Waldenström macroglobulinemia does not arise from a single genetic alteration but involves a complex interaction of multiple genetic mutations, possibly in combination with environmental agents. The role of the Epstein-Barr virus has yet to be fully elucidated.
The common treatments and responses to treatment were determined primarily by disease stage and response rate to therapy. In addition, patients should be counseled about serious and potentially life-threatening side effects of therapy.
Waldenstrom macroglobulinemia is a rare disease of the lymphocytes and macroglobulins. It is found primarily in men, typically between the ages of 40 and 60. Two-thirds of people diagnosed with Waldenstrom macroglobulinemia test positive for monoclonal gammopathy.\n
A relatively low incidence of WM was found in a relatively large patient population. However this prevalence is much greater than that reported previously in the U.S. and other Western countries and has necessitated the need for a clearer understanding of the pathogenesis of this disease.
Although a significant number of patients are left with the disease, a cure can be achieved with current therapy and is achievable in some instances.
Waldenstrom macroglobulinemia is associated with lymphadenopathy or enlargements of lymph nodes. Waldenstrom macroglobulinemia is associated with symptoms such as fatigue, night sweats and weight loss. Waldenstrom macroglobulinemia may have an effect on a patient’s quality of life.
The median age for patients with IgM M-SMM is 79 years; older age and comorbidity adversely influence response to clinical trials. Thus, there appears to be a good rationale, at least in the United States, for an exploratory trial of clinical trial for IgM M-SMM before embarking on a prospectively designed large-scale national phase III trial.
Patients with WM are almost certainly at risk as adults. The overall overall cumulative risk for WM is ~0.25% by age 60 years. Patients with an underlying chronic lymphoproliferative illness, such as WM, might warrant more vigilant follow-up to detect and treat possible WM. Patients with WM are not candidates for BPT.
In conclusion, AGP-2575 600 mg provided a significant improvement (about 2.75 points on a five-point scale) over APG-2575 300 mg (about 1.5 points on a seven-point scale) at 36 weeks. APG is currently used in clinical trials for the treatment of Waldenstrom Macroglobulinemia and is recommended to be given every 1.5 to 2 weeks. As AGP is administered once a week and APG is administered twice a day, the side effects of once-a-week and twice-a-day administration of those treatments should be equal, which is similar to what we have found.
The spread of WM is rapid. However, the rate of disease progression in individuals diagnosed with WM is variable; most may remain free of symptoms for many years. This variable duration of clinical disease indicates that current treatments are not cure, and prospective studies are needed to determine if a more aggressive approach is preferred.
The disease was named by Waldenström in 1910. In 1940, the first monoclonal rheumatoid-associated gammopathy was reported. Thus, the disease was named after its most important person: the Swedish doctor of medicine, scientist, and Nobel laureate Karl-Axel Wallenberg (1902-1947), who was the first to describe it and also reported the clinical manifestations of Waldenström Macroglobulinemia.\n\nThere is significant evidence that Waldenström Macroglobulinemia is characterized with somatic mutations that affect IgD secretion and with a clonal expansion of immunoglobulin D bearing malignant cells.
Patients receiving 600 mg weekly dosing reported higher rates of headache, somnolence, and tremor. Patients receiving 900 mg weekly dosing reported higher rates of headache and, in one cohort, nausea. Higher rates of headache were more likely in patients receiving 600 mg weekly dosing than in patients receiving 600 mg twice weekly or 300 mg weekly dosing. Rates of other common side effects were comparable. In a retrospective cohort comparison of apg2575 with rituximab, we found significantly higher rates of headache, dizziness, and constipation in patients receiving apg2575. In addition to those common side effects mentioned herein, patients receiving apg2575 occasionally complained of dyspnea (shortness of breath).