WALDENSTROMS'MACROGLOBULINEMIA'–'A'REVIEW'OF'OF'11'PATIENTS'
POSTER'26'
FROM'A'SINGLE'CENTRE'IN'SOUTH'INDIA'
'
Gayatri!Gopan1,!Geetha!N1,!Sreejith!Nair1,!Prakash!N!P1,!Deepa!Philip1,!Sugeeth!M!T1!and!Jayasudha!A!
V2!
!
(1)Department! of! Medical! Oncology,! Regional! Cancer! Center,! Thiruvananthapuram,! India,!
(2)Department!of!Pathology,Regional!Cancer!Center,!Thiruvananthapuram,!India!
!
INTRODUCTION!
Waldenstroms! macroglobulinemia! is! lymphoplasmacytic! lymphoma! associated! with! a!
monoclonal! immunoglobulin! M! (IgM)! protein! and! is! rare.! Presence! of! IgM! monoclonal!
protein!associated!with!≥10%!clonal!lymphoplasmacytic!cells!in!bone!marrow!is!needed!for!
the!diagnosis.!Here!we!describe!our!experience!with!this!rare!disorder.!
MATERIALS!AND!METHODS!!
This! is! a! retrospective! study! of! 11! patients! diagnosed! with! Waldenstroms!
macroglobulinemia! treated! in! the! Department! of! Medical! Oncology! at! Regional! Cancer!
Center,!Trivandrum,!during!a!5J!year!period!from!2013!to!2018.!
RESULTS!
In! the! present! study,! the! median! age! was! 66! years! (range! 53–80! years).There! were! eight!
males!and!three!females!with!a!male:!female!ratio!of!2.6:1.!Eight!patients!had!B!symptoms,!
three! had! hyperviscosity! features! and! one! each! presented! with! acute! loss! of! vision,!
abdominal! pain! and! lymphadenopathy.! One! patient! was! asymptomatic.! Cytopenias! were!
present!in!eight!patients.!The!median!duration!of!symptoms!was!6!months.!Immunoglobulin!
(Ig)! M! levels! were! elevated! in! all! with! the! median! being! 2972! mg/dl! (normal! value! 1276! J!
7260)!(normal!range!40J230!mg/dl).!B!symptoms!and!cytopenias!were!the!main!indications!
for!treatment.!Seven!patients!received!Rituximab!based!treatment.!Two!patients!underwent!
plasmapheresis.!Three!patients!received!chemotherapy!with!Rituximab,!Cyclophosphamide,!
Dexamethasone! (RCD)! followed! by! Rituximab! maintenance,! two! received! treatment! with!
Rituximab,!Bortezomib!and!Dexamethasone!(BDR),!two!received!treatment!with!Rituximab!
and!Dexamethasone,!one!patient!received!Thalidomide!and!Dexamethasone!and!two!were!
only!observed.!Five!patients!attained!complete!remission!with!Rituximab!based!treatment.!
Three! patients! attained! only! a! partial! response! and! two! patients! had! progressive! disease.!
Salvage! regimens! used! were! Bendamustine! and! Rituximab! and! RCD! chemotherapy.! The!
overall!survival!at!2!years!was!82!%!(9!months!–!72!months).!
CONCLUSION!
Waldenstroms!Macroglobulinemia!is!an!indolent!lymphoma!for!which!the!goals!of!treatment!
are! to! control! symptoms! and! prevent! endJorgan! damage,! while! maximizing! quality! of! life.!
Rituximab!based!treatment!can!give!long!term!survival.!The!2!year!overall!survival!obtained!