Survival and prognostic factors after initiation of treatment in Waldenstrom's macroglobulinemia

被引:36
作者
Dimopoulos, MA [1 ]
Hamilos, G [1 ]
Zervas, K [1 ]
Symeonidis, A [1 ]
Kouvatseas, G [1 ]
Roussou, P [1 ]
Gika, D [1 ]
Karmiris, T [1 ]
Bourantas, K [1 ]
Zomas, A [1 ]
Mitsouli, C [1 ]
Xilouri, I [1 ]
Vervessou, E [1 ]
Matsis, K [1 ]
Anagnostopoulos, N [1 ]
Economopoulos, T [1 ]
机构
[1] Univ Athens, Sch Med, Dept Clin Therapeut, GR-11527 Athens, Greece
关键词
prognosis; survival; treatment; Waldenstrom's macroglobulinemia;
D O I
10.1093/annonc/mdg334
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Waldenstrom's macroglobulinemia (WM) is an unusual lymphoplasmacytoid lymphoma characterized by the presence of a serum monoclonal immunoglobulin M. Although several studies have evaluated possible prognostic factors of this disease, few have focused on the survival and prognosis of symptomatic patients after the initiation of treatment. Patients and methods: Our study included 122 previously untreated patients with a median age of 67 years who required systemic treatment. Multiple variables were analyzed for their prognostic value on survival after initiation of treatment using univariate and Cox regression multivariate analysis. Results: The median overall survival was 106 months. Pretreatment factors associated with shorter survival were age greater than or equal to65 years, splenomegaly, B-symptoms (weight loss, fever or night sweats), hemoglobin <10 g/dl, platelets <100x10(6)/dl, albumin <3.5 g/dl and bone marrow lymphoplasmacytic infiltrate ≥50%. In the multivariate analysis, the two variables with independent prognostic value were age ≥65 years and hemoglobin <10 g/dl. Furthermore, we were able to divide our patients into three risk groups based on the presence of two, one or none of these two adverse prognostic factors. The median survival times in the high-, intermediate- and low-fisk groups were 46 months, 107 months and 172 months, respectively (P<0.0001). Discussion: Our findings suggest that advanced age and anemia appear to be the two dominant prognostic factors for survival after initiation of treatment in patients with WM. These two readily available parameters can stratify the patients into three distinct subgroups and may help the selection of appropriate treatment.
引用
收藏
页码:1299 / 1305
页数:7
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