| ObjectiveAnalyze the clinical characteristics and the factors related to the outcomes of Waldenstrom macroglobulinemia.MethodsCases with Waldenstrom macroglobulinemia(WM)during the period July 2011 to Sept 2020 were collected and followed up.Then we retrospectively analyzed the clinical characteristics including gender,age,hemoglobin,platelet,β2-microglobulin,serum Lactate dehydrogenase(LDH)levels,serum monoclonal immunoglobulin,creatinine,,uric acid,genetic characteristics,stratification of risk,ibrutinib treatment and its impact on their survival rate by univariate and multivariate analysis.ResultsA total of 68 patients with WM were included in this study,including 57 males and 11 females,with a median age of 66 years.The most common symptom observed was anemia related symptoms(50%),including dizziness,fatigue,pale,and shortness of breath.A complete clinical data was obtained from 68 patients,including 1 patient with diffuse large B-cell lymphoma,1 patient with primary nephritic syndrome,and 1 patient with myelodysplastic syndrome.7 patients did not receive any treatment in this study.So WM 61 patients that receive at least one therapy,were included in the survival analysis study.Based on the ISSWM score,the median OS in the low-risk group,medium-risk group,and high-risk group were successively decreased.What’s more,univariate analysis showed that the age(P=0.046),β2-microglobulin(P=0.045),LDH(P=0.023),risk group(P=0.039),mean erythrocyte volume(P=0.027)are correlated with the OS of WM.Whereas,the β2-microglobulin(P=0.03),LDH(P=0.026),risk group(P=0.022),mean erythrocyte volume(P=0.03)are correlated with its PFS.However,there is no significant difference in gender,hemoglobin,platelet,IgM,IgA,IgG,albumin,genetic characteristics,creatinine,uric acid,urea,red blood cell volume distribution width,globulin,ALT/AST,ibrutinib with OS and PFS.Multivariate analysis showed that mean corpuscular volume was an independent prognostic factor related to its OS.ConclusionWM is a highly heterogeneous disease,which has various clinical manifestations and lack of specificity.The most common first symptom of WM is anemia-related symptoms.We observed that,the age,β2-microglobulin,LDH,risk group,mean erythrocyte volume are important factors related to the prognosis of patients with WM.This indicates that mean erythrocyte volume can be an independent factor affecting the prognosis of WM.Patients in low-risk and medium-risk groups have better outcomes than those in the high-risk group.Patients at high risk with an ISSWM score higher than 2 indicate a poor prognosis.Comprehensive assessment with ISSWM、LDH and mean erythrocyte volume can be performed to select appropriate treatment to improve the prognosis of high-risk patients. |
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