Τίτλος:
Treatment of Waldenstrom's macroglobulinemia with rituximab
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose : Waldenstrom’s macroglobulinemia (WM) is a low-grade
lymphoplasmacytic lymphoma in which CD20 is usually expressed on tumor
cells. There is evidence that patients with WM may benefit from
treatment with the anti-CD20 monoclonal antibody rituximab. We performed
a prospective phase 11 study to clearly define the activity of rituximab
in patients with this disease.
Patients and Methods: Twenty-seven patients with WM were treated with
rituximab 375 mg/m(2) intravenously (IV) for 4 weeks. Three months after
completion of rituximab, patients without evidence of progressive
disease received repeat 4-week courses of this agent. All patients were
symptomatic, their median age was 72 years, and 15 patients were
previously untreated.
Results: Twelve patients (44%; 95% confidence interval, 25.5% to
64.7%) achieved a partial response after treatment with rituximab.
Median time to response was 3.3 months (range, 2.2 to 7.1 months).
Responses occurred in six (40%) of 15 previously untreated patients and
in six (50%) of 12 pretreated patients. Patients with a serum
immunoglobulin M less than 40 g/L had a significantly higher response
rate. The median time to progression for all patients was 16 months, and
with a median follow-up of 15.7 months, nine of 12 responding patients
remain free of progression. Treatment with rituximob was well tolerated,
with approximately one fourth of patients experiencing some mild form of
infusion-related toxicity, usually fever and chills.
Conclusion: Our prospective data indicate that rituximab is well
tolerated and active in patients with WM. Previously untreated and
pretreated patients seem to benefit equally. Repeat 4-week courses of
rituximab may prolong the duration of response of the disease, but this
observation requires confirmation in prospective, randomized trials.
Furthermore, studies that will combine rituximab with chemotherapy may
be relevant. (C) 2002 by American Society of Clinical Oncology.
Συγγραφείς:
Dimopoulos, MA
Zervas, C
Zomas, A
Kiamouris, C
Viniou,
NA
Grigoraki, V
Karkantaris, C
Mitsouli, C
Gika, D and
Christakis, J
Anagnostopoulos, N
Περιοδικό:
Journal of Clinical Oncology
Εκδότης:
Lippincott, Williams & Wilkins
DOI:
10.1200/JCO.2002.09.039
