TY - JOUR
T1 - Prognostic markers and criteria to initiate therapy in Waldenstrom's macroglobulinemia
T2 - Consensus panel recommendations from the Second International Workshop on Waldenstrom's Macroglobulinemia
AU - Kyle, Robert A.
AU - Treon, Steven P.
AU - Alexanian, Raymond
AU - Barlogie, Bart
AU - Björkholm, Magnus
AU - Dhodapkar, Madhav
AU - Lister, T. Andrew
AU - Merlini, Giampaolo
AU - Morel, Pierre
AU - Stone, Marvin
AU - Branagan, Andrew R.
AU - Leblond, Véronique
PY - 2003/4
Y1 - 2003/4
N2 - This presentation represents consensus recommendations on prognostic markers and criteria to initiate therapy in patients with Waldenstrom's macroglobulinemia (WM), which were prepared in conjunction with the Second International Workshop held in Athens, Greece during September 2002. The panel recommended that initiation of therapy should not be based on the IgM level per se since this may not correlate with the clinical manifestations of WM. The consensus panel agreed that initiation of therapy was appropriate for patients with constitutional symptoms such as recurrent fever, night sweats, fatigue due to anemia, or weight loss. The presence of progressive, symptomatic lymphadenopathy or splenomegaly provide additional reasons to begin therapy. The presence of anemia with a hemoglobin value of ≤ 10 g/dL or a platelet count < 100 × 109/L due to marrow infiltration also justifies treatment. Certain complications such as hyperviscosity syndrome, symptomatic sensorimotor peripheral neuropathy, systemic amyloidosis, renal insufficiency, or symptomatic cryoglobulinemia may also be indications for therapy. Recommendations for follow-up of watch-and-wait patients are that those with monoclonal gammopathy of undetermined significance (MGUS) should have serum protein electrophoresis repeated each year. Patients with asymptomatic (smoldering) macroglobulinemia should be evaluated every 6 months. Regarding prognostic markers, hemoglobin and β2-microglobulin levels at diagnosis are important prognostic markers in WM: they influence the timing of treatment and survival. Age is a consistently important prognostic factor for survival. However, the panel felt that current data are inadequate to support the use of any prognostic marker to select the timing and type of therapy, and called for studies on the application of prognostic markers in WM.
AB - This presentation represents consensus recommendations on prognostic markers and criteria to initiate therapy in patients with Waldenstrom's macroglobulinemia (WM), which were prepared in conjunction with the Second International Workshop held in Athens, Greece during September 2002. The panel recommended that initiation of therapy should not be based on the IgM level per se since this may not correlate with the clinical manifestations of WM. The consensus panel agreed that initiation of therapy was appropriate for patients with constitutional symptoms such as recurrent fever, night sweats, fatigue due to anemia, or weight loss. The presence of progressive, symptomatic lymphadenopathy or splenomegaly provide additional reasons to begin therapy. The presence of anemia with a hemoglobin value of ≤ 10 g/dL or a platelet count < 100 × 109/L due to marrow infiltration also justifies treatment. Certain complications such as hyperviscosity syndrome, symptomatic sensorimotor peripheral neuropathy, systemic amyloidosis, renal insufficiency, or symptomatic cryoglobulinemia may also be indications for therapy. Recommendations for follow-up of watch-and-wait patients are that those with monoclonal gammopathy of undetermined significance (MGUS) should have serum protein electrophoresis repeated each year. Patients with asymptomatic (smoldering) macroglobulinemia should be evaluated every 6 months. Regarding prognostic markers, hemoglobin and β2-microglobulin levels at diagnosis are important prognostic markers in WM: they influence the timing of treatment and survival. Age is a consistently important prognostic factor for survival. However, the panel felt that current data are inadequate to support the use of any prognostic marker to select the timing and type of therapy, and called for studies on the application of prognostic markers in WM.
UR - http://www.scopus.com/inward/record.url?scp=0037397347&partnerID=8YFLogxK
U2 - 10.1053/sonc.2003.50038
DO - 10.1053/sonc.2003.50038
M3 - Article
C2 - 12720119
AN - SCOPUS:0037397347
SN - 0093-7754
VL - 30
SP - 116
EP - 120
JO - Seminars in Oncology
JF - Seminars in Oncology
IS - 2
ER -