Outcome disparities among ethnic subgroups of Waldenström's macroglobulinemia: a population-based study.

BACKGROUND: Ethnic disparities in cancers are associated with variability in clinical outcomes. We present a Surveillance Epidemiology and End RESULTS (SEER)-based outcome analysis of multiethnic Waldenström's macroglobulinemia (WM) patients. METHODS: Adult WM patients diagnosed in 1992 or later (n = 3,175) were analyzed. Median overall survival (OS) was compared across different ethnicities stratified by year of diagnosis, registry identification, age at diagnosis, sex, and marital status. RESULTS: African-Americans (AA) had the youngest median age at diagnosis (63 years) and Whites had the oldest (73 years) (p < 0.001). Female gender, a younger age at diagnosis, and a recent year of diagnosis were associated with an improved OS. Hispanics had the worst (5.6 years) while Whites had the best (6.8 years) median OS. A significant interaction existed between median OS, gender, and race (p = 0.007). Among males, AA had the worst (4.3 years) and Asians had the best (7.3 years) median OS. A significant interaction was also noted between median OS, age at diagnosis, and race (p = 0.033). The worst median OS was seen in Hispanics among patients aged >75 years, and in AA among those aged <65 years. CONCLUSIONS: These disparities among WM patients may be multifactorial but need to be explored systematically to better understand the disease biology and for optimal triaging of health care resources.

Temporal and geographic variations of Waldenstrom macroglobulinemia incidence: a large population-based study.

BACKGROUND: Waldenstrom macroglobulinemia (WM) is a non-Hodgkin lymphoma (NHL) subtype. Little is known about the incidence and trends for this disease in the United States. METHODS: Twenty-year data from the Surveillance, Epidemiology, and End Results (SEER) program were used for this study. SEER*Stat was used for data analysis. RESULTS: Of the 95,797 cases of NHL diagnosed between 1988 and 2007 in 9 SEER registries, 1835 (1.9%) were new cases of WM. Median age at diagnosis of WM was 73 years. The overall annual age-adjusted incidence was 0.38 per 100,000 persons per year, which increased with age, ranging from 0.03 in patients aged <50 years to 2.85 in patients aged ≥80 years. The incidence of WM was higher in men (0.54) than in women (0.27; P < .001) and was higher in whites (0.41) than in African Americans (0.18) or other races (0.21; P < .05). The annual percentage change for the whole population was 1.01% (P > .05). The annual percentage change was 1.21% for whites (P < .05) and 0.80% (P > .05) for nonwhites. Significant annual percentage change increases were seen in the group aged 70 to 79 years (1.24%; P < .05) and in 3 geographic registries (P < .001). CONCLUSIONS: Although the overall incidence of WM remained steady over time, significant increases in incidence were seen over the past 20 years in whites, in those aged 70 to 79 years, and in 3 geographic registry areas.

Waldenström's macroglobulinemia is infrequent in Mexican Mestizos: experience of a hematological diseases referral center.

Along a 17-year period 7,373 patients were prospectively studied in a private practice Health facility; of these 11 were patients with Waldenström's macroglobulinemia; calculations from these data and previous publications show that this lymphoid malignancy represents in Mexico 0.18% of all hematologic malignancies, a figure 11 times lower than that described from caucasians. The median age was 65 years (range 31 to 84); there were 6 males and 5 females. Ten individuals were mexican mestizos, whereas one had a caucasian phenotype. The clinical features of the patients afflicted by the disease in Mexico were similar to those reported from caucasian populations. The median survival (SV) of the group of patients was 40 months, whereas the 42-month survival was 49%; the prognosis of the disease was relatively good despite the fact that complete remissions were unfrequent as a result of the treatment.

Familial macroglobulinemia in a Lebanese family with two sisters presenting Waldenström's disease.

We report a non-consanguineous family with ten children, in which two sisters were found to have Waldenström's disease with light chain IgM monoclonal components. Immunoglobulins were examined in four siblings and revealed high serum IgM concentrations with no monoclonal component. This additional case of familial Waldenström's macroglobulinemia stresses the usefulness of screening family members of patients with monoclonal gammopathy since they may be at high risk of developing the disease.