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Article Navigation >  Journal of Pharmaceutical Practice and Service  > 2016  >  34(5): 459-462

HOU Nan, AN Ran, HOU Jian. Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 459-462. doi: 10.3969/j.issn.1006-0111.2016.05.020
Citation: HOU Nan, AN Ran, HOU Jian. Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 459-462. doi: 10.3969/j.issn.1006-0111.2016.05.020
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Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment

doi: 10.3969/j.issn.1006-0111.2016.05.020

  • Department of Hemopathology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

  • Received Date: 2016-05-18
  • Rev Recd Date: 2016-07-18
  • Objective To summarize the clinical experience of bortezomib-based treatment for Waldenström macroglobulinemia and evaluate the therapeutic efficacy and safety. Methods The clinical data were collected for 15 patients with Waldenström macroglobulinemia receiving bortezomib-based treatment from December 2008 to October 2015.Three therapeutic regimens included BD (bortezomib and dexamethasone) in one case, RBD (bortezomib, rituximab and dexamethasone) in three cases and BCD (bortezomib, dexamethasone and cyclophosphamide) in eleven cases.Responses, adverse reactions and survival analysis were evaluated respectively. Results The overall response rate and major response rate were 93.3% and 80% including CR 1 case, VGPR 2 cases, PR 9 cases and MR 2 cases. The common adverse events included gastrointestinal (53.3%), leukopenia (20%), infection (20%) and peripheral neuropathy (26.7%). After a median follow-up of 21 (3-85) months, the median PFS (progression-free survival) time was 21 (3-36) months and 1 year PFS rate was 83.3%. Survival analysis showed that two prognostic risk factors related to PFS were high-risk group based on international prognostic scoring system for WM(IPSSWM)(P=0.015) and the low response to treatment (P=0.024). Conclusion Bortezomib-based therapeutic regimensexhibited significant efficacyfor patients with WM. IPSSWM and the responses to treatment can be usedto monitor the disease progression and evaluate the therapeutic result.
  • [1] 侯 健,彭利晖. 华氏巨球蛋白血症:循证医学新进展及共识更新[J]. 解放军医学杂志, 2013,38(9):705-709.
    [2] Roussel M, Lauwers-Cances V, Robillard N, et al. Front-line transplantation program with lenalidomide, bortezomib, and dexamethasone combination as induction and consolidation followed by lenalidomide maintenance in patients with multiple myeloma: a phase II study by the Intergroupe Francophone du Myelome[J]. J Clin Oncol, 2014,32(25):2712-2717.
    [3] Owen RG, Treon SP, Al-Katib A, et al. Clinicopathological definition of Waldenström's macroglobulinemia: consensus panel recommendations from the Second International Workshop on Waldenström's Macroglobulinemia[J]. Semin Oncol, 2003,30(2):110-115.
    [4] Morel P, Duhamel A, Gobbi P, et al. International prognostic scoring system for Waldenström macroglobulinemia[J]. Blood, 2009,113(18):4163-4170.
    [5] Anderson KC, Alsina M, Bensinger W, et al. Waldenström's macroglobulinemia/lymphoplasmacytic lymphoma, version 2.2013[J]. J Natl Compr Canc Netw, 2012,10(10):1211-1219.
    [6] Pascal L, Gay J, Willekens C, et al. Bortezomib and Waldenström's macroglobulinemia[J]. Expert Opin Pharmacother, 2009,10(5):909-916.
    [7] Dimopoulos MA, Anagnostopoulos A, Kyrtsonis MC, et al. Treatment of relapsed or refractory Waldenström's macroglobulinemia with bortezomib[J]. Haematologica, 2005,90(12):1655-1658.
    [8] Treon SP, Hunter ZR, Matous J, et al.Multicenter clinical trial of bortezomib in relapsed/refractory Waldenström's macroglobulinemia: results of WMCTG Trial 03-248[J]. Clin Cancer Res, 2007,13(11):3320-3325.
    [9] Chen CI, Kouroukis CT, White D, et al. Bortezomib is active in patients with untreated or relapsed Waldenström's macroglobulinemia: a phase II study of the National Cancer Institute of Canada Clinical Trials Group[J]. J Clin Oncol, 2007,25(12):1570-1575.
    [10] Chen C, Kouroukis CT, White D, et al. Bortezomib in relapsed or refractory Waldenström's macroglobulinemia[J]. Clin Lymphoma Myeloma, 2009,9(1):74-76.
    [11] Treon SP, Ioakimidis L, Soumerai JD, et al. Primary therapy of Waldenström macroglobulinemia with bortezomib, dexamethasone, and rituximab: WMCTG clinical trial 05-180[J]. J Clin Oncol, 2009,27(23):3830-3835.
    [12] Ghobrial IM, Hong F, Padmanabhan S, et al. Phase II trial of weekly bortezomib in combination with rituximab in relapsed or relapsed and refractory Waldenström macroglobulinemia[J]. J Clin Oncol, 2010,28(8):1422-1428.
    [13] Ghobrial IM, Xie W, Padmanabhan S, et al. Phase II trial of weekly bortezomib in combination with rituximab in untreated patients with Waldenström Macroglobulinemia[J]. Am J Hematol, 2010,85(9):670-674.
    [14] Richardson PG, Sonneveld P, Schuster M, et al. Extended follow-up of a phase 3 trial in relapsed multiple myeloma: final time-to-event results of the APEX trial[J]. Blood, 2007,110(10):3557-3560.
    [15] Richardson PG, Briemberg H, Jagannath S, et al. Frequency, characteristics, and reversibility of peripheral neuropathy during treatment of advanced multiple myeloma with bortezomib[J]. J Clin Oncol, 2006,24(19):3113-3120.
    [16] Yi S, Cui R, Li Z, et al. Distinct characteristics and new prognostic scoring system for Chinese patients with Waldenström macroglobulinemia[J]. Chin Med J (Engl), 2014,127(12):2327-2331.
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Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment

doi: 10.3969/j.issn.1006-0111.2016.05.020
  • Department of Hemopathology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Received Date: 2016-05-18
  • Rev Recd Date: 2016-07-18

Abstract: Objective To summarize the clinical experience of bortezomib-based treatment for Waldenström macroglobulinemia and evaluate the therapeutic efficacy and safety. Methods The clinical data were collected for 15 patients with Waldenström macroglobulinemia receiving bortezomib-based treatment from December 2008 to October 2015.Three therapeutic regimens included BD (bortezomib and dexamethasone) in one case, RBD (bortezomib, rituximab and dexamethasone) in three cases and BCD (bortezomib, dexamethasone and cyclophosphamide) in eleven cases.Responses, adverse reactions and survival analysis were evaluated respectively. Results The overall response rate and major response rate were 93.3% and 80% including CR 1 case, VGPR 2 cases, PR 9 cases and MR 2 cases. The common adverse events included gastrointestinal (53.3%), leukopenia (20%), infection (20%) and peripheral neuropathy (26.7%). After a median follow-up of 21 (3-85) months, the median PFS (progression-free survival) time was 21 (3-36) months and 1 year PFS rate was 83.3%. Survival analysis showed that two prognostic risk factors related to PFS were high-risk group based on international prognostic scoring system for WM(IPSSWM)(P=0.015) and the low response to treatment (P=0.024). Conclusion Bortezomib-based therapeutic regimensexhibited significant efficacyfor patients with WM. IPSSWM and the responses to treatment can be usedto monitor the disease progression and evaluate the therapeutic result.

HOU Nan, AN Ran, HOU Jian. Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 459-462. doi: 10.3969/j.issn.1006-0111.2016.05.020
Citation: HOU Nan, AN Ran, HOU Jian. Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment[J]. Journal of Pharmaceutical Practice and Service, 2016, 34(5): 459-462. doi: 10.3969/j.issn.1006-0111.2016.05.020
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