Treatment and outcome patterns of patients with Waldenström’s macroglobulinemia: a large, multicenter retrospective review in China

Cao, Xinxin; Yi, Shuhua; Jiang, Zhongxing; He, Jingsong; Yang, Wei; Du, Juan; Sun, Chaoyang; Wu, Yuzhang; Chen, Wen-Ming; Liu, Xiaojun; Li, Bing‐Zong; Li, Chunrui; Sang, Wei; Liu, Qinhua; Chu, Xiaoxia; Li, Fēi; Bai, Ou; Mao, Min; Fu, Rong; Wang, Wei; Wang, Luqun; Dong, Yujun; Luo, Jun; Li, Zhenling; Wei, Yongqiang; Zhang, Qi-Ke; Liu, Jing; Ding, Kaiyang; Zou, Liang; Hua, Luoming; Jing, Hongmei; He, Jiacai; Wang, Liang; Li, Jian; Qiu, Lugui

doi:10.1080/10428194.2021.1938030

Cited by 11 publications

(12 citation statements)

References 18 publications

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“…Despite recent improvements in treatment strategies, including rituximab, proteasome inhibitors, bendamustine, and BTK-inhibitors, Waldenström macroglobulinemia (WM) remains an incurable disease [1,2]. Our understanding of the pathogenesis and immune escape mechanisms of WM is still limited [3].…”

Section: Introductionmentioning

confidence: 99%

Single-cell profiles reveal tumor cell heterogeneity and immunosuppressive microenvironment in Waldenström macroglobulinemia

et al. 2022

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Background Waldenström macroglobulinemia (WM) is a rare and incurable indolent B-cell malignancy. The molecular pathogenesis and the role of immunosuppressive microenvironment in WM development are still incompletely understood. Methods The multicellular ecosystem in bone marrow (BM) of WM were delineated by single-cell RNA-sequencing (scRNA-seq) and investigated the underlying molecular characteristics. Results Our data uncovered the heterogeneity of malignant cells in WM, and investigated the kinetic co-evolution of WM and immune cells, which played pivotal roles in disease development and progression. Two novel subpopulations of malignant cells, CD19+CD3+ and CD138+CD3+, co-expressing T-cell marker genes were identified at single-cell resolution. Pseudotime-ordered analysis elucidated that CD19+CD3+ malignant cells presented at an early stage of WM-B cell differentiation. Colony formation assay further identified that CD19+CD3+ malignant cells acted as potential WM precursors. Based on the findings of T cell marker aberrant expressed on WM tumor cells, we speculate the long-time activation of tumor antigen-induced immunosuppressive microenvironment that is involved in the pathogenesis of WM. Therefore, our study further investigated the possible molecular mechanism of immune cell dysfunction. A precursor exhausted CD8-T cells and functional deletion of NK cells were identified in WM, and CD47 would be a potential therapeutic target to reverse the dysfunction of immune cells. Conclusions Our study facilitates further understanding of the biological heterogeneity of tumor cells and immunosuppressive microenvironment in WM. These data may have implications for the development of novel immunotherapies, such as targeting pre-exhausted CD8-T cells in WM.

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Section: Introductionmentioning

confidence: 99%

Single-cell profiles reveal tumor cell heterogeneity and immunosuppressive microenvironment in Waldenström macroglobulinemia

et al. 2022

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“…Similarly to other indolent lymphomas, treatment is indicated for WM/LPL only in cases of symptomatic disease, but the treatment landscape of WM/LPL is heterogeneous. The treatment regimens may depend on patients' age, performance status, comorbidities, genomic profiles, and economic aspects 5,29 . In our cohort, the most commonly used regimen was immunochemotherapy with rituximab (63.6% of the patients), followed by chlorambucil-containing regimens, other combination of chemotherapy, and single-agent rituximab.…”

Section: Discussionmentioning

confidence: 99%

“…A cohort study with 1141 patients showed the 3-year overall survival (OS) rate was 82.7%, and older age, elevated lactate dehydrogenase (LDH) and β 2 -microglobulin, thrombocytopenia, and hypoalbuminemia were negative prognostic factors for OS. 5 The International Prognostic Staging System for WM (IPSS-WM) is most commonly used to assess the prognosis of WM/LPL. It incorporates 5 adverse factors (age >65 years, hemoglobin ≤115 g/L, platelet count ≤100 Â 10 9 /L, β 2 -microglobulin >3 mg/L, and serum IgM >70 g/L) to stratify patients into low-, intermediate-, and high-risk groups.…”

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confidence: 99%

“…Comparing with other types of lymphoma, WM/LPL is an indolent disease with long survival, but patients' outcomes vary. A cohort study with 1141 patients showed the 3-year overall survival (OS) rate was 82.7%, and older age, elevated lactate dehydrogenase (LDH) and β 2 -microglobulin, thrombocytopenia, and hypoalbuminemia were negative prognostic factors for OS 5 . The International Prognostic Staging System for WM (IPSS-WM) is most commonly used to assess the prognosis of WM/LPL.…”

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confidence: 99%

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Baseline 18F-FDG PET/CT May Portend the Prognosis of Patients With Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma After First-Line Treatment

et al. 2022

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PurposeThe outcome of patients with Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) is variable. We aim to study if baseline 18F-FDG PET/CT has some prognostic significance in WM/LPL.MethodsThirty-three patients with newly diagnosed WM/LPL who underwent baseline 18F-FDG PET/CT and received active treatment thereafter were recruited in this retrospective study. Semiquantitative indices of baseline 18F-FDG PET/CT were measured as total lesion glycolysis (TLG), metabolic tumor volume (MTV), and SUVmax. The patients were followed up for at least 3 years or until reaching the endpoint, which were defined as progression-free survival (PFS) and the time to next treatment (TTNT).ResultsThe overall response rate of the first-line treatment in the recruited patients was 84.8% (28/33). The 3-year PFS and overall survival rates were 56.3% and 89.3%, respectively. Patients with PFS <36 months and TTNT <36 months showed TLG and MTV significantly higher than those with PFS ≥36 months and TTNT ≥36 months (P < 0.05). SUVmax in patients with PFS <36 months was significantly higher than those with PFS ≥36 months (P = 0.033). Receiver operating characteristic analysis demonstrated that cutoff values of TLG >291.28 SUVbw * mL, MTV >108.78 mL, and SUVmax >3.16 were optimal for predicting PFS <36 months. Kaplan-Meier analysis showed that TLG >291.28 SUVbw * mL and MTV >108.78 mL were predictive for shorter PFS (P = 0.003) and TTNT (P = 0.002). In multivariate analysis, TLG >291.28 SUVbw * mL and MTV >108.78 mL were independent predictors for shorter PFS (hazard ratio, 3.06; 95% confidence interval, 1.09–8.57; P = 0.033) and TTNT (hazard ratio, 10.01; 95% confidence interval, 2.56–39.22; P = 0.001).ConclusionsThe metabolic indices of TLG and MTV in baseline 18F-FDG PET/CT were independent prognostic factors to predict PFS and TTNT in patients with WM/LPL.

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“…Among the cytogenetic aberrations, trisomy 12 was statistically significantly associated with neutrophil count ≤1.5 × 10 9 /L (60.0% [3/5] Currently, the clinical characteristics and treatment outcomes of WM patients from multicenters in China have been reported, [7] while the cytogenetic landscape of Chinese patients still remains largely unexplored. Our study provided a comprehensive landscape on cytogenetic aberration in Chinese patients with LPL/WM, and it might well complement the understanding of LPL/WM in Chinese patients.…”

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confidence: 99%

Cytogenetic aberrations of lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia in Chinese patients

Xiong

Wang

et al. 2023

Chinese Medical Journal

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Treatment and outcome patterns of patients with Waldenström’s macroglobulinemia: a large, multicenter retrospective review in China

Cited by 11 publications

References 18 publications

Single-cell profiles reveal tumor cell heterogeneity and immunosuppressive microenvironment in Waldenström macroglobulinemia

Single-cell profiles reveal tumor cell heterogeneity and immunosuppressive microenvironment in Waldenström macroglobulinemia

Baseline 18F-FDG PET/CT May Portend the Prognosis of Patients With Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma After First-Line Treatment

Cytogenetic aberrations of lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia in Chinese patients

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