scholarly journals PB2017 SEQUENTIAL IMPROVEMENTS IN THE OUTCOME OF INTENSIVE INDUCTION CHEMOIMMUNOTHERAPY FOLLOWED BY AUTOLOGOUS STEM CELL TRANSPLANTATION IN PATIENTS WITH UNTREATED WALDENSTROM MACROGLOBULINEMIA.

HemaSphere ◽  
2019 ◽  
Vol 3 (S1) ◽  
pp. 912
Author(s):  
A. Grachev ◽  
E. Zvonkov ◽  
V. Ryzhko ◽  
E. Gribanova ◽  
I. Galtceva ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Waldenström Macroglobulinemia ◽  
Waldenstrom Macroglobulinemia

High-Dose Therapy and Autologous Stem-Cell Transplantation in Waldenström Macroglobulinemia: The Lymphoma Working Party of the European Group for Blood and Marrow Transplantation

2010 ◽  
Vol 28 (13) ◽  
pp. 2227-2232 ◽  
Author(s):  
Charalampia Kyriakou ◽  
Carmen Canals ◽  
David Sibon ◽  
Jean Yves Cahn ◽  
Majid Kazmi ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Marrow Transplantation ◽  
High Dose ◽  
Waldenström Macroglobulinemia ◽  
Blood And Marrow Transplantation ◽  
Waldenstrom Macroglobulinemia ◽  
European Group

Purpose The role of autologous stem-cell transplantation (ASCT) in Waldenström macroglobulinemia (WM) is not defined. The aim of this study was to analyze the results of ASCT in patients with WM and to determine the prognostic factors that have a significant impact on outcome. Patients and Methods We analyzed 158 adult patients with WM reported to the European Group for Blood and Marrow Transplantation (EBMT) between January 1991 and December 2005. Median time from diagnosis to ASCT was 1.7 years (range, 0.3 to 20.3 years), 32% of the patients experienced treatment failure with at least three lines of therapy, and 93% had sensitive disease at the time of ASCT. Conditioning regimen was total-body irradiation–based in 45 patients. Median follow-up for surviving patients was 4.2 years (range, 0.5 to 14.8 years). Results Nonrelapse mortality was 3.8% at 1 year. Ten patients developed a secondary malignancy, with a cumulative incidence of 8.4% at 5 years. Relapse rate was 52.1% at 5 years. Progression-free survival (PFS) and overall survival were 39.7% and 68.5%, respectively, at 5 years and were significantly influenced by number of lines of therapy and chemorefractoriness at ASCT. The achievement of a negative immunofixation after ASCT had a positive impact on PFS after ASCT. When used as consolidation at first response, ASCT provided a PFS of 44% at 5 years. Conclusion ASCT is a feasible procedure in young patients with advanced WM. ASCT should not be offered to patients with chemoresistant disease and to those who received more than three lines of therapy.

scholarly journals How I treat Waldenström macroglobulinemia

Blood ◽  
2015 ◽  
Vol 126 (6) ◽  
pp. 721-732 ◽  
Author(s):  
Steven P. Treon
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Proteasome Inhibitors ◽  
Nucleoside Analogs ◽  
T Cell Therapy ◽  
Familial Predisposition ◽  
Waldenström Macroglobulinemia ◽  
Waldenstrom Macroglobulinemia ◽  
Asymptomatic Patients

AbstractWaldenström macroglobulinemia (WM) is a B-cell neoplasm manifested by the accumulation of clonal immunoglobulin (Ig)M-secreting lymphoplasmacytic cells. MYD88 and CXCR4 warts, hypogammaglobulinemia, infections, myelokathexis syndrome-like somatic mutations are present in >90% and 30% to 35% of WM patients, respectively, and impact disease presentation, treatment outcome, and overall survival. Familial predisposition is common in WM. Asymptomatic patients should be observed. Patients with disease-related hemoglobin <10 g/L, platelets <100 × 109/L, bulky adenopathy and/or organomegaly, symptomatic hyperviscosity, peripheral neuropathy, amyloidosis, cryoglobulinemia, cold-agglutinin disease, or transformed disease should be considered for therapy. Plasmapheresis should be used for patients with symptomatic hyperviscosity and before rituximab for those with high serum IgM levels to preempt a symptomatic IgM flare. Treatment choice should take into account specific goals of therapy, necessity for rapid disease control, risk of treatment-related neuropathy, immunosuppression and secondary malignancies, and planning for future autologous stem cell transplantation. Frontline treatments include rituximab alone or rituximab combined with alkylators (bendamustine and cyclophosphamide), proteasome inhibitors (bortezomib and carfilzomib), nucleoside analogs (fludarabine and cladribine), and ibrutinib. In the salvage setting, an alternative frontline regimen, ibrutinib, everolimus, or stem cell transplantation can be considered. Investigational therapies under development for WM include agents that target MYD88, CXCR4, BCL2, and CD27/CD70 signaling, novel proteasome inhibitors, and chimeric antigen receptor-modified T-cell therapy.

Allogeneic Stem-Cell Transplantation in Patients With Waldenström Macroglobulinemia: Report From the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation

2010 ◽  
Vol 28 (33) ◽  
pp. 4926-4934 ◽  
Author(s):  
Charalampia Kyriakou ◽  
Carmen Canals ◽  
Jan J. Cornelissen ◽  
Gerard Socié ◽  
Roel Willemze ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Therapeutic Option ◽  
Working Party ◽  
Low Grade ◽  
Long Term Outcome ◽  
Waldenström Macroglobulinemia ◽  
Waldenstrom Macroglobulinemia

Purpose Allogeneic stem-cell transplantation (alloSCT) is a curative therapeutic option for patients with low-grade lymphoid malignancies. Information regarding alloSCT in Waldenström macroglobulinemia (WM) is limited. This study presents the long-term outcome of a large series of patients with WM treated with alloSCT. Patients and Methods A total of 86 patients received allograft by using either myeloablative (MAC; n = 37) or reduced-intensity conditioning (RIC; n = 49) regimens and were retrospectively studied. The median age was 49 years (range, 23 to 64 years); 47 patients had received three or more previous lines of therapy, and eight patients had experienced failure on a prior autologous stem-cell transplantation. A total of 59 patients (68.6%) had chemotherapy-sensitive disease at the time of alloSCT. Median follow-up of the surviving patients was 50 months (7 to 142 months). Results Nonrelapse mortality (NRM) at 3 years was 33% for MAC and 23% for RIC. The overall response rate was 75.6%. The relapse rates (RRs) at 3 years were 11% for MAC and 25% for RIC. Fourteen patients received donor lymphocyte infusions (DLIs) for disease relapse. PFS and OS at 5 years were 56% and 62% for MAC and 49% and 64% for RIC, respectively. The occurrence of chronic graft-versus-host disease (cGVHD) was associated with a higher NRM and a lower RR, leading to an improvement in PFS. Conclusion alloSCT can induce durable remissions in a selected population of young and heavily pretreated patients with WM. The low RR, the achievement of additional disease responses after DLIs, and the lower RR in patients developing cGVHD suggest the existence of a clinically relevant graft-versus-WM effect.

How I treat Waldenström macroglobulinemia

Blood ◽  
2009 ◽  
Vol 114 (12) ◽  
pp. 2375-2385 ◽  
Author(s):  
Steven P. Treon
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Specific Treatment ◽  
Familial Predisposition ◽  
Waldenström Macroglobulinemia ◽  
First Line Therapy ◽  
Waldenstrom Macroglobulinemia ◽  
Asymptomatic Patients

AbstractWaldenström macroglobulinemia (WM) is a distinct B-cell disorder resulting from the accumulation, predominantly in the bone marrow, of clonally related IgM-secreting lymphoplasmacytic cells. Genetic factors play an important role, with 20% of patients demonstrating a familial predisposition. Asymptomatic patients should be observed. Patients with a disease-related hemoglobin level less than 10 g/L, platelet count less than 100 × 109/L, bulky adenopathy or organomegaly, symptomatic hyperviscosity, peripheral neuropathy, amyloidosis, cryoglobulinemia, cold-agglutinin disease, or evidence of disease transformation should be considered for therapy. Plasmapheresis should be considered for symptomatic hyperviscosity and for prophylaxis in patients in whom rituximab therapy is contemplated. The use of rituximab as monotherapy or in combination with cyclophosphamide, nucleoside analog, bortezomib, or thalidomide-based regimens can be considered for the first-line therapy of WM and should take into account specific treatment goals, future autologous stem cell transplantation eligibility, and long-term risks of secondary malignancies. In the salvage setting, the reuse or use of an alternative frontline regimen can be considered as well as bortezomib, alemtuzumab, and stem cell transplantation. Newer agents, such as bendamustine and everolimus, can also be considered in the treatment of WM.

scholarly journals Incidence, Prevalence, Mortality, and Causes of Death in Waldenström Macroglobulinemia in South Korea: A Nationwide, Population-Based Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5654-5654
Author(s):  
Seri Jeong ◽  
Seom Gim Kong ◽  
Dajung Kim ◽  
Ho Sup Lee
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
South Korea ◽  
Cell Transplantation ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Population Based ◽  
Waldenström Macroglobulinemia ◽  
Waldenstrom Macroglobulinemia ◽  
Incidence Prevalence

Abstract Backgroud: Studies investigating the epidemiology of Waldenström macroglobulinemia (WM) in Asia are scarce. The aim of this study was to provide the epidemiological and clinical features of WM in South Korea at a national level, including incidence, prevalence, mortality, survival with competing risks, and causes of death. Methods: We used a national, population-based database maintained by the Health Insurance Review and Assessment Service, which includes information on all WM patients, diagnosed based on uniform criteria from 2003 to 2016. Results: The total number of patients newly diagnosed with WM was 429 during study period with a female to-male ratio of 3.2. The incidence from 2003 to 2016 increased from 0.03 to 0.11 per 105, and the prevalence in 2016 was 0.42 per 105. A total of 217 WM patients died during the study period (standardized mortality ratio =22.07) and the overall survival (OS) of WM patients was 47.5%. In the multivariate analysis, a significant factor associated with a worse OS was older age, whereas stem cell transplantation showed a better outcome (hazard ratio = 0.163; P = 0.0109). WM was the most common cause of death (n = 173; 79.7%), followed by other malignant neoplasms (n= 21; 9.7%). Conclusions: The national incidence of WM in Korea, a racially homogeneous country of Asia, was lower than that in previous reports from other countries, reflecting ethnic disparities. However, the incidence increased and mortality was the highest ever reported. The main cause of death was WM itself and stem cell transplantation was considerably effective. This study reflects the need for greater awareness of WM, particularly in Asian countries. Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document