Waldenström Makroglobulinemisi Tanılı Olgularda Tedavi Yanıtı Değerlendirilmesi; Tek Merkez Deneyimi

Öz

Waldenström makroglobulinemisi, nadir görülen bir lenfoplazmasitik lenfomadır ve monoklonal IgM üretimiyle karakterizedir. Hiperviskozite sendromu, anemi, nöropati gibi semptomlara yol açabilir. Tedavi endikasyonu spesifik bir IgM düzeyine bağlı değildir; klinik duruma göre karar verilir. Bu çalışma, X Hastanesi İç Hastalıkları Anabilim Dalı, Hematoloji Bilim Dalı Polikliniğinde 2019–2024 yılları arasında Waldenström makroglobulinemisi (WM) tanısı alan hastaların tedavi yanıtlarını retrospektif olarak değerlendirmeyi amaçlamaktadır. Çalışmaya 29 hasta dahil edildi. Hastaların demografik verileri ve birinci ve ikinci basamak tedavi yanıtları incelendi. Medyan tanı yaşı 78’di; %69’u erkekti. Median izlem süresi 58,76 ay idi. IPS risk skoruna göre %20,7’si düşük, %27,6’sı orta, %51,7’si yüksek riskliydi. Hastaların %82’sine tedavi başlandı; en çok kullanılan rejim rituksimab ve bendamustin (R-Benda) oldu. Birinci basamakta tedaviye yanıt oranı %75,9 idi. Laboratuvar parametrelerinden hemoglobin, platelet ve LDH değerleri mortaliteyi ayırt etmede öngördürücü parametreler olarak değerlendirildi. Tanı anı IPS risk skoru ile sağkalım arasında anlamlı farklılık yoktu (p>0,05). Sağkalım farkı Kaplan-Meier analizi ile değerlendirildi. Birinci basamak tedavide yanıt alınan hastaların daha uzun sağkalım gösterdiği görüldü. Konvansiyonel immünokemoterapiler, WM tedavisinde halen etkili ve tolere edilebilir tedavi seçeneği olarak öne çıkmaktadır. Ancak Bruton Kinaz inhibitörleri (BTK) gibi yeni ajanlarla karşılaştırmalı daha geniş çalışmalara ihtiyaç vardır. WM yönetiminde tedavi kararı bireyselleştirilmeli, hasta özellikleri ve klinik bulgulara göre karar verilmelidir.

Anahtar Kelimeler

• Waldenström Makroglobulinemisi
• IgM
• İmmünokemoterapi

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

Öz

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.

Anahtar Kelimeler

• Waldenström Macroglobulinemia
• IgM
• Immunochemotherapy

Kaynakça

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