Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Ansell, Stephen M.; Kyle, Robert A.; Reeder, Craig B.; Fonseca, Rafaël; Mıkhael, Joseph; Morice, William G.; Bergsagel, P. Leif; Buadi, Francis K.; Colgan, Joseph P.; Dingli, David; Dispenzieri, Angela; Greipp, Philip R.; Habermann, Thomas M.; Hayman, Suzanne R.; Inwards, David J.; Johnston, Patrick B.; Kumar, Shaji; Lacy, Martha Q.; Lust, John A.; Markovic, Svetomir N.; Micallef, Ivana N.; Nowakowski, Grzegorz S.; Porrata, Luis F.; Roy, Vivek; Russell, Stephen J.; Short, Kristen E. Detweiler; Stewart, A. Keith; Thompson, Carrie A.; Witzig, Thomas E.; Zeldenrust, Steven R.; Dalton, Robert J.; Rajkumar, S. Vincent; Gertz, Morie A.

doi:10.4065/mcp.2010.0304

Cited by 148 publications

(156 citation statements)

References 71 publications

(66 reference statements)

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“…Mayo Clinic Proceedings has published numerous articles highlighting the current treatment of cancer. [13][14][15][16][17] Most cancers are not curable, and most approved cancer drugs work only for a limited time. When one treatment fails, the patient will be treated with subsequent agents until all options are exhausted.…”

Section: Why Are Cancer Drugs So Expensive?mentioning

confidence: 99%

The High Cost of Cancer Drugs and What We Can Do About It

Siddiqui

Rajkumar

2012

Mayo Clinic Proceedings

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210

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Section: Why Are Cancer Drugs So Expensive?mentioning

confidence: 99%

The High Cost of Cancer Drugs and What We Can Do About It

Siddiqui

Rajkumar

2012

Mayo Clinic Proceedings

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210

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“…3 There is a study that suggests bimonthly/quarterly follow-ups during the first year after diagnosis and, if remaining stable, monitoring should be quarterly/half-yearly in the following years. 62 Patients with WM are candidates for treatment if they have clinical evidence of aggressive disease progression or if they have had clinical and laboratory manifestations associated with WM, such as lymphadenopathy or splenomegaly, symptoms of hyperviscosity, severe peripheral neuropathy, AL amyloidosis (resulting in tissue deposition of light immunoglobulin chains), cryoglobulinemia, autoimmune hemolytic anemia, hemoglobin concentration <10 g/dL and/or platelet count <100x10 9 /L.…”

Section: Prognosis Of Symptomatic Wmmentioning

confidence: 99%

“…63 In fact, the choice of treatment is a critical option and should not be taken so as to limit future options, since all patients will inevitably present relapses after initial treatment, requiring treatment. 3 Age, the presence of cytopenia, the need to control the disease and the possibility of autologous stem cell transplantation should be considered in the approach to treatment. 63 First-line therapy includes alkylating agents, purine analogs and monoclonal anti-CD20 antibodies.…”

Section: Prognosis Of Symptomatic Wmmentioning

confidence: 99%

Waldenström's macroglobulinemia - a review

Coimbra

Neves

Lima

et al. 2014

Rev. Assoc. Med. Bras.

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Waldenström's macroglobulinemia (WM) is a lymphoproliferative disease of B lymphocytes, characterized by a lymphoplasmocytic lymphoma in the bone marrow and by IgM monoclonal hypergammaglobulinemia. It was first described in 1944 by Jan Gösta Waldenström, reporting two patients with oronasal bleeding, lymphadenopathy, anemia, thrombocytopenia, high erythrocyte sedimentation rate and serum viscosity, normal radiography and bone marrow infiltrated by lymphoid cells. The WM is a rare disease with a typically indolent clinical course, affecting mainly individuals aged between 63 and 68 years. Most patients have clinical signs and symptoms related to hyperviscosity resulting from IgM monoclonal gammopathy, and/or cytopenias resulting from bone marrow infiltration by lymphoma. The differential diagnosis with other lymphomas is essential for the assessment of prognosis and therapeutic approach. Treatment of patients with asymptomatic WM does not improve the quality of life of patients, or increase their survival, being recommended, therefore, their follow-up. For the treatment of symptomatic patients, alkylating agents, purine analogs and anti-CD20 monoclonal antibodies are used. However, the disease is incurable and the response to therapy is not always favorable. Recent studies have shown promising results with bortezomib, an inhibitor of proteasomes, and some patients respond to thalidomide. In patients with relapse or refractory to therapy, autologous transplantation may be indicated. The aim of this paper is to describe in detail the current knowledge on the pathophysiology of WM, main clinical manifestations, diagnosis, prognosis and treatment.

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“…33 Moreover, purine nucleoside analogs need to be avoided in the induction therapy of these patients. Treatment recommendations from the Fourth International Workshop on Waldenströ m Macroglobulinemia 34 and from Mayo Clinic mSMART guidelines 4 specifically advise avoidance of purine nucleoside analogs if the patient is a candidate for an autologous transplant. 34 The ability to successfully mobilize stem cells is directly related to the number of lines of prior chemotherapy that have been administered.…”

Section: Autologous Stem Cell Transplantmentioning

confidence: 99%

“…Many patients have a presymptomatic phase; although they fulfill all other criteria for the diagnosis, they do not require therapy. 4 The cells express pan B-cell markers and are usually positive for CD5, CD20, CD10 and CD23 and are negative for CD3 and CD103. 5 The 6q deletion is present in 42% of patients and is associated with an adverse prognosis.…”

Section: Introductionmentioning

confidence: 99%

Stem cell transplant for Waldenström macroglobulinemia: an underutilized technique

Gertz

Reeder

Kyle

et al. 2011

Bone Marrow Transplant

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Waldenströ m macroglobulinemia is a highly chemosensitive lymphoplasmacytic lymphoma with response rates of 90% to firstline chemotherapy. The fraction of patients undergoing stem cell transplant for this disorder appears to be lower than that of patients with multiple myeloma. The indolent nature and favorable genetic profile should make Waldenströ m an ideal disorder for autologous stem cell transplant, with high response rates that are durable. We review the literature on autologous and allogeneic transplants for Waldenströ m macroglobulinemia and conclude that autologous transplant is effective and underutilized in the management of this disorder. Allogeneic transplant should be considered investigational and used only in the context of a clinical trial or when other chemotherapeutic options have been exhausted.

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Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Cited by 148 publications

References 71 publications

The High Cost of Cancer Drugs and What We Can Do About It

The High Cost of Cancer Drugs and What We Can Do About It

Waldenström's macroglobulinemia - a review

Stem cell transplant for Waldenström macroglobulinemia: an underutilized technique

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