medigraphic.com

2012, Number 4

<< Back Next >>

Rev Hematol Mex 2012; 13 (4)

Treatment of Waldenstrom’s macroglobulinemia with R-CHOP. Report of a case

Ramón-Rodríguez LG, Mustelier-Celza G, Ávila-Cabrera O, González-Pinedo L, Gutiérrez-Díaz A, Hernández-Padrón C

Language: Spanish
References: 17
Page: 201-206
PDF size: 229.33 Kb.


ABSTRACT

Waldenström’s macroglobulinemia is a lymphoplasmacytic lymphoma which produces monoclonal immunoglobulin M (IgM). This disorder is rare and it accounts for 2% of all hematologic malignancies. Here we present a 42-year-old male who was referred to the clinic complaining of asthenia, fatigue and shortness of breath on exertion. Pallor and inguinal lymph nodes were detected on physical examination. The patient presented with anemia, leucopenia, hyperproteinemia, and hypoalbuminemia. Serum electrophoresis and immunofixation showed lambda clonal immunoglobulin M (IgM) paraproteinemia. Bone marrow biopsy revealed infiltration by atypical plasmacytic lymphocytes and the diagnosis of Waldenström’s macroglobulinemia was made. Then 6 cycles of R-CHOP 21 were started and a partial response was achieved. A complete response was achieved after one year of maintenance therapy with rituximab. No significant toxicity was observed and the treatment was successful. Some comments about the current therapy of this disorder are made in this article.


REFERENCES

  1. Treon SP. How I treat Waldenström macroglobulinemia. Blood 2009;114:2375-2385.

  2. Harris NL, Jaffe ES, Stein H, et al. A revised European- American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994;84:1361-1392.

  3. Harris NL, Jaffe ES, Diebold J, et al. The World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November, 1997. J Clin Oncol 1999;155: 257-265.

  4. Morel P, Merlini G. Risk stratification in Waldenström macroglobulinemia. Expert Rev Hematol 2012;5:87-99.

  5. Johnson SA, Birchall J, Luckie C, Oscier DG, Owen RG. Guidelines on the management of Waldenström Macroglobulinaemia. Br J Haematol 2006;132:683-697.

  6. Gertz MA. Waldenström Macroglobulinemia: 2012 update on diagnosis, risk stratification, and management. Am J Hematol 2012;87:504-510.

  7. Sekhar J, Sanfilippo K, Zhang Q, Trinkaus K, Vij R, Morgensztern D. Waldenström’s macroglobulinemia: a Surveillance, Epidemiology, and End Results database review from 1988 to 2005. Leuk Lymphoma 2012;53:1625-1626.

  8. Dimopoulos MA, Anagnostopoulos A. Waldenström´s macroglobulinemia. Best Prac Res Clin Haematol 2005;18:747-765.

  9. Dimopoulos MA, Merlini G, Leblond V, Anagnostopoulos A, Alexanian R. How we treat Waldenström’s macroglobulinemia. Haematologica 2005;90:117-125.

  10. Ghobrial IM, Fonseca R, Greipp PR. Eastern Cooperative Oncology Group. Initial immunoglobulin M ‘flare’ after rituximab therapy in patients diagnosed with Waldenström’s macroglobulinemia: An Eastern Cooperative Oncology Group Study. Cancer 2004;101:2593-2598.

  11. Vijay A, Gertz MA. Current Treatment Options for Waldenström Macroglobulinemia. Clin Lymphoma Myeloma 2008;8:219-229.

  12. Treon SP, Hanzis C, Manning RJ, et al. Maintenance rituximab is associated with improved clinical outcome in rituximab naive patients with Waldenström Macroglobulinaemia who respond to a rituximab-containing regimen. Br J Haematol 2011;154:357-362.

  13. Buske C, Hoster E, Dreyling M, et al. German Low-Grade Lymphoma Study Group. The addition of rituximab to front-line therapy with CHOP (R-CHOP) results in a higher response rate and longer time to treatment failure in patients with lymphoplasmacytic lymphoma: Results of a randomized trial of the German Low-Grade Lymphoma Study Group (GLSG). Leukemia 2009;23:153-161.

  14. Weiss L, Melchardt T, Neureiter D, KemmerlingR, Moshir S, Pleyer L, et al. Complete Remission of Waldenström’s Macroglobulinemia With Azacitidine and Rituximab. J Clin Oncol 2011;29:696-98.

  15. Rummel MJ, Niederle N, von Grunhagen U. Bendamustine plus rituximab versus CHOP plus rituximab as first-line-treatment in patients with indolent lymphomas and Waldenström’s macroglobulinemia [abstract]. The Sixth International Workshop on Waldenström’s Macroglobulinemia, Oct 6-10, 2010, Venice, Italy.

  16. Gertz MA. Waldenström’s macroglobulinemia: is newer really better? Leuk Lymphoma 2010;51:2152-2153.

  17. Ruiz-Argüelles GJ, Ramírez-Cisneros FJ, Flores-Martínez J, Cernuda-Graham MC. Waldenström´s macroglobulinemia is infrequent in Mexican mestizos: Experience of a Hematological diseases referral center. Rev Invest Clín Méx 2000;52:497-499.




2020     |     www.medigraphic.com