title: Fludarabine therapy in Waldenström's macroglobulinemia.
abstract: OBJECTIVE
  To assess the response rate, remission duration, and survival of patients with Waldenström's macroglobulinemia treated with the adenine nucleoside analogue fludarabine.
  
  
  METHODS
  Twenty-eight patients with Waldenström's macroglobulinemia, of whom only 2 were previously untreated, received fludarabine at a dose of 20 to 30 mg/m2 intravenously daily for 5 days (20 patients) or 30 mg/m2 intravenously daily for 3 days (8 patients). Treatment was continued until maximum response was achieved. Responding patients were followed with no further treatment until relapse.
  
  
  RESULTS
  Ten patients responded (36%), including the 2 previously untreated patients and 8 of 26 patients (31%) who were resistant to prior therapies. Unmaintained remissions lasted for a median of 38 months. There were no fatalities associated with this treatment. Previously untreated patients and those with a primary resistant disease of relatively short duration were more likely to benefit from this treatment.
  
  
  CONCLUSIONS
  Fludarabine is an effective salvage agent for the treatment of patients with resistant Waldenström's macroglobulinemia. Further investigations of fludarabine in untreated patients and in combination with other active agents are warranted.
authors.affiliation: Department of Hematology, MD Anderson Cancer Center, Houston, Texas 77030.
authors.forename: M A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: S
authors.initials: S
authors.lastname: O'Brien
authors.forename: H
authors.initials: H
authors.lastname: Kantarjian
authors.forename: S
authors.initials: S
authors.lastname: Pierce
authors.forename: K
authors.initials: K
authors.lastname: Delasalle
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
authors.forename: R
authors.initials: R
authors.lastname: Alexanian
authors.forename: M J
authors.initials: MJ
authors.lastname: Keating
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine