Combo Treatment Improved Response for Patients with Waldenstrom Macroglobulinemia (WM)

Right now, there are a number of therapeutic options for people living with Waldenstrom macroglobulinemia (WM), such as chemotherapy, immunotherapy, radiation, plasmapheresis, stem cell transplantation, and targeted therapy. However, these treatments may not be entirely effective. Researchers found that an immunochemotherapy combination of dexamethasone, rituximab, and cyclophosphamide (DRC) showed efficacy in treating WM without inducing major toxicities; bortezomib (Velcade) showed similar efficacy as a monotherapy. According to an article in Targeted Oncology, a research study sought to understand whether combining bortezomib with DRC could be a safe, effective, and innovative treatment approach. 

Altogether, 202 participants were treated in the Phase 3 clinical trial. Patients received either DRC alone, or DRC in conjunction with bortezomib, for a 4-year and 8-month period. They underwent six total treatment cycles and were monitored for extended time following treatment. Researchers focused on progression-free survival, complete or partial response rates, and overall response rates. Findings from the study include:

  • 17.2% of patients in both treatment arms had a complete response, with 9.6% having a very-good partial response. 
  • The progression-free survival rate for 24-months (2 years) was 80.6% in those with the combination treatment and 72.8% with those using DRC alone. Similarly, major responses were seen in 80.6% of those on the combination and 69.9% in those receiving just DRC. 
  • Patients receiving DRC with bortezomib also saw faster response times. 
  • While the treatments were relatively safe and well-tolerated, some adverse reactions did occur. These include neutropenia (low neutrophil counts), anemia (low red blood cell counts), and thrombocytopenia (low platelet counts). Serious infections also occurred in some patients. 

Ultimately, while adding bortezomib to DRC did have a positive impact on patient outcome, more research is needed to determine whether this is a worthwhile treatment option. 

Check out the full study findings published in the Journal of Clinical Oncology

What is Waldenstrom Macroglobulinemia (WM)? 

Waldenstrom macroglobulinemia is a rare blood cell cancer that begins in lymphocytes, a type of white blood cell. More specifically, WM begins in B lymphocytes. Normally, B lymphocytes help the body fight infection. But the cells in WM create large amounts of abnormal IgM. Cancer cells then crowd out healthy red blood cells and make blood thicker than normal (hyperviscous). Risk factors include being male, being older in age, being Caucasian, and having a family history of WM.  

This cancer is indolent (slow-growing). Many people are asymptomatic in early stages. When symptoms appear, they may include: 

  • Anemia (low red blood cell count) 
  • Neutropenia (low white blood cell count)
  • Thrombocytopenia (low platelet count) 
  • Frequent infections
  • Shortness of breath
  • Fatigue and general weakness
  • Enlarged lymph nodes
  • Abdominal distention
  • Headache
  • Poor concentration
  • Unintentional weight loss
  • Diarrhea
  • Easy bruising and bleeding
  • Raised pink or flesh-colored skin lesions
Jessica Lynn

Jessica Lynn

Jessica Lynn has an educational background in writing and marketing. She firmly believes in the power of writing in amplifying voices, and looks forward to doing so for the rare disease community.

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