäquate Behandlung der Patienten zu gewährleisten.
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Unterschiede zwischen den Klassifikationen sollten als Chance für eine erneute Diskussion verstanden werden.
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Insbesondere im Hinblick auf den Einschluss und die Behandlung im Rahmen von Studien und die Entwicklung internationaler Therapiestandards ist eine zukünftige Konsensus-Klassifikation anzustreben.
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Aktuell ist es empfehlenswert, bei Differenzen beide Nomenklaturen anzuwenden.
Schlüsselwörter
Klassifikation - International Consensus Classification - WHO - B-Zell-Lymphom - Hodgkin-Lymphom - T-Zell-LymphomKeywords
classification - International Consensus Classification - WHO - B-cell lymphoma - Hodgkin lymphoma - T-cell lymphomaPublication History
Article published online:
15 May 2024
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