therapy for Waldenstrom macroglobulinemia对于常规治疗原发性巨球蛋白血症课件.pptVIP

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therapy for Waldenstrom macroglobulinemia对于常规治疗原发性巨球蛋白血症课件.ppt

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therapy for Waldenstrom macroglobulinemia对于常规治疗原发性巨球蛋白血症课件

Comparative outcomes following CP-R, CVP-R, and CHOP-R in Waldenstr?ms macroglobulinemia. Retrospective single institution study – CHOP-R (n = 23), CVP-R (n = 16), or CP-R (n = 19) ORR and CR rates : CHOP-R (ORR, 96%; CR, 17%); CVP-R (ORR 88%; CR 12%); CP-R (ORR, 95%; CR, 0%); p= NS. More treatment-related neuropathy and febrile neutropenia in patients treated with CVP-R and CHOP-R versus CP-R. Ioakimidis et al. Clin Lymphoma Myeloma. 2009 Mar;9(1):62-6. Alkylating agent based combinations – R-Bendamustine 30 patients with WM – bendamustine 90 mg/m2 I.V. on days 1, 2 and rituximab 375 mg/m2 I.V. on day 1. 6 patients received bendamustine with ofatumumab 1000 mg I.V. on day 1. Median number of treatment cycles was 5. ORR - 83.3%, with 5 VGPR and 20 PR. Median PFS was 13.2 months. Prolonged myelosuppression was more common in patients who received prior nucleoside analogues Treon et al. Clin Lymphoma Myeloma Leuk. 2011 Feb 1;11(1):133-5. Bendamustine plus rituximab compared with R-CHOP in WM patients A subset analysis in the prospective randomized STIL trial - bendamustine plus rituximab (BR) compared with R-CHOP Rummel MJ, et al. Lancet. 2013 Apr 6;381(9873):1203-10. Bortezomib based combinations – BDR/BR Bortezomib, dexamethasone, rituximab (BDR) – 23 untreated, symptomatic WM patients ORR 96% - 3 CRs, 5 VGPRs, 11 PRs Short follow up - PFS – not reached 61% had peripheral neuropathy Treon et al, J Clin Oncol. 2009 Aug 10;27(23):3830-5. Bortezomib, rituximab (BR) – 26 untreated, symptomatic WM patients ORR- 88% - 1 CR, 1 VGPR, 15 PRs PFS – not reached 12% had ≥ grade 3 neutropenia, no grade 3 or 4 neuropathy. Ghobrial et al. Am J Hematol. 2010 Sep;85(9):670-4. Rituximab alone for Waldenstr?ms macroglobulinemia 69 symptomatic WM patients – rituximab x 4 doses ORR 52% - 27% PR, 25% MR Median duration of response – 27 months Gertz et al, Leuk Lymphoma. 2004 Oct;45(10):2047-55. Same study – evaluated IgM levels for “flare” 54% had