“…Among 15 patients, only one patient failed to respond, with progressive disease, and six had a minor response (25–50% reduction in the level of the M protein). The risk of progression appears to be lower in patients treated with bendamustine-rituximab or bortezomib-dexamethasone-rituximab when compared to cyclophosphamide-dexamethasone-rituximab 50 – 52 .…”
Section: Therapy Of Waldenström Macroglobulinemiamentioning
Waldenström macroglobulinemia is often an indolent disorder, and many patients are candidates for observation with careful monitoring. For symptomatic patients, one must distinguish between those patients whose symptoms are related to immunologic manifestations associated with the IgM monoclonal protein and those that have symptoms related to progressive marrow and nodal infiltration with lymphoplasmacytic lymphoma. In Waldenström macroglobulinemia, the driver for therapy in the majority of patients is progressive anemia, secondary to bone marrow replacement by lymphoplasmacytic lymphoma. Recent introduction of MYD88 mutational analysis has been very useful for diagnostic purposes but is unclear what effect it might have on the prognosis or response rate to therapy. An algorithm is provided on the management of asymptomatic individuals and the sequence used for chemotherapeutic intervention of symptomatic patients.
“…Among 15 patients, only one patient failed to respond, with progressive disease, and six had a minor response (25–50% reduction in the level of the M protein). The risk of progression appears to be lower in patients treated with bendamustine-rituximab or bortezomib-dexamethasone-rituximab when compared to cyclophosphamide-dexamethasone-rituximab 50 – 52 .…”
Section: Therapy Of Waldenström Macroglobulinemiamentioning
Waldenström macroglobulinemia is often an indolent disorder, and many patients are candidates for observation with careful monitoring. For symptomatic patients, one must distinguish between those patients whose symptoms are related to immunologic manifestations associated with the IgM monoclonal protein and those that have symptoms related to progressive marrow and nodal infiltration with lymphoplasmacytic lymphoma. In Waldenström macroglobulinemia, the driver for therapy in the majority of patients is progressive anemia, secondary to bone marrow replacement by lymphoplasmacytic lymphoma. Recent introduction of MYD88 mutational analysis has been very useful for diagnostic purposes but is unclear what effect it might have on the prognosis or response rate to therapy. An algorithm is provided on the management of asymptomatic individuals and the sequence used for chemotherapeutic intervention of symptomatic patients.
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