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华氏巨球蛋白血症

Waldenström macroglobulinemia.

作者信息

Gertz Morie A

机构信息

Division of Hematology, Mayo Clinic, 200 First Street, SW, Siebens 667, Rochester, MN 55905, USA.

出版信息

Hematology. 2012 Apr;17 Suppl 1:S112-6. doi: 10.1179/102453312X13336169156212.

Abstract

Waldenström macroglobulinemia is a lymphoplasmacytic lymphoma. A serum monoclonal IgM protein is required to establish this diagnosis. The clinical features patients develop include normochromic normocytic anemia, thrombocytopenia, hepatosplenomegaly, lymphadenopathy and signs of hyperviscosity. The International Staging System for Waldenström macroglobulinemia divides patients prognostically based on age, hemoglobin, platelet count, IgM level, and beta2 microglobulin. Some patients with Waldenström macroglobulinemia have a smoldering form and can be observed without intervention. Active agents in the treatment of Waldenström macroglobulinemia include rituximab, chlorambucil, cyclophosphamide, fludarabine, bortezomib, lenalidomide, bendamustine, everolimus, and alemtuzumab. The current preferred Mayo Clinic non-study treatment is rituximab, cyclophosphamide, and dexamethasone. The median survival associated with this disease is now over 10 years.

摘要

华氏巨球蛋白血症是一种淋巴浆细胞性淋巴瘤。确诊此病需要血清单克隆IgM蛋白。患者出现的临床特征包括正细胞正色素性贫血、血小板减少、肝脾肿大、淋巴结病以及高黏滞血症体征。华氏巨球蛋白血症国际分期系统根据年龄、血红蛋白、血小板计数、IgM水平和β2微球蛋白对患者进行预后分组。一些华氏巨球蛋白血症患者呈无症状型,可不干预观察。治疗华氏巨球蛋白血症的常用药物包括利妥昔单抗、苯丁酸氮芥、环磷酰胺、氟达拉滨、硼替佐米、来那度胺、苯达莫司汀、依维莫司和阿仑单抗。目前梅奥诊所非研究性治疗的首选方案是利妥昔单抗、环磷酰胺和地塞米松。这种疾病的中位生存期现在超过10年。

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