Individualizing treatment for Waldenstrom's macroglobulinemia

摘要

Waldenstrom's macroglobulinemia (WM) is a distinct B-cell lymphoprolifer-ative disorder primarily characterized by lymphoplasmacytic cells infiltrating the bone marrow (BM), along with demonstration of an IgM monoclonal gammo-pathy [i-4]. According to the Revised European American Lymphoma (REAL) and WHO systems, WM is classified as a lymphoplasmacytic lymphoma [3,4]. Each year in the USA, there are 1500 new cases diagnosed and the median age of diagnosis is 60 years; the overall incidence of WM is approximately three per million persons per year [5-7]. In 11 population-based registries within the USA, the age-adjusted rates for men and women are 3.4 and 1.7 per million, respectively. Rates increased sharply with age: 0.1 per million individuals under 45 years of age and 36.3 per million individuals over 75 years of age. These rates are comparable to those for hairy-cell leukemia, and do not appear to be increasing. In addition, the rates are clearly higher for Caucasians than for African-Americans [5,8]. The median overall survival of patients with WM is 5?years; however, a recent study of 337 patients with symptomatic WM showed a median disease-specific survival of 11.2 years [7].