Extended Rituximab Therapy for Previously Untreated Patients with Waldenström's Macroglobulinemia

Dimopoulos, Meletios A.; Zervas, Constantinos; Zomas, Athanasios; Hamilos, George; Gika, Dimitra; Efstathiou, Eleni; Panayiotidis, Panayiotis; Vervessou, Elina; Anagnostopoulos, Nikolaos; Christakis, John

doi:10.3816/clm.2002.n.022

Cited by 67 publications

(31 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] WM cells express CD20 surface antigen; therefore, rituximab has become a key treatment component; however, it is associated with a modest response rate of ;30% and long time to response. [6][7][8] Thus, it is recommended that primary treatment should consist of rituximab-based combinations, to increase response rates and shorten time to response. 5 Nevertheless, rituximab-based combinations are associated with time to first response of 2 to 3 months.…”

Section: Introductionmentioning

confidence: 99%

BDR in newly diagnosed patients with WM: final analysis of a phase 2 study after a minimum follow-up of 6 years

Gavriatopoulou

García‐Sanz

Kastritis

et al. 2017

Blood

Self Cite

View full text Add to dashboard Cite

Key Points• BDR is a chemotherapy-free, non-stem-cell-toxic regimen associated with high response rates and long-term remissions.• The long-term safety profile of BDR is favorable, with high probability of response to reintroduction of rituximabbased regimens at relapse.In this phase 2 multicenter trial, we evaluated the efficacy of the combination of bortezomib, dexamethasone, and rituximab (BDR) in 59 previously untreated symptomatic patients with Waldenström macroglobulinemia (WM), most of which were of advanced age and with adverse prognostic factors. BDR consisted of a single 21-day cycle of bortezomib alone (1.3 mg/m 2 IV on days 1, 4, 8, and 11), followed by weekly IV bortezomib (1.6 mg/m 2 on days 1, 8, 15, and 22) for 4 additional 35-day cycles, with IV dexamethasone (40 mg) and IV rituximab (375 mg/m 2 ) on cycles 2 and 5, for a total treatment duration of 23 weeks. On intent to treat, 85% responded (3% complete response, 7% very good partial response, 58% partial response). After a minimum follow-up of 6 years, median progression-free survival was 43 months and median duration of response for patients with at least partial response was 64.5 months. Overall survival at 7 years was 66%. No patient had developed secondary myelodysplasia, whereas transformation to high-grade lymphoma occurred in 3 patients who had received chemoimmunotherapy after BDR. Thus, BDR is a very active, fixedduration, chemotherapy-free regimen, inducing durable responses and with a favorable long-term toxicity profile (www.

show abstract

Section: Introductionmentioning

confidence: 99%

BDR in newly diagnosed patients with WM: final analysis of a phase 2 study after a minimum follow-up of 6 years

Gavriatopoulou

García‐Sanz

Kastritis

et al. 2017

Blood

Self Cite

View full text Add to dashboard Cite

show abstract

“…Rituximab has been widely used for the treatment of WM and has minimal toxicity, but as a monotherapy it is associated with modest response rates. [3][4][5][6] Treatment with rituximab is also associated with a transient increase of serum IgM ("IgM flare") in 30% to 80% of patients 3,7,8 which may exacerbate complications associated with the high levels of paraprotein such as hyperviscosity syndrome. 7,8 Combinations of rituximab with chemotherapy (such as the dexamethasone, rituximab, and cyclophosphamide [DRC] regimen) are associated with better response rates than rituximab alone, however, complete responses are infrequent and median time to response is ;4 months.…”

Section: Introductionmentioning

confidence: 99%

Primary therapy of Waldenström macroglobulinemia (WM) with weekly bortezomib, low-dose dexamethasone, and rituximab (BDR): long-term results of a phase 2 study of the European Myeloma Network (EMN)

Dimopoulos

García‐Sanz

Gavriatopoulou

et al. 2013

Blood

Self Cite

177

108

View full text Add to dashboard Cite

Key Points• BDR is an active regimen and induces long-lasting responses in patients with newly diagnosed WM.• Induction with single-agent bortezomib may be effective in preventing complications of hyperviscosity or rituximabinduced IgM flare.In this phase 2 multicenter trial, we evaluated the activity of bortezomib, dexamethasone, and rituximab (BDR) combination in previously untreated symptomatic patients with Waldenström macroglobulinemia (WM). To prevent immunoglobulin M (IgM) "flare," single agent bortezomib (1.3 mg/m 2 IV days 1, 4, 8, and 11; 21-day cycle), was followed by weekly IV bortezomib (1.6 mg/m 2 days 1, 8, 15, and 22) every 35 days for 4 additional cycles, followed by IV dexamethasone (40 mg) and IV rituximab (375 mg/m 2 ) in cycles 2 and 5. Fifty-nine patients were treated; 45.5% and 40% were high and intermediate risk per the International Prognostic Scoring System for WM. On intent to treat, 85% responded (3% complete response, 7% very good partial response, 58% partial response [PR]). In 11% of patients, an increase of IgM ‡25% was observed after rituximab; no patient required plasmapheresis. After a minimum follow-up of 32 months, median progression-free survival was 42 months, 3-year duration of response for patients with ‡PR was 70%, and 3-year survival was 81%. Peripheral neuropathy occurred in 46% (grade ‡3 in 7%); only 8% discontinued bortezomib due to neuropathy. BDR is rapidly acting, well tolerated, and nonmyelotoxic, inducing durable responses in previously untreated WM.

show abstract

“…Overall, 27% achieved a partial response; 33%, a minor response; and 30%, stable disease [56]. Others have reported response rates of 35-44% [57][58][59][60].…”

Section: Rituximabmentioning

confidence: 99%

Waldenström macroglobulinemia: A review of therapy

Gertz

2005

American J Hematol

View full text Add to dashboard Cite

show abstract

Extended Rituximab Therapy for Previously Untreated Patients with Waldenström's Macroglobulinemia

Cited by 67 publications

References 20 publications

BDR in newly diagnosed patients with WM: final analysis of a phase 2 study after a minimum follow-up of 6 years

BDR in newly diagnosed patients with WM: final analysis of a phase 2 study after a minimum follow-up of 6 years

Primary therapy of Waldenström macroglobulinemia (WM) with weekly bortezomib, low-dose dexamethasone, and rituximab (BDR): long-term results of a phase 2 study of the European Myeloma Network (EMN)

Waldenström macroglobulinemia: A review of therapy

Contact Info

Product

Resources

About