Update on recommendations for assessing response from the Third International Workshop on Waldenstrom's Macroglobulinemia.
ABSTRACT This report by an international consensus panel updates current recommendations for defining clinical response in Waldenstrom's macroglobulinemia (WM). The previously published response criteria incorporated parameters for monoclonal protein reduction and/or improvement of marrow and nodal involvement, and included definitions of complete and partial remissions. The criteria have been updated to include minor response and stable disease categories. In addition, the criteria now recognize that delayed responses after treatment with nucleoside analogues and biologic agents and the time point for assessing response in patients with WM should be considered so as to not miss or miscategorize a response. The new criteria should therefore help in better delineating responses to therapy in patients with WM, particularly with the wide use of nucleoside analogues and biologically based agents for this disease.
- SourceAvailable from: PubMed CentralTurkish Journal of Haematology 12/2013; 30(4):422-3. · 0.49 Impact Factor
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ABSTRACT: Serum immunoglobulin (Ig) M monoclonal protein determined by electrophoresis (sIgM-MP) and total serum IgM (sIgM) by nephelometry are widely used for response assessment in Waldenström macroglobulinemia (WM), although have not been compared for predicting changes in underlying disease burden. We, therefore, compared these serum markers with changes in bone marrow (BM) and extramedullary disease for 73 patients who were rituximab naive and treated with a rituximab-containing regimen. By linear regression analysis, reductions in sIgM-MP and sIgM showed moderate correlation with BM disease involvement (r = 0.4051 and r = 0.4490, respectively), and did not differ from one another as estimators of BM disease response (P = .3745). Neither sIgM-MP nor sIgM showed a strong correlation with BM disease response in patients with low (<1000 mg/dL) or high (>5000 mg/dL) IgM levels and extramedullary disease response. sIgM-MP and sIgM, therefore, are comparable response markers in WM. Development of newer, more accurate surrogate response markers are needed to better delineate treatment outcomes in patients with WM and with low or high IgM levels, and extramedullary disease.Clinical lymphoma, myeloma & leukemia 04/2013; 13(2):250-2.
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ABSTRACT: BACKGROUND: The B-lymphocyte stimulator (BLYS) protein is known to regulate immunoglobulin in normal B cells, and be overexpressed in B-cell malignancies, including Waldenstrom macroglobulinemia (WM). PATIENTS AND METHODS: This trial evaluated the safety and activity of belimumab, a monoclonal antibody targeting BLYS, in 12 patients with WM in a single-arm phase II study. RESULTS: Ten patients had stable disease with therapy, although no objective responses were seen. Correlative studies showed patients to have low or undetectable baseline serum levels of BLYS, with the administration of belimumab having no effect on B-cell numbers. CONCLUSION: Belimumab cannot be recommended as a single-agent therapy for the treatment of symptomatic WM, although further evaluation in combination with other agents would be justified.Clinical lymphoma, myeloma & leukemia 06/2013;