Bendamustine and Rituximab Achieve a Major Survival Improvement Of Patients With Morbus Waldenström In Routine Care

Progress has been made in diagnosis and treatment of patients with Morbus Waldenström who receive their treatment within prospective clinical trials. Due to necessary inclusion and exclusion criteria only a very limited number of patients are treated in studies. Therefore results from clinical trials can't be transferred into routine care. Little practice data are available how patients with Morbus Waldenström are diagnosed and treated in routine care and whether improvements in survival are achieved.

A retrospective analysis of all patients with Morbus Waldenström who were treated in an oncology group practice in Germany between 1995-2012. Relevant clinical data concerning diagnosis, treatment and survival were transferred from clinical files into a database and analyzed statistically using SPSS and SURVSOFT.

52 patients with a median age of 67 (36-84) were identified. 67.3% were male and 32.7% female. Distribution according to IPSSWM-stage was: 21.2% low risk, 61.5% intermediate risk, 17.3% not evaluable (in most cases due to lacking β2 microglobulin data). 59.6% needed therapy with a median of 3 therapies (1-12). Regimens most frequently applied were: Bendamustine-containig (74.2%), Rituximab-containing (74.2%), Bendamustine+Rituximab-combinations (61.3%) and Chlorambucil-containing (45.2%). 6.5% of patients were treated within a clinical trial. Median overall survival was 12 years (0-19). Median relative survival was 13.6 years. 10-year relative survival was 86%. 10-year relative survival according to IPSSWM-stage was as follows: low risk 92%, intermediate risk 71%. Median overall survival of the patients who never needed any therapy was 11 years compared to 12 years of those patients who needed therapy. Median relative survival for patients who never needed therapy was not reached yet, median relative survival of the patients who needed therapy was 13.6 years.

Systemic treatment of patients with Morbus Waldenström in routine care consists mainly of Bendamustine, Rituximab and Bendamustine+Rituximab-combinations. Employment of the most active chemoimmunotherapies leads to a marked prolongation of survival compared to historical controls and registry data.

No relevant conflicts of interest to declare.