Assessment of Treatment Response in Patients Diagnosed with Waldenström’s Macroglobulinemia: Single-Center Experience

Vollständiger Abstract

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Waldenström macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma characterized by the production of monoclonal IgM. It may lead to symptoms such as hyperviscosity syndrome, anemia, and neuropathy. The indication for treatment is not based on a specific IgM level but is determined according to the clinical condition. This study aimed to retrospectively evaluate the treatment responses of patients diagnosed with WM between 2019 and 2024 at the Hematology Outpatient Clinic, Department of Internal Medicine, X Hospital. A total of 29 patients were included. Demographic characteristics and first- and second-line treatment responses were analyzed. The median age at diagnosis was 78 years; 69% were male. The median follow-up duration was 58.76 months. According to the IPS risk score, 20.7% were low risk, 27.6% intermediate risk, and 51.7% high risk. Treatment was initiated in 82% of patients, with rituximab plus bendamustine (R-Benda) being the most frequently used regimen. The overall response rate to first-line therapy was 75.9%. Among laboratory parameters, hemoglobin, platelet count, and LDH were identified as predictive factors for mortality. No significant difference in survival was observed according to IPS risk score at diagnosis (p>0.05). Survival differences were assessed using Kaplan-Meier analysis. Patients who achieved a response to first-line therapy demonstrated longer survival. Conventional immunochemotherapy remains an effective and tolerable treatment option in WM. However, larger comparative studies with novel agents such as Bruton tyrosine kinase (BTK) inhibitors are needed. Treatment decisions in WM should be individualized based on patient characteristics and clinical findings.