Update on treatment recommendations from the Third International Workshop on Waldenstrom's macroglobulinemia.
Waldenström macroglobulinemia (WM) is a B-cell disorder characterized by the infiltration of lymphoplasmacytic cells into bone marrow and the presence of an IgM monoclonal gammopathy. As part of the Third International Workshop on WM, held October 7 to 10, 2004 in Paris, France, a consensus panel charged with providing treatment recommendations for WM updated its recommendations on both frontline and salvage therapies. The panel considered encouraging results from recent studies that addressed the use of extended-dose rituximab as well as other treatment options: therapy with either nucleoside analogs and alkylator agents, rituximab in combination with nucleoside analogs, nucleoside analogs plus alkylator agents, or combination chemotherapies, such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or cyclophosphamide and dexamethasone. The panel determined that these were reasonable treatment options for WM patients and such therapeutic approaches were likely to yield results that are at least as good as if not better than the currently recommended use of single-agent alkylator, nucleoside analog, or standard-dose rituximab therapy. Such approaches were deemed to be reasonable treatment for WM patients in both the upfront and salvage settings, though randomized studies addressing the efficacy and toxicity of such novel approaches over previously established standard of care options are needed.
Treon
Steven P
SP
Bing Program for Waldenström's Macroglobulinemia, Dana Farber Cancer Institute LG102, 44 Binney Street, Boston, MA 02115, USA. steven_treon@dfci.harvard.edu
Gertz
Morie A
MA
Dimopoulos
Meletios
M
Anagnostopoulos
Athanasios
A
Blade
Joan
J
Branagan
Andrew R
AR
Garcia-Sanz
Ramon
R
Johnson
Stephen
S
Kimby
Eva
E
Leblond
Veronique
V
Fermand
Jean-Paul
JP
Maloney
David G
DG
Merlini
Giampaolo
G
Morel
Pierre
P
Morra
Enrica
E
Nichols
Gwen
G
Ocio
Enrique M
EM
Owen
Roger
R
Stone
Marvin J
MJ
D000477:Alkylating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D009705:Nucleosides / Q000008:administration & dosage / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D000069283:Rituximab; D016879:Salvage Therapy; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy / Q000628:therapy*
D000477:Alkylating Agents; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D009705:Nucleosides; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone