Work

Transformation and survival in patients with Waldenström macroglobulinemia: a population-based study

Year: 2025

Type: article

Abstract: BACKGROUND: Waldenström's macroglobulinemia (WM) is a rare hematologic neoplasm characterized by an indolent clinical course. However, a significant proportion of patients undergo histological transformation to aggressive diffuse large B-cell lymphoma (DLBCL). Long-term population-based data on the transformation and survival are scarce. Based on the Surveillance, Epidemiology, and End Results (SEER) database, we performed this study to estimate the risk of transformation and outcomes of patients with WM. METHODS: 8191 patients with WM were retrieved from the SEER database. Competing risk methods were employed to evaluate the cumulative incidences and putative risk factors for transformation. Survival outcomes were analyzed using Kaplan-Meier and Cox proportional hazards regression. RESULTS: The cumulative incidence rates for transformation at 5 and 10 years were 1.0% (95% CI, 0.8%-1.3%) and 1.9% (95% CI, 1.5%-2.2%), respectively. A substantial increase in total mortality was related to the time-dependent transformation (HR, 4.21 [95% CI, 3.36-5.26]; P < 0.001). Patients who presented with transformation > 24 months after WM diagnosis had a longer overall survival (OS) than those who experienced transformation within 24 months (5-year rate, 81.9% [95% CI, 74.7%-89.9%] v 42.7% [95% CI, 26.4%-69.2%]; P < 0.001). The OS was shorter for patients with DLBCL transformed from WM than for those with matched de novo DLBCL (5-year rate, 28.0% [95% CI, 20.5%-38.1%] v 49.5% [95% CI, 41.2%-59.4%]; P = 0.001). CONCLUSIONS: Histological transformation to DLBCL was associated with significantly increased mortality in patients with WM, and the survival outcomes substantially worse than matched de novo DLBCL cases.

Source: Discover Oncology

DOI: 10.1007/s12672-025-03946-6

Authors: Yu Du, Xiaona Chang, Xiangxiang Li, Shugang Xing

Institutions: Tongji Hospital, Huazhong University of Science and Technology, Wuhan Union Hospital

Language: English

Topic: Chronic Lymphocytic Leukemia Research

Subfield: Genetics

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,690