化学免疫疗法
医学
华登氏巨球蛋白血症
淋巴浆细胞淋巴瘤
美罗华
巨球蛋白血症
内科学
淋巴瘤
不利影响
疾病
肿瘤科
胃肠病学
外科
多发性骨髓瘤
作者
Dipti Talaulikar,Cécile Tomowiak,Elise Toussaint,Pierre Morel,Prashant Kapoor,Jorge J. Castillo,Alain Delmer,Éric Durot
标识
DOI:10.1016/j.hoc.2023.04.009
摘要
Histologic transformation (HT) to diffuse large B-cell lymphoma occurs rarely in Waldenström macroglobulinemia, with higher incidence in MYD88 wild-type patients. HT is suspected clinically when rapidly enlarging lymph nodes, elevated lactate dehydrogenase levels, or extranodal disease occur. Histologic assessment is required for diagnosis. HT carries a worse prognosis compared with nontransformed Waldenström macroglobulinemia. A validated prognostic score based on three adverse risk factors stratifies three risk groups. The most common frontline treatment is chemoimmunotherapy, such as R-CHOP. Central nervous system prophylaxis should be considered if feasible and consolidation with autologous transplant should be discussed in fit patients responding to chemoimmunotherapy.
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