title: First-line treatment of Waldenström's disease with cladribine. Arbeitsgemeinschaft Medikamentöse Tumortherapie.
abstract: OBJECTIVE
  To assess the activity and side effects of cladribine (2-CdA) treatment in patients with advanced Waldenström's disease.
  
  
  METHODS
  Ten symptomatic patients without prior therapy were included in a prospective multicenter trial. 2-CdA was administered daily at 0.12 mg/kg body weight in a 2-h i.v. infusion over 5 consecutive days: this was repeated every 28 days for four cycles. Patients achieving a remission received interferon alfa-2c (1F) 15 micrograms s.c. three times a week for 1 year.
  
  
  RESULTS
  All 10 patients responded to 2-CdA (100%; 95% confidence interval, 68-100%), with one complete (CR) and eight partial responders (PR): one patient had only one 2-CdA cycle and showed a minor improvement (MR). Patients tolerated the treatment well. Despite considerable immunosuppression, an infection occurred in only two patients. After a median observation period of 57 weeks, three patients had shown progression, including one who died of lymphoma.
  
  
  CONCLUSIONS
  2-CdA induction and IF maintenance is a well-tolerated therapy for symptomatic untreated patients with advanced Waldenström's disease and offers excellent palliation.
authors.affiliation: First Department of Medicine, AOKh-Linz, Austria.
authors.forename: M A
authors.initials: MA
authors.lastname: Fridrik
authors.forename: G
authors.initials: G
authors.lastname: Jäger
authors.forename: C
authors.initials: C
authors.lastname: Baldinger
authors.forename: O
authors.initials: O
authors.lastname: Krieger
authors.forename: A
authors.initials: A
authors.lastname: Chott
authors.forename: P
authors.initials: P
authors.lastname: Bettelheim
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017338:Cladribine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D011446:Prospective Studies; D011994:Recombinant Proteins; D012074:Remission Induction; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D007370:Interferon Type I; D011994:Recombinant Proteins; D017338:Cladribine