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Alkylating agents for Waldenstrom's macroglobulinaemia.

Kun Yang¹, Jianlong Tan, Taixiang Wu

¹Chinese Cochrane Centre, Chinese EBM Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China, 610041.

The Cochrane Database of Systematic Reviews

|January 23, 2009

Summary

Alkylating agents are not proven effective for Waldenstrom's macroglobulinaemia (WM). A review found no evidence supporting their use in treating this B-cell disorder.

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Area of Science:

Hematology
Oncology
Clinical Trials

Background:

Waldenstrom's macroglobulinaemia (WM) is a rare B-cell lymphoproliferative disorder.
Treatment efficacy of alkylating agents in WM remains uncertain.

Purpose of the Study:

To evaluate the effects and safety of alkylating agents for Waldenstrom's macroglobulinaemia.

Main Methods:

Systematic search of multiple databases (Cochrane, MEDLINE, EMBASE, etc.) and conference proceedings.
Inclusion of randomized controlled trials (RCTs) comparing alkylating agents in WM patients.
Independent assessment of trial quality and data extraction by two authors.

Main Results:

One trial (92 participants) compared fludarabine to cyclophosphamide, doxorubicin, and prednisone (CAP).

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Fludarabine showed a superior response rate and duration compared to CAP in pretreated/relapsed WM.

No statistically significant difference in overall survival was observed between treatments.

Conclusions:

Alkylating agents have been used historically but lack robust randomized trial evidence in WM.
Current evidence does not support the effectiveness of alkylating agents for treating Waldenstrom's macroglobulinaemia.