Rituxan for Waldenstrom’s macroglobulinemia – pro

Waldenström’s macroglobulinemia (WM) is a CD20 expressing B-cell malignancy represented by the pathological diagnosis of IgM secreting lymphoplasmacytic lymphoma. Since 1999, there have been many reprts and several phase II studies of Rituxan in this disease. Major response rates of 30% have been reported in most studies with standard dose rituximab, i.e. 4 weekly infusions at 375 mg/m2/week. A recent guideline states: “Rituximab is active in the treatment of WM but associated with the risk of transient exacerbation of clinical effects of the disease and should only be used with caution especially in patients with symptoms of hyperviscosity and/or IgM levels > 40g/L. Level of evidence IIb, Grade of recommendation B.” In light of this guidelien, Rituxan should not be considered experiemntal since it is recognized by exp[ert opinon to be useful in the form of the guideline.

A. Vijay and M. A. Gertz
Waldenstrom macroglobulinemia
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S. P. Treon, C. Emmanouilides, E. Kimby, A. Kelliher, F. Preffer, A. R. Branagan, K. C. Anderson, S. R. Frankel, and On behalf the Waldenstrom's Macroglobulinemia Clin
Extended rituximab therapy in Waldenstrom's macroglobulinemia
Ann. Onc., January 1, 2005; 16(1): 132 - 138.

J. Boye, T. Elter, and A. Engert
An overview of the current clinical use of the anti-CD20 monoclonal antibody rituximab
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Johnson SA, Birchall J, Luckie C, Oscier DG, Owen RG, Haemato-Oncology Task Force of the British Committee for Standards in Haematology. Guidelines on the management of Waldenstrom macroglobulinaemia. Br J Haematol 2006 Mar;132(6):683-97. [108 references]

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