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Myeloma

Fludarabine plus cyclophosphamide in Waldenström's macroglobulinemia: results in 49 patients

Leukemia volume 19, pages 1831–1834 (2005)Cite this article

Abstract

Fludarabine (FDR) therapy gives a response rate of about 30% in previously treated patients with Waldenström's macroglobulinemia (WM). The combination of FDR and cyclophosphamide (Cy) has been shown to be effective in chronic lymphoproliferative disorders. We administered the combination of FDR (30 mg/m2 i.v. D1–D3) and Cy (300 mg/m2 i.v. D1–D3) to 49 patients. Median age was 64 years. The median hemoglobin, albumin, beta 2 microglobulin and immunoglobulin M (IgM) levels were 9.9 g/100 ml, 39.6 g/l, 3 mg/l and 24.7 g/l, respectively. In all, 14 patients (29%) had not previously been treated. FDR/Cy was administered every 4 weeks for a median of four cycles. In all, 38 patients (77.6%) had partial responses, nine had stable disease and two had progressive disease. After a median of follow-up of 25 months, six patients relapsed and two patients developed large-cell lymphoma. The median time to treatment failure was 27 months. The main toxicity was hematological. In all, 12 patients died, four from progression, one from large-cell lymphoma, three from infection and four from a second malignancy. Two factors negatively influenced overall and event-free survival, age >65 years and IgM <40 g/l. The FDR/Cy combination, therefore, gives a high response rate in WM, even in previously treated patients with factors of poor prognosis.

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Authors and Affiliations

  1. Service d'hématologie Hôpital Pitié Salpêtrière, Paris, France

    J Tamburini, S Choquet & V Leblond

  2. Centre d'Investigations Cliniques et INSERM ERM 321, Hôpital Saint-Louis, Paris, France

    V Lévy

  3. Service d'hématologie Hôpital Hôtel Dieu, Clermont-Ferrand, France

    C Chaleteix

  4. Service d'immunologie clinique Hôpital Saint-Louis, Paris, France

    J P Fermand

  5. Service d'hématologie Centre hospitalier Robert Debré, Reims, France

    A Delmer

  6. Service d'hématologie Centre hospitalier Schaffner, Lens, France

    L Stalniewicz & P Morel

  7. Service d'hématologie Hôpital Cochin, Paris, France

    F Dreyfus

  8. Laboratoire d'hématologie Hôpital Bichat, Paris, France

    M J Grange

  9. Service d'hématologie Hôpital de Metz, Metz, France

    B Christian

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  1. J Tamburini
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Correspondence to V Leblond.

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Tamburini, J., Lévy, V., Chaleteix, C. et al. Fludarabine plus cyclophosphamide in Waldenström's macroglobulinemia: results in 49 patients. Leukemia 19, 1831–1834 (2005). https://doi.org/10.1038/sj.leu.2403885

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