Paradoxical increases in serum IgM and viscosity levels following rituximab in Waldenstrom's macroglobulinemia

Annals of Oncology : Official Journal of the European Society for Medical Oncology
S P TreonK C Anderson

Abstract

The anti-CD20 monoclonal antibody rituximab is an important therapeutic in Waldenstrom's macroglobulinemia (WM), producing response rates of 50-70%. Responses, which are based on serum IgM levels, have typically been evaluated at 12 weeks. Paradoxically, we have observed that serum IgM levels can abruptly rise following rituximab therapy in patients with WM, and can often lead to morbidity on the basis of hyperviscosity. Eleven WM patients with CD20+ tumor cells who received rituximab at our Institution and had serum IgM levels measured within a 12-week period following start of therapy were evaluated. Therapy consisted of four weekly infusions of rituximab at 375 mg/m(2). Pre- and post-therapy serum IgM levels were determined by nephelometry and corresponding serum viscosity levels were determined by viscometry. Ten of the 11 patients demonstrated an abrupt rise in serum IgM levels, with a >25% increase occurring in eight (73%) patients. Mean serum IgM levels for all 10 spiking patients rose from 4370 (range, 655-7940) to a peak of 5865 (range, 872-11 800) mg/dl (P=0.004), which occurred at a mean of 4 (range, 1-8) weeks following initiation of therapy. Mean serum viscosity levels also increased from 3.5 to 5.6 centipoise (CP)...Continue Reading

Citations

Jul 20, 2007·Current Treatment Options in Oncology·Meletios A Dimopoulos, Athanasios Anagnostopoulos
Jan 22, 2009·International Journal of Hematology·Hassane IzzedineGilbert Deray
Oct 23, 2013·Annals of Oncology : Official Journal of the European Society for Medical Oncology·C BuskeUNKNOWN ESMO Guidelines Working Group
Aug 21, 2008·Blood·Steven P TreonKenneth C Anderson
Jul 21, 2009·Blood·Steven P Treon
Jun 10, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Steven P TreonIrene M Ghobrial
Feb 10, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Irene M GhobrialJeffrey Matous
Oct 29, 2011·Clinical Investigation·Ghayas C IssaAldo M Roccaro
Sep 13, 2014·Hematology/oncology Clinics of North America·Steven P TreonGiampaolo Merlini
Aug 7, 2012·Leukemia & Lymphoma·Morie Gertz
Jan 30, 2016·BMC Neurology·Richard A Rison, Said R Beydoun
Aug 4, 2007·British Journal of Haematology·Rafael Fonseca, Suzanne Hayman
Feb 21, 2006·British Journal of Haematology·S A JohnsonUNKNOWN Haemato-Oncology Task Force of the British Committee for Standards in Haematology
Mar 6, 2008·British Journal of Haematology·Prashant KapoorPhilip R Greipp
Jul 14, 2016·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Suvro Sankha DattaPrasun Bhattacharya
May 24, 2015·Blood·Steven P Treon
Oct 29, 2008·Hematology/oncology Clinics of North America·Stefan Peinert, John F Seymour
Jun 1, 2007·Journal of the Neurological Sciences·Michelle L MauermannChristopher J Klein
Jun 20, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Meletios Athanasios DimopoulosGerasimos Pangalis
Mar 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Meletios A DimopoulosSteven P Treon
Dec 31, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Vanita NoronhaThomas Duffy
May 10, 2017·British Journal of Haematology·Joshua N GustineJorge J Castillo
May 20, 2017·Immunopharmacology and Immunotoxicology·Jan NovakTomas Kozak
Jul 6, 2017·British Journal of Haematology·Adam J OlszewskiJorge J Castillo
May 18, 2018·Expert Opinion on Drug Safety·Ramón García-SanzMaría Eugenia Sarasquete
Jul 26, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Steven P TreonJorge J Castillo
Mar 1, 2006·Expert Review of Anticancer Therapy·Stephen A Johnson
Dec 5, 2017·Journal of Market Access & Health Policy·Andrea AielloLuca Laurenti

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