TY - JOUR
T1 - No significant improvement in the outcome of patients with Waldenström's macroglobulinemia treated over the last 25 years
AU - Kastritis, Efstathios
AU - Kyrtsonis, Marie Christine
AU - Hatjiharissi, Evdoxia
AU - Symeonidis, Argiris
AU - Michalis, Eurydiki
AU - Repoussis, Panagiotis
AU - Tsatalas, Konstantinos
AU - Michael, Michael
AU - Sioni, Anastasia
AU - Kartasis, Zafiris
AU - Stefanoudaki, Ekaterini
AU - Voulgarelis, Michael
AU - Delimpasi, Sosana
AU - Gavriatopoulou, Maria
AU - Koulieris, Efstathios
AU - Gika, Dimitra
AU - Vervesou, Elissavet
AU - Konstantopoulos, Konstantinos
AU - Kokkini, Garyfalia
AU - Zomas, Athanasios
AU - Roussou, Paraskevi
AU - Anagnostopoulos, Nikolaos
AU - Economopoulos, Theofanis
AU - Terpos, Evangelos
AU - Zervas, Konstantinos
AU - Dimopoulos, Meletios A.
PY - 2011/6
Y1 - 2011/6
N2 - The treatment of Waldenström's macroglobulinemia (WM) has changed over the last decades, mainly because of the introduction of nucleoside analogues and of rituximab while novel agents such as bortezomib have been recently introduced. We performed an analysis to investigate whether the outcome of patients with WM has improved over the last years, compared to that of patients who started treatment before new drugs became widely available, especially as part of the frontline treatment. We analyzed 345 symptomatic patients with WM: 130 who initiated treatment before and 215 who started treatment after January 1, 2000. Patients who started treatment in the latter group were older and had more often elevated beta2-microglobulin but the other characteristics were similar between the two groups. Most patients who started treatment before January 1, 2000 were treated upfront with alkylating agent-based regimens and most patients who started treatment after January 1, 2000 received rituximab-based regimens as initial treatment. Objective response (63 and 59%, respectively) and median overall survival, OS, (106.5 months for Group A and is estimated at 94 months for Group B, P = 0.327) were similar. There was also no difference regarding OS or cause specific survival (CSS) in each risk group according to IPSSWM. Our observation may be explained by the indolent course of WM in several patients and by the lack of profound cytoreduction in patients with high-risk disease. Possible differences in the 15- or 20-year survival rate between the two groups may be detected with further follow-up of these patients.
AB - The treatment of Waldenström's macroglobulinemia (WM) has changed over the last decades, mainly because of the introduction of nucleoside analogues and of rituximab while novel agents such as bortezomib have been recently introduced. We performed an analysis to investigate whether the outcome of patients with WM has improved over the last years, compared to that of patients who started treatment before new drugs became widely available, especially as part of the frontline treatment. We analyzed 345 symptomatic patients with WM: 130 who initiated treatment before and 215 who started treatment after January 1, 2000. Patients who started treatment in the latter group were older and had more often elevated beta2-microglobulin but the other characteristics were similar between the two groups. Most patients who started treatment before January 1, 2000 were treated upfront with alkylating agent-based regimens and most patients who started treatment after January 1, 2000 received rituximab-based regimens as initial treatment. Objective response (63 and 59%, respectively) and median overall survival, OS, (106.5 months for Group A and is estimated at 94 months for Group B, P = 0.327) were similar. There was also no difference regarding OS or cause specific survival (CSS) in each risk group according to IPSSWM. Our observation may be explained by the indolent course of WM in several patients and by the lack of profound cytoreduction in patients with high-risk disease. Possible differences in the 15- or 20-year survival rate between the two groups may be detected with further follow-up of these patients.
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U2 - 10.1002/ajh.22027
DO - 10.1002/ajh.22027
M3 - Article
C2 - 21509798
AN - SCOPUS:79956137322
SN - 0361-8609
VL - 86
SP - 479
EP - 483
JO - American journal of hematology
JF - American journal of hematology
IS - 6
ER -