Department of Hematology, Affiliated Hospital of Nantong University, Nantong, China.
Eur J Haematol. 2017 Dec;99(6):489-494. doi: 10.1111/ejh.12935. Epub 2017 Sep 13.
This retrospective study was designed to determine the efficacy and safety of low-dose bortezomib and dexamethasone (lBD) in elderly Chinese patients with Waldenstrӧm macroglobulinemia (WM).
Ten patients with WM aged over 60 years received first-line treatment with lBD.
The median age was 70 years (range, 61-77 years). The overall response rate was 80%, including 1 patient who achieved a complete response, 1 patient with very good partial response, and 6 patients with a partial response. Median time to response was 1.8 months after treatment with lBD. Six (60%) patients achieved a partial response, including 2 (20%) patients who had a more than 75% reduction in serum immunoglobulin M levels. A rapid reduction in paraprotein was observed in three patients who received plasmapheresis. After a median follow-up period of 36 months, all patients were still alive and six had no disease progression. The estimated median time to progression was 39 months (range, 15-60 months). The most common adverse events were anemia, thrombocytopenia, neuropathy, and neutropenia. Peripheral neuropathy was the most common non-hematological toxicity in six (60%) patients, but did not result in the discontinuation of bortezomib.
Our findings show that lBD is an effective and tolerable treatment regimen for elderly patients with WM.
本回顾性研究旨在确定低剂量硼替佐米和地塞米松（lBD）治疗老年华氏巨球蛋白血症（WM）患者的疗效和安全性。
10 例年龄超过 60 岁的 WM 患者接受 lBD 一线治疗。
中位年龄为 70 岁（范围，61-77 岁）。总体缓解率为 80%，包括 1 例完全缓解，1 例非常好的部分缓解和 6 例部分缓解。lBD 治疗后中位反应时间为 1.8 个月。6（60%）例患者获得部分缓解，包括 2（20%）例患者血清免疫球蛋白 M 水平降低超过 75%。3 例接受血浆置换的患者观察到异常蛋白迅速减少。中位随访 36 个月后，所有患者均存活，6 例无疾病进展。估计进展时间的中位数为 39 个月（范围，15-60 个月）。最常见的不良反应为贫血、血小板减少、周围神经病和中性粒细胞减少。周围神经病是 6 例（60%）患者最常见的非血液学毒性，但未导致硼替佐米停药。
我们的研究结果表明，lBD 是老年 WM 患者的一种有效且耐受良好的治疗方案。
