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Titolo
Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases
Autor(es)
Soggetto
Myeloma
Waldenstrom Macroglobulinemia
Immunoglobulin M
Prognosis
Clasificación UNESCO
3205.04 Hematología
Fecha de publicación
2001-12
Editore
Wiley
Citación
García‐Sanz, R., Montoto, S., Torrequebrada, A., De Coca, A. G., Petit, J., Sureda, A., ... & Miguel, J. F. S. (2001). Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. British journal of haematology, 115(3), 575-582. https://doi.org/10.1046/j.1365-2141.2001.03144.x
Resumen
[EN]In this report we analyse the presenting features of a series of patients diagnosed with Waldenström macroglobulinaemia (WM) in Spain over the last 10 years. Criteria for diagnosis required a serum monoclonal IgM protein > or = 30 g/l and > 20% bone marrow lymphocytes. Two hundred and seventeen patients were included in the study, with a median age of 69 years and male/female ratio of 2:1. The most common symptoms at diagnosis were anaemia (38%), hyperviscosity (31%), B symptoms (23%), bleeding (23%) and neurological symptoms (22%). Sixty-one patients (27%) were asymptomatic at diagnosis and, to date, 32 of them have not received chemotherapy. Variables predicting a shorter survival free of therapy were haemoglobin < 12.5 g/dl and high beta2microglobulin (beta2M). The 83% of patients who did receive treatment were distributed as follows: chlorambucil/prednisone (43%), intermittent chlorambucil (11%), continuous chlorambucil (26%), cyclophosphamide/vincristine/prednisone (COP, 13.5%) and other (6.5%). Response to therapy was complete in 2%, partial in 48% and minor in 10%. Finally, 28% and 13% of patients presented stable and progressive disease, respectively, which was more common among patients treated with COP. Progression-free survival was 43% at 5 years, with three independent predictors for shorter progression-free survival (PFS): COP treatment, age > 65 and B symptoms at diagnosis. The 10-year projected overall survival (OS) was 55%. The two most frequent causes of death were development of second malignancies (31%), or infections (19%). The two main variables predicting a poor OS were hyperviscosity and high beta2M. In summary, this study favours the use of chlorambucil-based therapy as the standard treatment for WM, and describes a subset of patients who should be considered as suffering a smouldering form and who therefore do not require treatment for a long period of time.
Descrizione
Fue un trabajo descriptivo extenso que dio origen al grupo español Macroglobulinemia de Waldenström, que desde entonces y hasta hoy está liderado por el Dr. García Sanz y es uno de los principales grupos internacionales en esta patología, con contribuciones relevantes en el campo clínico, pronósti-co y biológico
URI
ISSN
0007-1048
DOI
10.1046/j.1365-2141.2001.03144.x
Versión del editor
Aparece en las colecciones
Patrocinador
Hospital Universitario de Salamanca
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