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Fludarabine in Waldenstrom's macroglobulinemia.
Véronique Leblond1, Sylvain Choquet
1Hôpital Pitié Salpêtriére, Paris, France.
Seminars in Oncology
|April 30, 2003
Summary
Waldenstrom's macroglobulinemia (WM) is an incurable B-cell cancer. Fludarabine shows activity in treating WM, with response rates from 30-50% in previously treated patients.
Area of Science:
- Hematology
- Oncology
Background:
- Waldenstrom's macroglobulinemia (WM) is a rare, incurable B-cell malignancy.
- Current treatments include alkylating agents and corticosteroids, with purine analogues like fludarabine also demonstrating activity.
Purpose of the Study:
- To review the efficacy and toxicity of fludarabine in treating Waldenstrom's macroglobulinemia.
- To assess response rates and duration of response in patients treated with fludarabine.
Main Methods:
- Review of phase 2 trials involving purine analogues, specifically fludarabine, in previously treated WM patients since 1990.
- Analysis of response rates, duration of response, and principal toxicities.
Main Results:
- Fludarabine induced responses in approximately one-third of WM patients resistant to prior treatments.
- Response rates for fludarabine in previously treated patients range from 30% to 50%, with higher rates in patients sensitive to primary therapy.
- Responses to fludarabine lasted between 32 and 41 months, with myelosuppression as the primary toxicity.
Conclusions:
- Fludarabine is an active agent in Waldenstrom's macroglobulinemia, particularly in previously treated patients.
- Further trials investigating fludarabine combination therapies, such as with rituximab, are ongoing.