Progression in smoldering Waldenstrom macroglobulinemia: long-term results.

Blood 2012 May 26;119(19):4462-6. Epub 2012 Mar 26.

Division of Hematology, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.

The purpose of this study was to define the risk of progression and survival of patients with smoldering Waldenström macroglobulinemia (SWM). SWM is defined clinically as having a serum monoclonal IgM protein≥3 g/dL and/or≥10% bone marrow lymphoplasmacytic infiltration but no evidence of end-organ damage (anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly). We searched a computerized database and reviewed the medical records of all patients at Mayo Clinic who fulfilled the criteria of SWM between 1974 and 1995. During 285 cumulative person-years of follow-up of the 48 patients with SWM (median, 15.4 years), 34 (71%) progressed to symptomatic Waldenström macroglobulinemia (WM) requiring treatment, one to primary amyloidosis, and one to lymphoma (total, 75%). The cumulative probability of progression to symptomatic WM, amyloidosis, or lymphoma was 6% at 1 year, 39% at 3 years, 59% at 5 years, and 68% at 10 years. The major risk factors for progression were percentage of lymphoplasmacytic cells in the bone marrow, size of the serum M-spike, and the hemoglobin value. Patients with SWM should be followed and not treated until symptomatic WM develops. Treatment on a clinical trial for those at greatest risk of progression should be considered.

Download full-text PDF

Source
http://www.bloodjournal.org/cgi/doi/10.1182/blood-2011-10-38
Publisher Site
http://dx.doi.org/10.1182/blood-2011-10-384768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362362PMC
May 2012
5 Reads

Publication Analysis

Top Keywords

waldenström macroglobulinemia
8
bone marrow
8
risk progression
8
amyloidosis lymphoma
8
patients swm
8
swm
5
progression
5
154 years
4
years
4
median 154
4
years 71%
4
71% progressed
4
treatment primary
4
primary amyloidosis
4
lymphoma total
4
requiring treatment
4
macroglobulinemia requiring
4
progressed symptomatic
4
symptomatic waldenström
4
swm median
4

Similar Publications