Fludarabine based combinations are highly effective as first-line or salvage treatment in patients with Waldenström macroglobulinemia.
Leuk Lymphoma
; 51(12): 2188-97, 2010 Dec.
Article
en En
| MEDLINE
| ID: mdl-20939696
Treatment with single-agent chemotherapy or rituximab (R) is safe and moderately effective for patients with Waldenström macroglobulinemia (WM). We analyzed the efficacy and toxicity of fludarabine (F)-combinations. Twenty-nine treatment episodes were administered to 27 patients, including FC (F 25 mg/m(2) days 1-3, cyclophosphamide [C] 250 mg/m(2) days 1-3; nâ=â7), FCR (FC + R 375 mg/m(2) day 1; nâ=â18), FM (F + mitoxantrone [M] 10 mg/m(2) day 1; nâ=â3), and FR (nâ=â1). Patient characteristics were median age 57 years (36-89), 83% male, 10 previously untreated (34%). In total, 123 cycles were administered, a median of four (2-6) per patient. Gradeâ≥â3 neutropenia and infections complicated 28% and 3% of cycles, respectively. Responses were achieved in 26 cases (90%), one complete, 23 partial, and two minor. The median progression-free survival was 43.1 months, and at a median follow-up of 66.5 months the actuarial 5- and 10-year overall survival-rates were 88% and 75%, respectively. All 10 previously untreated patients responded (one CR, nine PR), and were alive at a median follow-up of 50 (6-106) months. Three heavily pretreated patients subsequently developed AML/MDS (one fatal) at 56, 61, and 91 months post F-based treatment. F-combination therapy is highly active in WM, both untreated and alkylator-refractory. However, a possible contribution to the cumulative risk of treatment-related MDS/AML requires ongoing monitoring.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vidarabina
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Protocolos de Quimioterapia Combinada Antineoplásica
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Macroglobulinemia de Waldenström
Tipo de estudio:
Evaluation_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adult
/
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Leuk Lymphoma
Asunto de la revista:
HEMATOLOGIA
/
NEOPLASIAS
Año:
2010
Tipo del documento:
Article
País de afiliación:
Australia
Pais de publicación:
Estados Unidos