Frontline therapy with bendamustine rituximab (BR) and rituximab cyclophosphamide vincristine prednisone (RCVP) confers similar long-term outcomes in patients with treatment naïve Waldenström macroglobulinemia in a real-world setting: a population-based analysis

Leuk Lymphoma. 2024 Mar;65(3):346-352. doi: 10.1080/10428194.2023.2290466. Epub 2023 Dec 29.

Abstract

We report on outcomes of 111 patients with treatment naïve Waldenström macroglobulinemia (TN WM) treated with frontline bendamustine-rituximab (BR) (n = 57) or rituximab-cyclophosphamide-vincristine-prednisone (RCVP) (n = 54). Median follow-up was 60.7 months (range 1.9-231.6). Median progression-free survival (PFS) was 60.5 months (95% CI 47.6-73.4) for BR and 79.0 months (95% CI 31.3-126.8) for RCVP (p = .96). Median overall survival (OS) was not reached for BR and 153.4 months (95% CI 114.5-192.4) for RCVP (p = .37). While overall and major response rates did not differ between treatment groups, BR had numerically higher rate of very good partial response or better response (51% vs. 37%, p = .30) and complete response (26% vs. 13%, p = .13). RCVP confers comparable outcomes to BR in a real-world population of TN WM patients and remains an effective regimen, particularly when tolerance or frailty is an issue, or in resource-limited settings.

Keywords: RCVP; Waldenström macroglobulinemia; bendamustine rituximab; real-world population analysis.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bendamustine Hydrochloride / adverse effects
  • Cyclophosphamide / adverse effects
  • Humans
  • Prednisone / adverse effects
  • Rituximab / adverse effects
  • Vincristine / adverse effects
  • Waldenstrom Macroglobulinemia* / diagnosis
  • Waldenstrom Macroglobulinemia* / drug therapy
  • Waldenstrom Macroglobulinemia* / etiology

Substances

  • Rituximab
  • Bendamustine Hydrochloride
  • Vincristine
  • Prednisone
  • Cyclophosphamide