Abstract:

Preliminary evidence suggests that rituximab, a chimeric antibody that targets CD20+ B cells, may be active in Waldenstrom's macroglobulinemia (WM). In May 1999 we initiated a prospective trial during which patients with WM were treated with rituximab, 375 mg/m2, administered by IV infusion weekly for 4 consecutive weeks. Three months after completion of rituximab, patients without evidence of progressive disease received repeat 4-week courses of this agent. Twelve patients have been treated so far.Eight patients were previously untreated, 2 primary refractory and 2 were treated during resistant relapse. The median age was 77 years (range: 39 to 85 years), hemoglobin was < 10.0 gr/ dl in 5 patients, lymphadenopathy and splenomegaly were present in 6 and 5 patients respectively. After the initial 4-week courses of rituximab responses were as follows: 75% reduction of IgM in 3 patients, 50% reduction of IgM in 2 patients, 25% reduction of IgM in 1 patient, stable disease in 4 patients and progressive disease in 2 patients. At least 50% reduction of IgM was noted in 3 of 8 previously untreated patients and in 2 of 4 pretreated patients. Among the 10 patients eligible for the second 4-week course of rituximab, 5 patients are évaluable so far: a 25% decrease of IgM was noted in two patients with stable disease after the first course of rituximab. Disappearance or significant reduction of lymphadenopathy or splenomegaly and of bone marrow lymphocytosis occurred in all responding patients. Treatment with rituximab was well tolerated: 3 patients developed grade 1,2 rigors and fever and 2 patients developed flushing. Our prospective study indicate that rituximab is an active and well torelated agent for the treatment of WM.

Notes:

Cited By :6Export Date: 21 February 2017

Website