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Blood, 1 December 2008, Vol. 112, No. 12, pp. 4452-4457. Prepublished online as a Blood First Edition Paper on August 19, 2008; DOI 10.1182/blood-2008-04-150854. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-04-150854v1 112/12/4452    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Treon, S. P. Articles by Anderson, K. C. Search for Related Content PubMed PubMed Citation Articles by Treon, S. P. Articles by Anderson, K. C. Related Collections Neoplasia Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Thalidomide and rituximab in Waldenstrom macroglobulinemia Steven P. Treon1,2, Jacob D. Soumerai1, Andrew R. Branagan1, Zachary R. Hunter1, Christopher J. Patterson1, Leukothea Ioakimidis1, Frederick M. Briccetti3, Mark Pasmantier4, Harvey Zimbler5, Robert B. Cooper6, Maria Moore7, John Hill, II8, Alan Rauch9, Lawrence Garbo9, Luis Chu10, Cynthia Chua11, Stephen H. Nantel12, David R. Lovett13, Hans Boedeker14, Henry Sonneborn15, John Howard16, Paul Musto17, Bryan T. Ciccarelli1, Evdoxia Hatjiharissi1,2, and Kenneth C. Anderson2,18 1 Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA; 2 Harvard Medical School, Boston, MA; 3 New Hampshire Hematology Oncology, Concord; 4 New York Presbyterian Hospital, Weill Medical College, New York, NY; 5 Berkshire Hematology Oncology, Pittsfield, MA; 6 Praxair Cancer Center, Danbury Hospital, CT; 7 Park Ridge Hospital, Hendersonville, NC; 8 Hendersonville Hematology Oncology, NC; 9 New York Oncology Hematology, Albany; 10 Florida Cancer Specialists, Sarasota; 11 Oncology Hematology Care, Cincinnati, OH; 12 British Columbia Cancer Agency, Vancouver General Hospital, Vancouver, BC; 13 Cape Cod Hospital, Hyannis, MA; 14 Bridgton Hospital, ME; 15 Seacoast Cancer Center, Portsmouth, NH; 16 Virginia Oncology Associates, Norfolk; 17 Commonwealth Hematology Oncology, Quincy, MA; and 18 Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, MA Thalidomide enhances rituximab-mediated, antibody-dependent, cell-mediated cytotoxicity. We therefore conducted a phase 2 study using thalidomide and rituximab in symptomatic Waldenstrom macroglobulinemia (WM) patients naive to either agent. Intended therapy consisted of daily thalidomide (200 mg for 2 weeks, then 400 mg for 50 weeks) and rituximab (375 mg/m2 per week) dosed on weeks 2 to 5 and 13 to 16. Twenty-five patients were enrolled, 20 of whom were untreated. Responses were complete response (n = 1), partial response (n = 15), and major response (n = 2), for overall and major response rate of 72% and 64%, respectively, on an intent-to-treat basis. Median serum IgM decreased from 3670 to 1590 mg/dL (P < .001), whereas median hematocrit rose from 33.0% to 37.6% (P = .004) at best response. Median time to progression for responders was 38 months. Peripheral neuropathy to thalidomide was the most common adverse event. Among 11 patients experiencing grade 2 or greater neuropathy, 10 resolved to grade 1 or less at a median of 6.7 months. Thalidomide in combination with rituximab is active and produces long-term responses in WM. Lower doses of thalidomide (ie, 200 mg/day) should be considered given the high frequency of treatment-related neuropathy in this patient population. This trial is registered at www.clinicaltrials.gov as #NCT00142116 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. P. Treon How I treat Waldenstrom macroglobulinemia Blood, September 17, 2009; 114(12): 2375 - 2385. [Abstract] [Full Text] [PDF] S. P. Treon, L. Ioakimidis, J. D. Soumerai, C. J. Patterson, P. Sheehy, M. Nelson, M. Willen, J. Matous, J. Mattern II, J. G. Diener, et al. Primary Therapy of Waldenstrom Macroglobulinemia With Bortezomib, Dexamethasone, and Rituximab: WMCTG Clinical Trial 05-180 J. Clin. Oncol., August 10, 2009; 27(23): 3830 - 3835. [Abstract] [Full Text] [PDF]

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