Low-dose bortezomib and dexamethasone as primary therapy in elderly patients with Waldenstrӧm macroglobulinemia.

Abstract

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 60years received first-line treatment with lBD. The median age was 70years (range, 61-77years). 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 1.8months 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 36months, all patients were still alive and six had no disease progression. The estimated median time to progression was 39months (range, 15-60months). 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.