Impact of rituximab and half-dose CHOP as primary therapy for untreated symptomatic Waldenström Macroglobulinemia: review of a combined regimen of rituximab with an alkylating agent
Blood Research
;
: 117-122, 2018.
Article
in English
| WPRIM
| ID: wpr-714933
ABSTRACT
BACKGROUND:
Waldenström Macroglobulinemia (WM) is a rare subtype of indolent B-cell lymphoma, and prospective randomized studies on WM are scarce. The R-CHOP therapy [rituximab (R), cyclophosphamide, hydroxy-doxorubicin, vincristine, and prednisone] is a popular and recommended regimen for primary therapy, prescribed by several treatment guidelines for WM. However, treatment with R-CHOP is accompanied by severe myelosuppression and high rates of peripheral neuropathy. Therefore, we retrospectively evaluated the efficacy and toxicity of half-dose CHOP combined with R as a primary therapy for WM.METHODS:
Patients with untreated symptomatic WM, treated at the Disaster Medical Center between April 2011 and September 2016, were retrospectively analyzed after administration of 6 cycles of half-dose R-CHOP for every 3 weeks. The response, median time to response, best response, progression-free survival, overall survival, and toxicities were evaluated.RESULTS:
Of the 20 WM patients analyzed, 16 (80%) received half-dose R-CHOP without vincristine, and 13 (65%) responded to the treatment. With a median follow-up duration of 26.3 months, the 2-year progression-free survival and 2-year overall survival rates were 70 and 93.3%, respectively. The median time to response and best response were 6 and 9.9 weeks, respectively. Grade 3/4 leukocytopenia, neutropenia, febrile neutropenia, and Grade 1 peripheral neuropathy developed in 32, 37, 0, and 21% of patients, respectively.CONCLUSION:
The half-dose R-CHOP is an effective and well-tolerated primary therapy for WM. To the best of our knowledge, this is the first study reporting the use of a reduced-dose R-CHOP regimen for the primary treatment of WM.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Vincristine
/
Survival Rate
/
Prospective Studies
/
Retrospective Studies
/
Follow-Up Studies
/
Lymphoma, B-Cell
/
Waldenstrom Macroglobulinemia
/
Peripheral Nervous System Diseases
/
Disease-Free Survival
/
Cyclophosphamide
Type of study:
Diagnostic study
/
Practice guideline
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Blood Research
Year:
2018
Type:
Article
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