Update on Recommendations for Assessing Response from the Third International Workshop on Waldenström's Macroglobulinemia

Kimby, Eva; Treon, Steven P.; Anagnostopoulos, Athanasios; Dimopoulos, Meletios Α.; García‐Sanz, Ramón; Gertz, Morie A.; Johnson, Stephen A.; Leblond, Véronique; Fermand, Jean Paul; Maloney, David G.; Merlini, Giampaolo; Morel, Pierre; Morra, Enrica; Nichols, Gwen; Ocio, Enrique M.; Owen, Roger G.; Stone, Marvin J.; Bladé, Joan

doi:10.3816/clm.2006.n.013

Cited by 108 publications

(77 citation statements)

References 16 publications

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“…Patients were formally evaluated for clinical response after cycle 3 and cycle 6 using the criteria established at the Second International Workshop on Waldenstrom's Macroglobulinemia [5,6]. Patients, who were removed from the study for progressive disease (PD), toxicity, or refusal to continue on study, were observed for event monitoring every 3 months.…”

Section: Methodsmentioning

confidence: 99%

“…Tumor assessment for WM was performed using the consensus panel recommendations [6]. Patients were assessed every 28 days during the 6 cycles of therapy and every 3 months thereafter.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical presentation and prognosis of patients with WM include cytopenias, hyperviscosity, neuropathy, cryoglobulinemia, cold-agglutinin hemolytic anemia, amyloidosis, hepatosplenomegaly, and lymphadenopathy. Lymphadenopathy and organomegaly are reported to occur in about 20% of patients with WM and CT scans have been recommended for follow up of disease response in patients with positive findings before therapy [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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The role of ¹⁸F‐FDG PET/CT imaging in Waldenstrom macroglobulinemia

et al. 2011

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Disease assessment in WM is dependent on the quantification of the IgM monoclonal protein and percent involvement of the bone marrow. There is a need for imaging studies that objectively measure tumor load in these patients. In this study, we sought to examine the role of combined FDG-PET/CT imaging in the detection of tumor load and in the assessment of response to therapy. Thirty-five patients were enrolled on a prospective study using bortezomib and rituximab therapy and were included in this study because they completed a pre-and post-treatment FDG-PET/CT imaging at one facility (12 newly diagnosed and 23 relapsed/refractory). The use of combined FDG-PET/CT imaging showed positive findings in 83% of patients with WM, unlike prior studies using conventional imaging that indicate that only 20% of patients have lymphadenopathy or hepatosplenomegaly. Moreover, 43% of patients had abnormal bone marrow uptake on FDG-PET imaging that can potentially help in the assessment of their tumor load, especially with heterogenous sampling of the bone marrow. There was no statistical correlation between EORTC response criteria for FDG-PET/CT and response by monoclonal protein. This is the first study to examine the role of FDG-PET/CT imaging in WM. Future studies should examine the role of FDG-PET/CT in conjunction with monoclonal protein response in the assessment of progression-free survival in patients with WM. Am. J. Hematol. 86:567-572, 2011. V

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Section: Methodsmentioning

confidence: 99%

“…Tumor assessment for WM was performed using the consensus panel recommendations [6]. Patients were assessed every 28 days during the 6 cycles of therapy and every 3 months thereafter.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of ¹⁸F‐FDG PET/CT imaging in Waldenstrom macroglobulinemia

et al. 2011

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“…Tumor assessment was performed using the consensus panel recommendations [13]. Patients were assessed every 28 days during the six cycles of therapy and every 3 months thereafter.…”

Section: Methodsmentioning

confidence: 99%

“…The primary endpoint was the percent of patients with at least a MR and secondary endpoints included safety, time to progression (TTP), progression-free survival (PFS), OS, and time to next therapy (TTNT). TTNT is an important endpoint for patients with WM because often these patients meet criteria for progression (>25% increase in IgM protein), but remain asymptomatic and clinically are not treated until they become symptomatic based on the consensus recommendations for treatment of WM patients [12,13]. Therefore, we wanted to capture both the TTP and the TTNT because they both provide information that is important in clinical practice.…”

Section: Methodsmentioning

confidence: 99%

Phase II trial of weekly bortezomib in combination with rituximab in untreated patients with Waldenström Macroglobulinemia

et al. 2010

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This study aimed to determine the activity and safety of weekly bortezomib and rituximab in patients with untreated Waldenströ m Macroglobulinemia (WM). Patients with no prior therapy and symptomatic disease were eligible. Patients received bortezomib IV weekly at 1.6 mg/m 2 on days 1, 8, 15, q 28 days 3 6 cycles, and rituximab 375 mg/m 2 weekly on cycles 1 and 4. Primary endpoint was the percent of patients with at least a minor response (MR). Twenty-six patients were treated. At least MR was observed in 23/26 patients (88%) (95% CI: 70-98%) with 1 complete response (4%), 1 near-complete response (4%), 15 partial remission (58%), and 6 MR (23%). Using IgM response evaluated by nephlometry, all 26 patients (100%) achieved at least MR or better. The median time to progression has not been reached, with an estimated 1-year event free rate of 79% (95% CI: 53, 91%). Common grade 3 and 4 therapy related adverse events included reversible neutropenia in 12%, anemia in 8%, and thrombocytopenia in 8%. No grade 3 or 4 neuropathy occurred. The combination of weekly bortezomib and rituximab exhibited significant activity and minimal neurological toxicity in patients with untreated WM. Am. J. Hematol. 85:670-674, 2010. V

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