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: The combination of bortezomib and rituximab was evaluated in patients with mantle cell lymphoma (MCL), follicular lymphoma (FL) and Waldenström macroglobulinaemia (WM), in a Phase I and later, a randomized Phase II study. In the randomized study, 42 patients with recurrent/refractory disease received either: bortezomib 1·3 mg/m(2) on days 1, 4, 8 and 11 of a 3-week cycle with rituximab 375 mg/m(2) on day 1 (21 patients) or: bortezomib 1·6 mg/m(2) and rituximab on days 1, 8, 15 and 22 of a 5-week cycle (with rituximab being given only in cycles 1 and 4).Twenty-eight patients were withdrawn (toxicity 16, progression 7, and 'patient choice' 5). The main toxicities were neurological, gastro-intestinal and haematological. The overall response rate was 28/42(67%) and by histology: MCL 11/19, FL 8/15, and WM 9/10. Ten of 28 responding patients remained progression-free at 1-3·5 years. Toxicity and efficacy were equivalent between the two groups. The combination has significant toxicity but is effective, particularly in patients with WM.British Journal of Haematology 11/2010; 151(4):346-53. · 4.94 Impact Factor
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ABSTRACT: The International Scoring System for Waldenstrom Macroglobulinemia (ISSWM) has been designed for patients requiring a first line therapy. In order to identify patients who may need reinforced therapy later during the follow-up, we assessed in 51 patients the prognostic role of ISSWM before a salvage therapy including fludarabine.ISSWM-risk before salvage regimen was low, intermediate and high in 22, 33, and 45% of patients respectively. The 2-year subsequent survival was 66% in high-risk patients and 96% in remaining patients (p=0.019). No difference was found between low and intermediate-risk patients. In the salvage setting, response was associated with prolonged survival (p=0.005). In conclusion, ISSWM is effective for identifying high-risk patients in advanced phase. Therefore, ISSWM should be reported for all treatment studies in WM patients. Response to salvage regimen retained prognostic value for subsequent survival in patients with advanced WM.Haematologica 03/2011; 96(5):785-8. · 5.94 Impact Factor