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Blood, 16 April 2009, Vol. 113, No. 16, pp. 3673-3678. Prepublished online as a Blood First Edition Paper on November 17, 2008; DOI 10.1182/blood-2008-09-177329. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-09-177329v1 113/16/3673    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 Kimby, E. Search for Related Content PubMed PubMed Citation Articles by Treon, S. P. Articles by Kimby, E. Related Collections Free Research Articles Lymphoid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Long-term outcomes to fludarabine and rituximab in Waldenström macroglobulinemia Steven P. Treon1, Andrew R. Branagan1, Leukothea Ioakimidis1, Jacob D. Soumerai1, Christopher J. Patterson1, Barry Turnbull2, Parveen Wasi3, Christos Emmanouilides4, Stanley R. Frankel5, Andrew Lister6, Pierre Morel7, Jeffrey Matous8, Stephanie A. Gregory9, and Eva Kimby10 1 Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; 2 BioBridges, Boston, MA; 3 McMaster University Medical Center, Hamilton, ON; 4 University of California Los Angeles (UCLA) Medical Center; 5 Greenebaum Cancer Center, University of Maryland, Baltimore; 6 Medical Oncology, St Bartholomew's Hospital and Cancer Research, London, United Kingdom; 7 Clinical Hematology, Centre Hospitalier Schaffner, Lens, France; 8 Rocky Mountain Cancer Center, Denver, CO; 9 Rush University Medical Center, Chicago, IL; and 10 Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden We report the long-term outcome of a multicenter, prospective study examining fludarabine and rituximab in Waldenström macroglobulinemia (WM). WM patients with less than 2 prior therapies were eligible. Intended therapy consisted of 6 cycles (25 mg/m2 per day for 5 days) of fludarabine and 8 infusions (375 mg/m2 per week) of rituximab. A total of 43 patients were enrolled. Responses were: complete response (n = 2), very good partial response (n = 14), partial response (n = 21), and minor response (n = 4), for overall and major response rates of 95.3% and 86.0%, respectively. Median time to progression for all patients was 51.2 months and was longer for untreated patients (P = .017) and those achieving at least a very good partial response (P = .049). Grade 3 or higher toxicities included neutropenia (n = 27), thrombocytopenia (n = 7), and pneumonia (n = 6), including 2 patients who died of non–Pneumocystis carinii pneumonia. With a median follow-up of 40.3 months, we observed 3 cases of transformation to aggressive lymphoma and 3 cases of myelodysplastic syndrome/acute myeloid leukemia. The results of this study demonstrate that fludarabine and rituximab are highly active in WM, although short- and long-term toxicities need to be carefully weighed against other available treatment options. This study is registered at clinicaltrials.gov as NCT00020800 [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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