Treatment of Waldenstrom's Macroglobulinemia with Rituximab: Prognostic Factors for Response and Progression
- 1 October 2004
- journal article
- clinical trial
- Published by Taylor & Francis Ltd in Leukemia & Lymphoma
- Vol. 45 (10), 2057-2061
- https://doi.org/10.1080/10428190410001723287
Abstract
Recent data have suggested that rituximab is an active agent for the treatment of Waldenstrom's macroglobulinemia (WM). However, the patients that are more likely to benefit have not been clearly defined. In order to address this question we evaluated 52 patients who were treated with single-agent rituximab in the context of prospective studies. Several clinical and laboratory variables were assessed for their correlation with response and time to progression. Twenty-three (44%) patients achieved a partial response after treatment with rituximab. Previously untreated and pretreated patients had the same probability for response. Higher response rates were noted in patients with serum monoclonal protein < 40 g/l, with serum albumin > or = 35 g/l and with kappa light chain. The median time to progression for all patients was 13.8 months. A multivariate analysis indicated that elevated serum monoclonal protein levels and low serum albumin were the dominant variables associated with shorter progression. Presence of two, one or none of these adverse prognostic factors was associated with time to progression of 3.6 months, 11 months and more than 40 months, respectively. We conclude that rituximab is an effective treatment modality for patients with WM. Patients with both low levels of monoclonal protein and normal albumin are the best candidates for treatment with standard dose rituximab.This publication has 7 references indexed in Scilit:
- 2-chlorodeoxyadenosine alone and in combination for previously untreated Waldenstrom's macroglobulinemiaSeminars in Oncology, 2003
- CD20-Directed Antibody-Mediated Immunotherapy Induces Responses and Facilitates Hematologic Recovery in Patients With Waldenstrom’s MacroglobulinemiaJournal of Immunotherapy, 2001
- World Health Organization Classification of Neoplastic Diseases of the Hematopoietic and Lymphoid Tissues: Report of the Clinical Advisory Committee Meeting—Airlie House, Virginia, November 1997Journal of Clinical Oncology, 1999
- Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program.Journal of Clinical Oncology, 1998
- IDEC-C2B8 (Rituximab) Anti-CD20 Monoclonal Antibody Therapy in Patients With Relapsed Low-Grade Non-Hodgkin's LymphomaBlood, 1997
- Primary therapy of Waldenström's macroglobulinemia with 2-chlorodeoxyadenosine.Journal of Clinical Oncology, 1994
- Transitions in CD45 isoform expression indicate continuous differentiation of a monoclonal CD5+ CD11b+ B lineage in Waldenstrom's macroglobulinemiaAmerican Journal of Hematology, 1991