[Current therapeutic strategies for mantle cell lymphoma]. / Aktuelle Therapiestrategien beim Mantelzelllymphom.

Mantle cell lymphoma is a subtype of B­cell lymphoma with a mostly aggressive behavior and poor long-term prognosis. The choice of therapy depends on the age, performance status and risk profile of the patient. Randomized trials have confirmed the superiority of a dose-intensified induction therapy containing cytarabine followed by autologous stem cell transplantation in the first-line treatment of younger patients with a good general condition. Elderly patients benefit from a rituximab maintenance therapy after immunochemotherapy. Novel targeted therapies of the B­cell receptor pathway with the Bruton's tyrosine kinase inhibitor ibrutinib and the mechanistic target of rapamycin (mTOR) antagonist temsirolimus as well as immunomodulatory drugs (lenalidomide) have shown promising results in relapsed disease. The proteasome inhibitor bortezomib has been approved for first-line treatment in combination with conventional chemotherapy.

[Symptomatic therapy of SIADH in small cell lung cancer by tolvaptan]. / Symptomatische Therapie des SIADH bei kleinzelligem Bronchialkarzinom mit Tolvaptan.

HISTORY AND CLINICAL FINDINGS: A 69-year-old woman with small cell lung cancer presented in the emergency ward because of severe back pain. She had received tolvaptan treatment in hospital for paraneoplastic SIADH but had discontinued the drug after discharge from hospital 3 days ago. Restriction of fluid intake was not tolerated. INVESTIGATIONS: Consistent with SIADH, there were profound hyponatraemia, elevated urine osmolality and urine sodium. TREATMENT AND COURSE: After a generalized seizure triggered by hyponatraemia, tolvaptan was reintroduced in addition to radiochemotherapy. Serum sodium concentration increased and finally returned to normal. CONCLUSION: If restriction of fluid intake is not tolerated by the patients the vasopressin antagonist tolvaptan provides an alternative symptomatic treatment of paraneoplastic SIADH.

Compliance testing by measurement of piracetam in urine--a possible method of compliance control for piracetam intakers. An empirical investigation.

All teams of investigators concerned with compliance rate have come to the conclusion that one can seldom rely on patients to take their tablets as prescribed. In case of long-term medication the problem becomes even more acute. A method for checking on compliance is, therefore, of great help in controlling medical therapy as well as in judging the effectiveness of pharmaceuticals. The results of this study imply that diachronic determination of piracetam concentration in patients' urine is an especially simple way of testing compliance without undue strain on the patient.