Τίτλος:
International prognostic scoring system for Waldenstrom
macroglobulinemia
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Recently, many new drugs have been developed for the treatment of
Waldenstrom macroglobulinemia (WM). To optimize the treatment according
to the prognosis and to facilitate the comparison of trials, we
developed an International Prognostic Scoring System for WM in a series
of 587 patients with clearly defined criteria for diagnosis and for
initiation of treatment. The median survival after treatment initiation
was 87 months. Five adverse covariates were identified: advanced age (>
65 years), hemoglobin less than or equal to 11.5 g/dL, platelet count
less than or equal to 100 x 10(9)/L, beta 2-microglobulin more than 3
mg/L, and serum monoclonal protein concentration more than 7.0 g/dL.
Low-risk patients (27%) presented with no or 1 of the adverse
characteristics and advanced age, intermediate-risk patients (38%) with
2 adverse characteristics or only advanced age, and high-risk patients
(35%) with more than 2 adverse characteristics. Five-year survival
rates were 87%, 68%, and 36%, respectively (P<.001). The ISSWM
retained its prognostic significance in subgroups defined by age,
treatment with alkylating agent, and purine analog. Thus, the ISSWM may
provide a means to design risk-adapted studies. However, independent
validation and new biologic markers may enhance its significance.
(Blood. 2009; 113: 4163-4170)
Συγγραφείς:
Morel, Pierre
Duhamel, Alain
Gobbi, Paolo
Dimopoulos,
Meletios A.
Dhodapkar, Madhav V.
McCoy, Jason
Crowley, John
and Ocio, Enrique M.
Garcia-Sanz, Ramon
Treon, Steven P. and
Leblond, Veronique
Kyle, Robert A.
Barlogie, Bart
Merlini,
Giampaolo
Περιοδικό:
Blood advances
Εκδότης:
AMER SOC HEMATOLOGY
DOI:
10.1182/blood-2008-08-174961
