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Labreuche J, Assouan D, Durot E, Tomowiak C, Roos-Weil D, Toussaint E, Bijou F, Lemal R, Brion A, Laribi K, Ysebaert L, Duhamel A, Morel P. Does early disease progression predicts survival after first line-treatment of Waldenström macroglobulinemia? Hematol Oncol 2022; 40:400-408. [PMID: 35385885 PMCID: PMC9541850 DOI: 10.1002/hon.2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/10/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022]
Abstract
In symptomatic Waldenström macroglobulinemia (sWM) patients, prognosis is assessed with the international prognostic scoring system (IPSSWM). In follicular lymphoma and other B‐cell and T‐cell lymphomas, disease progression within 24 months (POD24) or (in patients without POD24) after 24 months has been proposed as the start date for stratifying subsequent survival. In the present report, we assessed in a large series of 472 sWM patients, the prognostic value of this new dynamic endpoint already reported in many other lymphomas subtypes. The 3 year subsequent survival for patients with POD24 was 75% and 93% for patients without POD24. In sWM patients, departure from the proportional hazards assumption complicated this analysis. In patients without POD24, the median subsequent progression‐free survival time of 43 months accounted for favorable outcome, whereas survival after progression was not influenced by the time to progression. In addition, sensitivity analysis showed that the baseline IPSSWM score also influenced survival after POD24. In sWM patients, we conclude that the apparent difference in survival after POD24 or the 24 months time‐point (in patients without POD24) is mainly explained by the prolonged subsequent progression free survival of latter patients. Indeed, the mortality after progression is not influenced by the time to this event.
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Affiliation(s)
- Julien Labreuche
- Universite de Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales Lille, France.,Departement de Biostatistique, CHU de Lille, Lille, France
| | - Deborah Assouan
- Service d'Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens, France
| | - Eric Durot
- Service d'Hématologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, France
| | - Cecile Tomowiak
- Service d'Oncologie Hématologie et Thérapie cellulaire, CHU de Poitiers, Poitiers, France
| | | | - Elise Toussaint
- Departement d'Hematologie, CHU de Strasbourg, Strasbourg, France
| | - Fontanet Bijou
- Departement d'Hematologie, Institut Bergonié, Bordeaux, France
| | - Richard Lemal
- Service d'Hematologie Clinique Adultes de Thérapie Cellulaire, Hôpital Estaing, Université d'Auvergne EA7283, Inserm CIC-501, CHU Clermont-Ferrand, Clermont Ferrand, France
| | - Annie Brion
- Departement d'Hematologie, CHRU de Besançon, Besançon, France
| | - Kamel Laribi
- Departement d'Hematologie, Centre Hospitalier du Mans, Le Mans, France
| | - Loic Ysebaert
- Service d'Hématologie IUC Toulouse-Oncopole Toulouse, France
| | - Alain Duhamel
- Universite de Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales Lille, France.,Departement de Biostatistique, CHU de Lille, Lille, France
| | - Pierre Morel
- Universite de Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales Lille, France.,Service d'Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens, France.,Service d'Hematologie Clinique, Centre Hospitalier Schaffner, Lens, France
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