Deutsche medizinische Wochenschrift
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A majority of patients with newly diagnosed malignant disease are 70 years old or older. Frailty - i. e. increased vulnerability towards stressors at older age - is a major challenge during the oncological work-up and treatment in the elderly. Therefore, older cancer patients should receive a systematic assessment of frailty by use of standard tools. ⋯ However, patients with such characteristics are at increased risk of complications compared to younger subjects. Physicians and medical staff involved in treatment must therefore co-operate well. This article provides an overview of the current evidence and highlights key aspects of diagnosis and treatment of malignant diseases in the elderly.
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Dtsch. Med. Wochenschr. · Sep 2021
Review[A decade of checkpoint inhibitors: current standard of care and future trends].
Therapy with checkpoint inhibitors still revolutionizes the therapeutical landscape in oncology. Since the first approval of a checkpoint inhibitor for the therapy of malignant melanoma 2011, many other approvals in the field of hematology and oncology followed. ⋯ Here we review the different treatment strategies of mono- and combination-therapies. Additionally, important biomarkers for the treatment with checkpoint inhibitors are discussed.
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Dtsch. Med. Wochenschr. · Sep 2021
Review[Dilemma situation: Acute mental illness during pregnancy].
Acute mental illness during pregnancy is an emergency medical situation requiring immediate intervention. A variety of medical, pharmacologic, legal, and ethical dilemmas must be resolved to simultaneously ensure the well-being of the mother and unborn child. This article provides an overview of the management of common psychiatric emergency situations in pregnancy.
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Dtsch. Med. Wochenschr. · Sep 2021
Review[Practical aspects of the application of CAR T cells and management of their toxicities].
CD19 CAR T cells induce - in part long-lasting - remissions in heavily pretreated patients with relapsed/refractory B-cell malignancies. However, they are associated with unique toxicities, and patient management therefore requires specific expertise. ⋯ We discuss practical aspects of CAR T cell therapy from the patient's initial presentation, over leukapheresis, to CAR T cell transfusion. Additionally, we highlight the pathophysiology and principles of the management of the most common toxicities (cytokine release syndrome [CRS], immune cell associated neurotoxicity syndrome [ICANS] and cytopenias).