Initial Immunoglobulin M ‘Flare’ after Rituximab Therapy in Patients Diagnosed with Waldenstrom Macroglobulinemia
Ghobrial, Irene M.
Greipp, Philip R.
Vesole, David H.
Gertz, Morie A.
MetadataShow full item record
BACKGROUND. The goal of the current study was to characterize the initial upsurge in immunoglobulin M (IgM) levels after treatment with rituximab in patients with Waldenstrom macroglobulinemia (WM). METHODS. As part of a Phase II Eastern Cooperative Oncology Group study, 72 patients were treated with rituximab (375 mg/m2 weekly for 4 weeks) between April 2000 and January 2002. IgM levels in these patients were measured at five separate time points so that any temporal changes that occurred could be characterized. RESULTS. Of the 54 patients for whom the relevant IgM measurements were available, 29 (54%) experienced an increase in IgM levels between baseline and the first scheduled postbaseline time point. At 2 months, 13 of 22 evaluable patients (59%) continued to have elevated IgM levels, and at 4 months, elevated IgM levels persisted in 4 of 15 evaluable patients (27%). Overall, a nonlinear trend characterized by an initial increase in IgM levels followed by a decrease in these levels was observed (P 0.0001). CONCLUSIONS. Treating physicians should be aware that an IgM ‘flare’ may occur in up to 54% of patients treated with rituximab; however, most of these patients experience a decrease in IgM levels within 4 months after the initiation of therapy. Therefore, patients should not be discouraged from continuing to receive this potentially effective therapeutic agent, as responses to rituximab may develop slowly. Longer follow-up will reveal whether patients who experience an upsurge in IgM levels have poorer overall survival or shorter times to progression compared with patients who do not experience this IgM flare. Factors predicting an initial increase in IgM levels could not be identified.
Is part ofCancer, 2004, vol. 101, núm. 11, p. 2593-2598
European research projects
Showing items related by title, author, creator and subject.
Fonseca, Rafael; Blood, Emily; Rué i Monné, Montserrat; Harrington, David; Oken, Martin M.; Kyle, Robert A.; Dewald, Gordon W.; Van Ness, Brian; Van Wier, Scott A.; Henderson, Kimberly J.; Bailey, Richard J.; Greipp, Philip R. (American Society of Hematology, 2003)Nonrandom recurrent chromosomal abnormalities are ubiquitous in multiple myeloma (MM) and include, among others, translocations of the immunoglobulin heavy chain locus (IgH). IgH translocations in MM result in the ...
Costs and cost-efficacy analysis of the 2016 GESIDA/Spanish AIDS National Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Crespo, Manuel; Domingo, Pere; Estrada, Vicente; Iribarren, José Antonio; Knobel, Hernando; Lázaro, Pablo; López Aldeguer, José; Lozano, Fernando; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M. (Elsevier, 2017)Introduction: GESIDA and the AIDS National Plan panel of experts suggest preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2016. ...
Phase III Study of PSC-833 (Valspodar) in Combination with Vincristine, Doxorubicin, and Dexamethasone (Valspodar/VAD) versus VAD Alone in Patients with Recurring or Refractory Multiple Myeloma (E1A95) Friedenberg, William R.; Rué i Monné, Montserrat; Blood, Emily; Dalton, William S.; Shustik, Chaim; Larson, Richard A.; Sonneveld, Pieter; Greipp, Philip R. (Wiley, 2006)BACKGROUND. Preliminary studies have shown valspodar (PSC-833: Novartis Pharmaceuticals, East Hanover, NJ) to be a potent inhibitor of multidrug resistance (MDR), one cause of resistance to chemotherapy. An international ...