Primary Treatment of Waldenström Macroglobulinemia With Dexamethasone, Rituximab, and Cyclophosphamide
Year: 2007
Type: article
Study design: Clinical Trial
Abstract: PURPOSE: Alkylating agents and the anti-CD20 monoclonal antibody rituximab are among appropriate choices for the primary treatment of symptomatic patients with Waldenström macroglobulinemia (WM), and they induce at least a partial response in 30% to 50% of patients. To improve these results, we designed a phase II study that included previously untreated symptomatic patients with WM who received a combination of dexamethasone, rituximab, and cyclophosphamide (DRC). PATIENTS AND METHODS: Seventy-two patients were treated with dexamethasone 20 mg intravenously followed by rituximab 375 mg/m2 intravenously on day 1 and cyclophosphamide 100 mg/m2 orally bid on days 1 to 5 (total dose, 1,000 mg/m2). This regimen was repeated every 21 days for 6 months. Patients' median age was 69 years and many had features of advanced disease such as anemia (57%), hypoalbuminemia (40%), and elevated serum beta2-microglobulin (43%). RESULTS: On an intent-to-treat basis, 83% of patients (95% CI, 73% to 91%) achieved a response, including 7% complete, 67% partial, and 9% minor responses. The median time to response was 4.1 months. The 2-year progression-free survival rate for all patients was 67%; for patients who responded to DRC, it was 80%. The 2-year disease-specific survival rate was 90%. Treatment with DRC was well tolerated, with 9% of patients experiencing grade 3 or 4 neutropenia and approximately 20% of patients experiencing some form of toxicity related to rituximab. CONCLUSION: Our large, multicenter trial showed that the non-stem-cell toxic DRC regimen is an active, well-tolerated treatment for symptomatic patients with WM.
Source: Journal of Clinical Oncology
Authors: Meletios Athanasios Dimopoulos, Athanasios Anagnostopoulos, Marie-Christine Kyrtsonis, Konstantinos Zervas, Constantinos Tsatalas, Garyfallia Kokkinis, Panagiotis Repoussis, Argyris Symeonidis, Souzana Delimpasi, Eirini Katodritou, Elina Vervessou, Evridiki Michali, Anastasia Pouli, Dimitra Gika, Amalia Vassou, Evangelos Terpos, Nikolaos Anagnostopoulos, Theophanis Economopoulos, Gerasimos Pangalis
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1972632013