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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 10, 2008 Accepted July 7, 2008 Thalidomide and rituximab in Waldenstrom's macroglobulinemia Steven P. Treon*, Jacob D Soumerai, Andrew R. Branagan, Zachary R. Hunter, Christopher J. Patterson, Leukothea Ioakimidis, Frederick M. Briccetti, Mark Pasmantier, Harvey Zimbler, Robert B. Cooper, Maria Moore, John Hill II, Alan Rauch, Lawrence Garbo, Luis Chu, Cynthia Chua, Stephen H. Nantel, David R. Lovett, Hans Boedeker, Henry Sonneborn, John Howard, Paul Musto, Bryan T. Ciccarelli, Evdoxia Hatjiharissi, and Kenneth C. Anderson Bing Center for Waldentrom's Macroglobulinemia, Dana Farber Cancer Institute, Boston, MA, United States New Hampshire Hematology Oncology, Concord, NH, United States New York Presbyterian Hospital, Weill Medical College, New York, NY, United States Berkshire Hematology Oncology, Pittsfield, MA, United States Praxair Cancer Center, Danbury Hospital, Danbury, CT, United States Park Ridge Hospital, Hendersonville, NC, United States Hendersonville Hematology Oncology, Hendersonville, NC, United States New York Oncology Hematology, Albany, NY, United States Florida Cancer Specialists, Sarasota, FL, United States Oncology Hematology Care, Cincinnati, OH, United States British Columbia Cancer Agency, Vancouver General Hospital, Vancouver, BC, Canada Cape Cod Hospital, Hyannis, MA, United States Bridgton Hospital, Bridgton, MA, United States Seacoast Cancer Center, Portsmouth, NH, United States Virginia Oncology Associates, Norfolk, VA, United States Commonwealth Hematology Oncology, Quincy, MA, United States Harvard Medical School, Boston, MA, United States Jerome Lipper Multiple Myeloma Center, Dana Farber Cancer Institute, Boston, MA, United States * Corresponding author; email: steven_treon{at}dfci.harvard.edu. Thalidomide enhances rituximab-mediated antibody dependent cell mediated cytotoxicity. We therefore conducted a phase II study using thalidomide and rituximab in symptomatic Waldenstrom’s macroglobulinemia (WM) patients naïve 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/week) dosed on weeks 2-5, 13-16. Twenty-five patients were enrolled, 20 of whom were untreated. Responses were as follows: CR (n=1); PR (n=15); MR (n=2), for an overall and a major response rate of 72% and 64%, respectively, on an intent to treat basis. Median serum IgM decreased from 3,670 to 1,590 mg/dL (p<0.001), while median hematocrit rose from 33.0% to 37.6% (p=0.004) at best response. The 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 neuropathy, 10 resolved to grade 1 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 (i.e. 200 mg per day) should be considered given the high frequency of treatment related neuropathy in this patient population. This trial is registered at ClinicalTrials.gov under identifier NCT00142116. 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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