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Blood, 30 April 2009, Vol. 113, No. 18, pp. 4163-4170. Prepublished online as a Blood First Edition Paper on February 5, 2009; DOI 10.1182/blood-2008-08-174961. This Article Full Text Full Text (PDF) Supplemental Appendices and Table All Versions of this Article: blood-2008-08-174961v1 113/18/4163    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 Morel, P. Articles by Merlini, G. Search for Related Content PubMed PubMed Citation Articles by Morel, P. Articles by Merlini, G. 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 International prognostic scoring system for Waldenström macroglobulinemia Pierre Morel1,2, Alain Duhamel3, Paolo Gobbi4, Meletios A. Dimopoulos5, Madhav V. Dhodapkar6, Jason McCoy7, John Crowley7, Enrique M. Ocio8, Ramon Garcia-Sanz8, Steven P. Treon9, Veronique Leblond2,10, Robert A. Kyle11, Bart Barlogie12, and Giampaolo Merlini4 1 Hôpital Schaffner, Lens, France; 2 French Cooperative Group Chronic Lymphocytic Leukaemia/Waldenstrom Macroglobulinemia, Paris, France; 3 Faculte de Medecine, Lille, France; 4 Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy; 5 University of Athens School of Medicine, Athens, Greece; 6 Rockefeller University, New York, NY; 7 Southwest Oncology Group, Seattle, WA; 8 Spanish Group for the Study of Waldenstrom Macroglobulinaemia, Salamanca, Spain; 9 Dana-Farber Cancer Institute, Boston, MA; 10 Hôpital Pitié Salpêtrière Université Pierre et Marie Curie, Paris, France; 11 Mayo Clinic, Rochester, MN; and 12 University of Arkansas for Medical Sciences, Little Rock Recently, many new drugs have been developed for the treatment of Waldenström macroglobulinemia (WM). To optimize the treatment according to the prognosis and to facilitate the comparison of trials, we developed an International Prognostic Scoring System for WM in a series of 587 patients with clearly defined criteria for diagnosis and for initiation of treatment. The median survival after treatment initiation was 87 months. Five adverse covariates were identified: advanced age (>65 years), hemoglobin less than or equal to 11.5 g/dL, platelet count less than or equal to 100 x 109/L, β2-microglobulin more than 3 mg/L, and serum monoclonal protein concentration more than 7.0 g/dL. Low-risk patients (27%) presented with no or 1 of the adverse characteristics and advanced age, intermediate-risk patients (38%) with 2 adverse characteristics or only advanced age, and high-risk patients (35%) with more than 2 adverse characteristics. Five-year survival rates were 87%, 68%, and 36%, respectively (P < .001). The ISSWM retained its prognostic significance in subgroups defined by age, treatment with alkylating agent, and purine analog. Thus, the ISSWM may provide a means to design risk-adapted studies. However, independent validation and new biologic markers may enhance its significance. 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]

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