Clinical Characteristics and Treatment Outcomes of Patients with Waldenstrom Macroglobulinemia

Area of Science:

• Hematology
• Oncology
• Rare Diseases

Background:

• Waldenstrom macroglobulinemia (WM) is a rare B-cell lymphoproliferative disorder.
• Limited data exists on WM characteristics and outcomes specifically from India.
• This study addresses the need for Indian-specific WM data.

Purpose of the Study:

• To describe the clinical characteristics and treatment outcomes of WM patients in India.
• To compare findings with existing Western literature.
• To investigate the incidence of MYD88 mutations in Indian WM patients.

Main Methods:

• Retrospective analysis of 55 WM patients treated at a single center from 2009-2023.
• Data collection included patient demographics, clinical presentation, laboratory values, MYD88 mutation status, treatment regimens, and outcomes.
• Statistical analysis of survival and response rates.

Main Results:

• The median age of patients was 62 years, with a male predominance (3.2:1).
• Common symptoms included those attributable to WM (76.4%) and Immunoglobulin M (IgM) related issues (9.1%).
• Median hemoglobin was 7.4 g/dL, median serum IgM was 4.87 g/L. MYD88 mutation was positive in 53.3% of tested patients.
• Chemo-immunotherapy, particularly Bendamustine-Rituximab, was the most common first-line treatment.
• Overall and major response rates to front-line therapy were 78.2% and 69.1%, respectively.
• Median event-free survival, time to next therapy, and overall survival were 45, 51, and 150 months, respectively.
• Progressive disease was the most common cause of death (42.9%).

Conclusions:

• Indian WM patients present with characteristics and outcomes comparable to those reported in Western literature.
• A lower incidence of MYD88 mutations was observed in this Indian cohort compared to some Western studies.
• This study provides valuable insights into WM management and epidemiology in the Indian subcontinent.