Survival and prognostic factors after initiation of treatment in Waldenstrom’s macroglobulinemia

Dimopoulos, Meletios Α.; Hamilos, George; Zervas, Konstantinos; Symeonidis, Argiris; Kouvatseas, G.; Roussou, Paraskevi; Gika, Dimitra; Karmiris, Themis; Bourantas, Konstantinos L.; Zomas, Athanasios; Mitsouli, C.; Xilouri, Irini; Vervessou, Elina; Matsis, K.; Anagnostopoulos, Nicolaos; Economopoulos, T.

doi:10.1093/annonc/mdg334

Cited by 44 publications

(16 citation statements)

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“…Other adverse characteristics found in 3 or more studies were leucopenia, 6,7,20 high concentration of serum IgM paraprotein, 7,9,22 the pattern or the percentage of bone marrow infiltration, 18,19,23 a poor performance status, 18,20 and the presence of constitutional symptoms. 6,9,19,21 From these analyses, few prognostic indices have been proposed, but none of them has been widely accepted and used. Finally, in most series, both asymptomatic and symptomatic patients have been included.…”

Section: Introductionmentioning

confidence: 99%

“…11 Therefore, agreement in the treatment algorithm of WM patients would be greatly facilitated by the availability of a simple and accurate prognostic index for overall survival similar to the International Prognostic Index for aggressive non-Hodgkin lymphoma, 15 the Follicular Lymphoma International Prognostic Index, 16 or the International Staging System for Multiple Myeloma. 17 In retrospective analyses, advanced age, [6][7][8][9][18][19][20][21][22] low hemoglobin concentration, [6][7][8][9][19][20][21][22] low platelet count, [6][7][8][18][19][20][21] low albumin concentration, 7,8,19,22 and elevated serum ␤2-microglobulin [7][8][9]19,20 were constantly associated with a poor clinical outcome. Other adverse characteristics found in 3 or more studies were leucopenia, 6,7,20 high concentration of serum IgM paraprotein, 7,9,22 the pattern or the percentage of bone marrow infiltration, 18,19,23 a poor performance status, 18,…”

Section: Introductionmentioning

confidence: 99%

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International prognostic scoring system for Waldenström macroglobulinemia

Morel¹,

Duhamel

Gobbi

et al. 2009

Blood

362

241

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Recently, many new drugs have been developed for the treatment of Waldenströ m macroglobulinemia (WM). To optimize the treatment according to the prognosis and to facilitate the comparison of trials, we developed an International Prognostic Scoring System for WM in a series of 587 patients with clearly defined criteria for diagnosis and for initiation of treatment. The median survival after treatment initiation was 87 months. Five adverse covariates were identified: advanced age (>65 years), hemoglobin less than or equal to 11.5 g/dL, platelet count less than or equal to 100 ؋ 10 9 /L, ␤2-microglobulin more than 3 mg/L, and serum monoclonal protein concentration more than 7.0 g/dL. Low-risk patients (27%) presented with no or 1 of the adverse characteristics and advanced age, intermediate-risk patients (38%) with 2 adverse characteristics or only advanced age, and high-risk patients (35%) with more than 2 adverse characteristics. Five-year survival rates were 87%, 68%, and 36%, respectively (P < .001). The ISSWM retained its prognostic significance in subgroups defined by age, treatment with alkylating agent, and purine analog. Thus, the ISSWM may provide a means to design risk-adapted studies. However, independent validation and new biologic markers may enhance its significance. (Blood. 2009;113:4163-4170)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

International prognostic scoring system for Waldenström macroglobulinemia

Morel¹,

Duhamel

Gobbi

et al. 2009

Blood

362

241

View full text Add to dashboard Cite

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“…Age had a poor prognostic significance in most studies. [19][20][21][22][23][24] Indeed, a large proportion of patients die from unrelated causes because of their advanced age at diagnosis. Several studies have shown a negative prognostic influence of high monoclonal IgM levels 22,25 but Dhodapkhar et al 5,26 found that patients with a low monoclonal concentration and a high beta 2 microglobulin had poor outcomes.…”

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confidence: 99%

Fludarabine plus cyclophosphamide in Waldenström's macroglobulinemia: results in 49 patients

et al. 2005

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“…WM remains an incurable disease with an overall medial survival of only 5-6 years and a median disease specific survival of 11.2 years 7 . Factors associated with poor prognosis include advanced age, high β2-microglobulin (β2M), cytopenias, low albumin, serum IgM monoclonal protein, and organomegaly [7][8][9][10][11] . Based on a series of 587 patients, an international prognostic scoring system (ISS-WM) was recently presented, table 1.…”

Section: Introductionmentioning

confidence: 99%

New therapeutic approaches for Waldenstrom macroglobulinemia

Stedman¹,

Roccaro²,

Leleu³

et al. 2010

Drugs Fut

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Waldenstrom Macroglobulinemia (WM) is a B-cell disorder characterized by the infiltration of the bone marrow (BM) with lymphoplasmacytic cells, as well as detection of an IgM monoclonal gammopathy in the serum. WM is an incurable disease, with an overall medial survival of only 5-6 years. First-line therapy of WM has been based on single-agent or combination therapy with alkylator agents (e.g. chlorambucil or cyclophasphamide), nucleoside analogues (cladribine or fludarabine), and the monoclonal antibody rituximab. Novel therapeutic agents that have demonstrated efficacy in WM include thalidomide, lenalidomide, bortezomib, everolimus, Atacicept, and perifosine. The range of the ORR to these agents is between 25-80%. Ongoing and planned future clinical trials include those using PKC inhibitors such as enzastaurin, new proteasome inhibitors such as carfilzomib, histone deacetylase inhibitors such as panobinostat, humanized CD20 antibodies such as Ofatumumab, and additional alkylating agents such as bendamustine. These agents, when compared to traditional chemotherapeutic agents, may lead in the future to higher responses, longer remissions and better quality of life for patients with WM.

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Survival and prognostic factors after initiation of treatment in Waldenstrom’s macroglobulinemia

Cited by 44 publications

References 16 publications

International prognostic scoring system for Waldenström macroglobulinemia

International prognostic scoring system for Waldenström macroglobulinemia

Fludarabine plus cyclophosphamide in Waldenström's macroglobulinemia: results in 49 patients

New therapeutic approaches for Waldenstrom macroglobulinemia

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