title: No significant improvement in the outcome of patients with Waldenström's macroglobulinemia treated over the last 25 years.
abstract: The treatment of Waldenström's macroglobulinemia (WM) has changed over the last decades, mainly because of the introduction of nucleoside analogues and of rituximab while novel agents such as bortezomib have been recently introduced. We performed an analysis to investigate whether the outcome of patients with WM has improved over the last years, compared to that of patients who started treatment before new drugs became widely available, especially as part of the frontline treatment. We analyzed 345 symptomatic patients with WM: 130 who initiated treatment before and 215 who started treatment after January 1, 2000. Patients who started treatment in the latter group were older and had more often elevated beta2-microglobulin but the other characteristics were similar between the two groups. Most patients who started treatment before January 1, 2000 were treated upfront with alkylating agent-based regimens and most patients who started treatment after January 1, 2000 received rituximab-based regimens as initial treatment. Objective response (63 and 59%, respectively) and median overall survival, OS, (106.5 months for Group A and is estimated at 94 months for Group B, P = 0.327) were similar. There was also no difference regarding OS or cause specific survival (CSS) in each risk group according to IPSSWM. Our observation may be explained by the indolent course of WM in several patients and by the lack of profound cytoreduction in patients with high-risk disease. Possible differences in the 15- or 20-year survival rate between the two groups may be detected with further follow-up of these patients.
authors.affiliation: Department of Clinical Therapeutics, University of Athens School of Medicine, 80 Vas Sofias Ave. 115 28, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Kastritis
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Kyrtsonis
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Hatjiharissi
authors.forename: Argiris
authors.initials: A
authors.lastname: Symeonidis
authors.forename: Eurydiki
authors.initials: E
authors.lastname: Michalis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Repoussis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsatalas
authors.forename: Michael
authors.initials: M
authors.lastname: Michael
authors.forename: Anastasia
authors.initials: A
authors.lastname: Sioni
authors.forename: Zafiris
authors.initials: Z
authors.lastname: Kartasis
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Stefanoudaki
authors.forename: Michael
authors.initials: M
authors.lastname: Voulgarelis
authors.forename: Sosana
authors.initials: S
authors.lastname: Delimpasi
authors.forename: Maria
authors.initials: M
authors.lastname: Gavriatopoulou
authors.forename: Efstathios
authors.initials: E
authors.lastname: Koulieris
authors.forename: Dimitra
authors.initials: D
authors.lastname: Gika
authors.forename: Elissavet
authors.initials: E
authors.lastname: Vervesou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Konstantopoulos
authors.forename: Garyfalia
authors.initials: G
authors.lastname: Kokkini
authors.forename: Athanasios
authors.initials: A
authors.lastname: Zomas
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Roussou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Anagnostopoulos
authors.forename: Theofanis
authors.initials: T
authors.lastname: Economopoulos
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zervas
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement / Q000639:trends; D000069283:Rituximab; D015996:Survival Rate; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy* / Q000401:mortality*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000069283:Rituximab