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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 21, 2008 Accepted December 27, 2008 International prognostic scoring system for Waldenstrom's macroglobulinemia Pierre Morel*, Alain Duhamel, Paolo Gobbi, Meletios A. Dimopoulos, Madhav V. Dhodapkar, Jason McCoy, John Crowley, Enrique M. Ocio, Ramon Garcia-Sanz, Steven P. Treon, Veronique Leblond, Robert A. Kyle, Bart Barlogie, and Giampaolo Merlini Hopital Schaffner, Lens, France Faculte de Medecine, Lille, France Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy University of Athens School of Medicine, Athens, Greece The Rockefeller University, New York, NY, United States Southwest Oncology Group, Seattle, WA, United States Spanish Group for the Study of Waldenstrom Macroglobulinaemia, Salamanca, Spain Dana Farber Cancer Institute, Boston, MA, United States French cooperative group Chronic Lymphocytic leukaemia/Waldenstrom Macroglobulinemia, Paris, France Mayo Clinic, Rochester, MN, United States University of Arkansas for Medical Sciences, Little Rock, AR, United States * Corresponding author; email: pmorel{at}ch-lens.fr. Recently, many new drugs have been developed for the treatment of Waldenstrom's macroglobulinemia (WM). In order to optimize the treatment according to the prognosis and to facilitate the comparison of trials we developed an international scoring system for WM (ISSWM) in a series of 587 patients with clearly defined criteria for diagnosis and for initiation of treatment. With a median follow-up of 64 months, the median survival after treatment initiation was 87 months. Five adverse covariates were identified: age >65 years, hemoglobin 11·5 g/dL, platelet count 100 x 109/L, 2-microglobulin >3 mg/L and serum monoclonal protein concentration >7.0 g/dL. Low risk patients (27% of patients) presented with 1 adverse characteristic and age 65 years, intermediate risk patients (38%) with 2 adverse characteristics or only age >65 years and high risk patients (35%) with >2 adverse characteristics. Five-year survival rates were 87%, 68% and 36% respectively (p<0·0001). The ISSWM retained its prognostic significance in subgroups defined by age 65 years, >65 years, treatment with alkylating agent, and purine analogue. Thus, the combination of age, 2-microglobulin, monoclonal protein concentration and blood counts may provide a means to design risk-adapted studies. However, independent validation and new biological 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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