TY - JOUR
T1 - Assessment of fixed-duration therapies for treatment-naïve Waldenström macroglobulinemia
AU - Abeykoon, Jithma P.
AU - Zanwar, Saurabh
AU - Ansell, Stephen M.
AU - Muchtar, Eli
AU - He, Rong
AU - Greipp, Patricia T.
AU - King, Rebecca L.
AU - Ailawadhi, Sikander
AU - Paludo, Jonas
AU - Larsen, Jeremy T.
AU - Habermann, Thomas M.
AU - Inwards, David
AU - Go, Ronald S.
AU - Thanarajasingam, Gita
AU - Buadi, Francis
AU - Dispenzieri, Angela
AU - Thompson, Carrie A.
AU - Witzig, Thomas E.
AU - Lacy, Martha
AU - Gonsalves, Wilson
AU - Nowakowski, Grzegorz S.
AU - Dingli, David
AU - Rajkumar, Sundararajan Vincent
AU - Kyle, Robert A.
AU - Sher, Taimur
AU - Roy, Vivek
AU - Rosenthal, Allison
AU - Chanan-Khan, Asher A.
AU - Reeder, Craig
AU - Gertz, Morie A.
AU - Kumar, Shaji
AU - Kapoor, Prashant
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Comparative data guiding initial therapy for Waldenström macroglobulinemia (WM), an infrequently encountered non-Hodgkin lymphoma, are sparse. We evaluated three commonly used rituximab-based frontline regimens: rituximab-bendamustine (R-Benda); dexamethasone, rituximab, cyclophosphamide (DRC); and bortezomib, dexamethasone, rituximab (BDR) in 220 treatment-naïve patients with WM, seen at Mayo Clinic between November 1, 2000 and October 31, 2019. The median follow-up was 4.5 (95%CI: 4–5) years. The R-Benda cohort (n = 83) demonstrated superior overall response rate (ORR: 98%), in comparison to DRC (n = 92, ORR: 78%) or BDR (n = 45, ORR: 84%) cohorts, p = 0.003. Similarly, longer progression-free survival (PFS) was evident with R-Benda use [median 5.2 vs. 4.3 (DRC) and 1.8 years (BDR), p < 0.001]. The time-to-next therapy (TTNT) favored R-Benda [median, not-reached, 4.4 (DRC) and 2.6 years (BDR), p < 0.001). These endpoints were comparable between the DRC and BDR cohorts. Overall survival (OS) was similar across the three cohorts, p = 0.77. In a subset analysis of 142 patients genotyped for MYD88L265P mutation, the ORR, PFS and TTNT were unaffected by the patients' MYD88 signature within each cohort. In conclusion, ORR, PFS and TTNT with R-Benda are superior compared to DRC or BDR in treatment-naïve patients with active WM. The patient outcomes with any one of these three regimens are unaffected by the MYD88L265P mutation status.
AB - Comparative data guiding initial therapy for Waldenström macroglobulinemia (WM), an infrequently encountered non-Hodgkin lymphoma, are sparse. We evaluated three commonly used rituximab-based frontline regimens: rituximab-bendamustine (R-Benda); dexamethasone, rituximab, cyclophosphamide (DRC); and bortezomib, dexamethasone, rituximab (BDR) in 220 treatment-naïve patients with WM, seen at Mayo Clinic between November 1, 2000 and October 31, 2019. The median follow-up was 4.5 (95%CI: 4–5) years. The R-Benda cohort (n = 83) demonstrated superior overall response rate (ORR: 98%), in comparison to DRC (n = 92, ORR: 78%) or BDR (n = 45, ORR: 84%) cohorts, p = 0.003. Similarly, longer progression-free survival (PFS) was evident with R-Benda use [median 5.2 vs. 4.3 (DRC) and 1.8 years (BDR), p < 0.001]. The time-to-next therapy (TTNT) favored R-Benda [median, not-reached, 4.4 (DRC) and 2.6 years (BDR), p < 0.001). These endpoints were comparable between the DRC and BDR cohorts. Overall survival (OS) was similar across the three cohorts, p = 0.77. In a subset analysis of 142 patients genotyped for MYD88L265P mutation, the ORR, PFS and TTNT were unaffected by the patients' MYD88 signature within each cohort. In conclusion, ORR, PFS and TTNT with R-Benda are superior compared to DRC or BDR in treatment-naïve patients with active WM. The patient outcomes with any one of these three regimens are unaffected by the MYD88L265P mutation status.
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U2 - 10.1002/ajh.26210
DO - 10.1002/ajh.26210
M3 - Article
C2 - 33909933
AN - SCOPUS:85106223485
SN - 0361-8609
VL - 96
SP - 945
EP - 953
JO - American journal of hematology
JF - American journal of hematology
IS - 8
ER -