BACKGROUND Waldenstr?m’s macroglobulinemia(WM) is a rare lymphoid neoplasia, which can have renal complications. These rarely occur, and most common renal manifestations are mild proteinuria and microscopic hematuria...BACKGROUND Waldenstr?m’s macroglobulinemia(WM) is a rare lymphoid neoplasia, which can have renal complications. These rarely occur, and most common renal manifestations are mild proteinuria and microscopic hematuria. Herein we describe a case of WM that presented with pseudothrombi depositing in capillaries associated with minimal change nephrotic syndrome and chronic kidney disease(CKD).CASE SUMMARY A 52-year-old man presented with features suggesting nephrotic syndrome.Extensive workups were done, and there were elevated serum levels of interleukin-6 and vascular endothelial growth factor(VEGF), capillary pseudothrombus accumulation associated with minimal change nephrotic syndrome, CKD, and WM. Treatment was directed at the patient’s WM with bortezomib, thalidomide, and dexamethasone whereby serum immunoglobulin M(IgM) decreased. The damage of IgM on the kidney was corrected; thus, the patient’s proteinuria and serum creatinine had improved. The patient is still under clinical follow-up.CONCLUSION It is essential for clinicians to promptly pay more attention to patients presenting with features of nephrotic syndrome and do extensive workups to come up with a proper therapy strategy.展开更多
Waldenstrom＇s macroglobulinemia/lymphoplasmacytic lymphoma （WM/LPL） is a low-grade B-cell non- Hodgkin＇s lymphoma with an indolent clinical course. Higher-grade non-Hodgkin lymphoma （NHL） and therapy- related my...Waldenstrom＇s macroglobulinemia/lymphoplasmacytic lymphoma （WM/LPL） is a low-grade B-cell non- Hodgkin＇s lymphoma with an indolent clinical course. Higher-grade non-Hodgkin lymphoma （NHL） and therapy- related myelodysplasia/acute leukemia （t-MDS/AML） have been reported in patients with WM/LPL in previous studies. However, only two cases with WM/LPL were reported to develop to Hodgkin lymphoma （HL）. Here, we report the first case of WM/LPL who developed classical HL simultaneously 3 years after initial nucleoside analog-based chemotherapy.展开更多
In the original publication of our paper,“Sequential treatment escalation improves survival in patients with Waldenstrom macroglobulinemia,”published on Blood Science,2024 Jan;6(1):e00179,we have identified several ...In the original publication of our paper,“Sequential treatment escalation improves survival in patients with Waldenstrom macroglobulinemia,”published on Blood Science,2024 Jan;6(1):e00179,we have identified several errors that require correction.展开更多
Waldenstrom macroglobulinemia(WM)is a type of incurable,indolent B-cell lymphoma that is prone to relapse.Over time,treatment strategies have progressed from cytotoxic drugs to rituximab(R)-or bortezomib(V)-based regi...Waldenstrom macroglobulinemia(WM)is a type of incurable,indolent B-cell lymphoma that is prone to relapse.Over time,treatment strategies have progressed from cytotoxic drugs to rituximab(R)-or bortezomib(V)-based regimens,and have now entered into an era of Bruton tyrosine kinase inhibitor(BTKi)-based regimens.However,the optimal treatment for the relapsed patients is still unclear.Herein,we analyzed the outcomes of the first-and second-line therapies in 377 patients with WM to illustrate the optimal choices for second-line therapy.After a median follow-up of 45.4 months,89 patients received second-line therapy,and 53 patients were evaluated for response.The major response rates(MRR)of first-and second-line treatment were 65.1%and 67.9%(P=0.678).The median progression-free survival(PFS)for the second-line therapy(PFS2)was shorter than that for the first-line therapy(PFS1)(56.3 vs 40.7 months,P=0.03).However,PFS2 in targeted drugs group(R-/V-/BTKi-based regimens)was comparable to PFS1(60.7 months vs 44.7 months,respectively,P=0.21).Regarding second-line therapy,patients who underwent sequential treatment escalation—such as transitioning from cytotoxic drugs to R-/V-/BTKi-based regimens or from R-/V-based to BTKi-based regimens(escalation group)—had higher MRR(80.6%vs 47.1%,respectively,P=0.023)and longer PFS2(50.4 vs 23.5 months,respectively,P<0.001)compared to the non-escalation group.Patients in the escalation group also had longer post-relapse overall survival compared with the non-escalation group(median,not reached vs 50.7 months,respectively,P=0.039).Our findings indicate that sequential treatment escalation may improve the survival of patients with WM.展开更多
文摘BACKGROUND Waldenstr?m’s macroglobulinemia(WM) is a rare lymphoid neoplasia, which can have renal complications. These rarely occur, and most common renal manifestations are mild proteinuria and microscopic hematuria. Herein we describe a case of WM that presented with pseudothrombi depositing in capillaries associated with minimal change nephrotic syndrome and chronic kidney disease(CKD).CASE SUMMARY A 52-year-old man presented with features suggesting nephrotic syndrome.Extensive workups were done, and there were elevated serum levels of interleukin-6 and vascular endothelial growth factor(VEGF), capillary pseudothrombus accumulation associated with minimal change nephrotic syndrome, CKD, and WM. Treatment was directed at the patient’s WM with bortezomib, thalidomide, and dexamethasone whereby serum immunoglobulin M(IgM) decreased. The damage of IgM on the kidney was corrected; thus, the patient’s proteinuria and serum creatinine had improved. The patient is still under clinical follow-up.CONCLUSION It is essential for clinicians to promptly pay more attention to patients presenting with features of nephrotic syndrome and do extensive workups to come up with a proper therapy strategy.
文摘Waldenstrom＇s macroglobulinemia/lymphoplasmacytic lymphoma （WM/LPL） is a low-grade B-cell non- Hodgkin＇s lymphoma with an indolent clinical course. Higher-grade non-Hodgkin lymphoma （NHL） and therapy- related myelodysplasia/acute leukemia （t-MDS/AML） have been reported in patients with WM/LPL in previous studies. However, only two cases with WM/LPL were reported to develop to Hodgkin lymphoma （HL）. Here, we report the first case of WM/LPL who developed classical HL simultaneously 3 years after initial nucleoside analog-based chemotherapy.
文摘In the original publication of our paper,“Sequential treatment escalation improves survival in patients with Waldenstrom macroglobulinemia,”published on Blood Science,2024 Jan;6(1):e00179,we have identified several errors that require correction.
基金supported by grants from the National Nature Science Foundation of China(81970187,82170193,81920108006,and 81900203)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2022-I2M-1-022,2021-I2M-C,and T-B-081).
文摘Waldenstrom macroglobulinemia(WM)is a type of incurable,indolent B-cell lymphoma that is prone to relapse.Over time,treatment strategies have progressed from cytotoxic drugs to rituximab(R)-or bortezomib(V)-based regimens,and have now entered into an era of Bruton tyrosine kinase inhibitor(BTKi)-based regimens.However,the optimal treatment for the relapsed patients is still unclear.Herein,we analyzed the outcomes of the first-and second-line therapies in 377 patients with WM to illustrate the optimal choices for second-line therapy.After a median follow-up of 45.4 months,89 patients received second-line therapy,and 53 patients were evaluated for response.The major response rates(MRR)of first-and second-line treatment were 65.1%and 67.9%(P=0.678).The median progression-free survival(PFS)for the second-line therapy(PFS2)was shorter than that for the first-line therapy(PFS1)(56.3 vs 40.7 months,P=0.03).However,PFS2 in targeted drugs group(R-/V-/BTKi-based regimens)was comparable to PFS1(60.7 months vs 44.7 months,respectively,P=0.21).Regarding second-line therapy,patients who underwent sequential treatment escalation—such as transitioning from cytotoxic drugs to R-/V-/BTKi-based regimens or from R-/V-based to BTKi-based regimens(escalation group)—had higher MRR(80.6%vs 47.1%,respectively,P=0.023)and longer PFS2(50.4 vs 23.5 months,respectively,P<0.001)compared to the non-escalation group.Patients in the escalation group also had longer post-relapse overall survival compared with the non-escalation group(median,not reached vs 50.7 months,respectively,P=0.039).Our findings indicate that sequential treatment escalation may improve the survival of patients with WM.
