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Fludarabine therapy in Waldenström's macroglobulinemia
M A Dimopoulos1, S O'Brien, H Kantarjian
1Department of Hematology, MD Anderson Cancer Center, Houston, Texas 77030.
The American Journal of Medicine
|July 1, 1993
Summary
Fludarabine shows effectiveness as a salvage treatment for Waldenström's macroglobulinemia, achieving a 36% response rate and long remissions. Further research is recommended for untreated patients.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Waldenström's macroglobulinemia (WM) is a rare B-cell lymphoproliferative disorder.
- Effective salvage therapies for resistant WM are crucial.
Purpose of the Study:
- To evaluate fludarabine's efficacy in treating Waldenström's macroglobulinemia.
- To assess response rates, remission duration, and survival outcomes.
Main Methods:
- A cohort of 28 WM patients received fludarabine (20-30 mg/m2 daily for 3-5 days).
- Patients included both previously untreated and those resistant to prior therapies.
- Treatment continued until maximum response, with follow-up until relapse.
Main Results:
- A 36% overall response rate was observed (10/28 patients).
- Remissions lasted a median of 38 months without maintenance therapy.
- Patients with primary resistant disease and shorter duration benefited most.
Conclusions:
- Fludarabine is an effective salvage agent for resistant Waldenström's macroglobulinemia.
- Further investigation in untreated WM and combination therapies is warranted.