Deepening of response after completing rituximab-containing therapy in patients with Waldenstrom macroglobulinemia.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bone Marrow
/ pathology
Female
Follow-Up Studies
Humans
Immunoglobulin M
/ blood
Maintenance Chemotherapy
Male
Middle Aged
Myeloid Differentiation Factor 88
/ genetics
Paraproteins
/ analysis
Progression-Free Survival
Receptors, CXCR4
/ genetics
Retrospective Studies
Rituximab
/ administration & dosage
Survival Analysis
Waldenstrom Macroglobulinemia
/ blood
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
20
09
2019
revised:
13
12
2019
accepted:
20
12
2019
pubmed:
24
12
2019
medline:
20
4
2021
entrez:
24
12
2019
Statut:
ppublish
Résumé
Rituximab-containing regimens are commonly used for frontline therapy in patients with symptomatic Waldenström macroglobulinemia (WM). We had observed that a portion of WM patients experienced deepening of response months to years after therapy completion. We carried a retrospective study aimed at describing this phenomenon. We gathered baseline data, and responses at end of induction, end of maintenance and best response. Deepening of response was defined as ≥25% decrease in serum IgM achieved at a later time from therapy completion. Of 178 patients included, 116 (65%) received maintenance therapy and 62 (35%) were observed. In patients who received maintenance, 44 (38%) had ≥25% decrease in serum IgM level after the end of maintenance with a median time from end of maintenance to lowest IgM level of 1.6 years (range 0.1-7.9 years). In patients who were observed, 19 (31%) had ≥25% decrease in serum IgM level after the end of induction with a median time from end of induction to lowest IgM level of 1.6 years (range 0.2-5.1 years). Baseline hemoglobin <11.5 g/dL, bone marrow involvement ≥50%, CXCR4 mutations and serum IgM ≥4000 mg/dL were associated with lower odds of deepening of response after therapy completion. Deepening of response was associated with better progression-free survival (PFS; HR 0.46, 95% CI 0.26-0.80; P = .006) and better survival after frontline treatment initiation (SAFTI; HR 0.21, 95% CI 0.06-0.73; P = .01). In conclusion, deepening of response occurs in one third of WM patients after completing rituximab-containing regimens and was associated with better PFS and SAFTI.
Substances chimiques
CXCR4 protein, human
0
Immunoglobulin M
0
MYD88 protein, human
0
Myeloid Differentiation Factor 88
0
Paraproteins
0
Receptors, CXCR4
0
Rituximab
4F4X42SYQ6
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
372-378Informations de copyright
© 2019 Wiley Periodicals, Inc.
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