Waldenström's macroglobulinemia: prognostic factors and recent therapeutic advances.
Waldenström's macroglobulinemia is a rare B cell malignancy. All prognostic studies have identified the adverse prognostic effect of advanced age and low hemoglobin level for survival, whereas the prognostic value of a high level of monoclonal component remains controversial. Response to treatment is probably a favorable prognostic factor for overall survival. Conventional treatment is based on alkylating agents, and especially chlorambucil. Purine analogues, used initially for salvage treatment, are increasingly employed as front-line therapy. Purine analogues have not been compared with alkylating agents as first-line therapy in randomized trials, and it is unclear whether purine analogues extend survival. An anti-CD20 monoclonal antibody has given a response rate in about 30% of patients. Autologous and allogeneic stem cell transplantation may be considered for patients with refractory or relapsing disease.
Leblond
V
V
Service d'Hématologie, Hopital Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France. veronique.leblond@psl.ap-hop-paris.fr
Tournilhac
O
O
Morel
P
P
D003131:Combined Modality Therapy; D006801:Humans; D011379:Prognosis; D008258:Waldenstrom Macroglobulinemia / Q000175:diagnosis* / Q000628:therapy*