Primary Treatment of Waldenström Macroglobulinemia With Dexamethasone, Rituximab, and Cyclophosphamide
| Autor: | Marie-Christine Kyrtsonis, Dimitra Gika, Nikolaos Anagnostopoulos, Konstantinos Zervas, Panagiotis Repoussis, Anastasia Pouli, T. Economopoulos, Meletios A. Dimopoulos, Souzana Delimpasi, Evangelos Terpos, Garyfallia Kokkinis, Argyris Symeonidis, Constantinos Tsatalas, Gerasimos Pangalis, Evridiki Michali, Elina Vervessou, Athanasios Anagnostopoulos, Amalia Vassou, Eirini Katodritou |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Cyclophosphamide Antineoplastic Agents Neutropenia Gastroenterology Dexamethasone Antibodies Monoclonal Murine-Derived Internal medicine Multicenter trial Humans Medicine Prospective Studies Survival rate Aged business.industry Antibodies Monoclonal Waldenstrom macroglobulinemia Middle Aged medicine.disease Survival Analysis Surgery Regimen Treatment Outcome Oncology Disease Progression Drug Therapy Combination Female Rituximab Waldenstrom Macroglobulinemia business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 25:3344-3349 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose Alkylating agents and the anti-CD20 monoclonal antibody rituximab are among appropriate choices for the primary treatment of symptomatic patients with Waldenström macroglobulinemia (WM), and they induce at least a partial response in 30% to 50% of patients. To improve these results, we designed a phase II study that included previously untreated symptomatic patients with WM who received a combination of dexamethasone, rituximab, and cyclophosphamide (DRC). Patients and Methods Seventy-two patients were treated with dexamethasone 20 mg intravenously followed by rituximab 375 mg/m2 intravenously on day 1 and cyclophosphamide 100 mg/m2 orally bid on days 1 to 5 (total dose, 1,000 mg/m2). This regimen was repeated every 21 days for 6 months. Patients' median age was 69 years and many had features of advanced disease such as anemia (57%), hypoalbuminemia (40%), and elevated serum beta2-microglobulin (43%). Results On an intent-to-treat basis, 83% of patients (95% CI, 73% to 91%) achieved a response, including 7% complete, 67% partial, and 9% minor responses. The median time to response was 4.1 months. The 2-year progression-free survival rate for all patients was 67%; for patients who responded to DRC, it was 80%. The 2-year disease-specific survival rate was 90%. Treatment with DRC was well tolerated, with 9% of patients experiencing grade 3 or 4 neutropenia and approximately 20% of patients experiencing some form of toxicity related to rituximab. Conclusion Our large, multicenter trial showed that the non–stem-cell toxic DRC regimen is an active, well-tolerated treatment for symptomatic patients with WM. |
| Databáze: | OpenAIRE |
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