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Blood, 1 May 2006, Vol. 107, No. 9, pp. 3442-3446.
Prepublished online as a Blood First Edition Paper on January 12, 2006; DOI 10.1182/blood-2005-02-0833.


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REVIEW ARTICLES

Update on treatment recommendations from the Third International Workshop on Waldenström's Macroglobulinemia

Steven P. Treon, Morie A. Gertz, Meletios Dimopoulos, Athanasios Anagnostopoulos, Joan Blade, Andrew R. Branagan, Ramon Garcia-Sanz, Stephen Johnson, Eva Kimby, Veronique LeBlond, Jean-Paul Fermand, David G. Maloney, Giampaolo Merlini, Pierre Morel, Enrica Morra, Gwen Nichols, Enrique M. Ocio, Roger Owen, and Marvin J. Stone

From the Bing Program for Waldenström's Macroglobulinemia, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA; Department of Hematology, Mayo School of Medicine, Rochester MN; University of Athens School of Medicine, Athens, Greece; Hospital Clinic, Barcelona, Spain; Hospital Universitario de Salamanca, Salamanca, Spain; Taunton and Somerset Hospital, Somerset, United Kingdom; Huddinge University Hospital, Stockholm, Sweden; Hopital Pitie Salpetriere, Paris, France; Hopital Saint Louis, Paris, France; Fred Hutchinson Cancer Center, Seattle, WA; Scientific Institute Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy; Hospitalier Schaffner, Lens, France; Niguarda Ca'Granda Hospital, Milano, Italy; Columbia University, New York, NY; Universitario de Salamanca, Salamanca, Spain; Leeds General Infirmary, Leeds, United Kingdom; and Baylor Sammons Cancer Center, Dallas, TX.

Waldenström macroglobulinemia (WM) is a B-cell disorder characterized by the infiltration of lymphoplasmacytic cells into bone marrow and the presence of an IgM monoclonal gammopathy. As part of the Third International Workshop on WM, held October 7 to 10, 2004 in Paris, France, a consensus panel charged with providing treatment recommendations for WM updated its recommendations on both frontline and salvage therapies. The panel considered encouraging results from recent studies that addressed the use of extended-dose rituximab as well as other treatment options: therapy with either nucleoside analogs and alkylator agents, rituximab in combination with nucleoside analogs, nucleoside analogs plus alkylator agents, or combination chemotherapies, such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or cyclophosphamide and dexamethasone. The panel determined that these were reasonable treatment options for WM patients and such therapeutic approaches were likely to yield results that are at least as good as if not better than the currently recommended use of single-agent alkylator, nucleoside analog, or standard-dose rituximab therapy. Such approaches were deemed to be reasonable treatment for WM patients in both the upfront and salvage settings, though randomized studies addressing the efficacy and toxicity of such novel approaches over previously established standard of care options are needed.


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