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. 2022 Jun;197(6):728-735.
doi: 10.1111/bjh.18157. Epub 2022 Apr 8.

Inflammatory Waldenström's macroglobulinaemia: A French monocentric retrospective study of 67 patients

Dikelele Elessa  1   2 , Pierre-Edouard Debureaux  1   2 , Camille Villesuzanne  1   2 , Frederic Davi  3 , Clotilde Bravetti  3 , Stephanie Harel  1   2 , Alexis Talbot  1   2 , Eric Oksenhendler  2   4 , Marion Malphettes  2   4 , Catherine Thieblemont  2   5 , Hannah Moatti  2   5 , Odile Maarek  2   6 , Bertrand Arnulf  1   2 , Bruno Royer  1   2
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Inflammatory Waldenström's macroglobulinaemia: A French monocentric retrospective study of 67 patients

Dikelele Elessa et al. Br J Haematol. 2022 Jun.

Abstract

Waldenström's macroglobulinaemia (WM) is a B-cell neoplasm resulting from bone marrow lymphoplasmacytic infiltration and monoclonal IgM secretion. Some patients present concomitant inflammatory syndrome attributed to the disease activity; we named this syndrome inflammatory WM (IWM). We retrospectively analysed all WM patients seen in a single tertiary referral centre from January 2007 to May 2021, and after excluding aetiologies for the inflammatory syndrome using a pertinent blood workup, including C-reactive protein (CRP), and imaging, we identified 67 (28%) IWM, 166 (68%) non-IWM, and nine (4%) WM with inflammatory syndrome of unknown origin. At treatment initiation, IWM patients had more severe anaemia (median Hb 90 vs 99 g/l; p < 0.01), higher platelet count (median 245 vs 196 × 109/l; p < 0.01) and comparable serum IgM level (median 24.9 vs 23.0 g/l; p = 0.28). A positive correlation was found between inflammatory and haematological responses (minimal response or better) (odds ratio 32.08; 95% confidence interval 8.80-98.03; p < 0.001). Overall survivals (OS) were similar (median OS: 17 vs 20 years; p = 0.11) but time to next treatment (TNT) was significantly shorter for IWM (TNT1: 1.6 vs 4.8 years, p < 0.0001). IWM mostly shared the same presentation and outcome as WM without inflammatory syndrome.

Keywords: Waldenström's macroglobulinaemia; clinical aspects; inflammation; lymphomas.

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References

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