Extent of bone marrow infiltration predicts disease progression in asymptomatic Waldenström macroglobulinemia
High bone marrow tumor burden (≥25%) predicts shorter time to progression in asymptomatic Waldenström macroglobulinemia.
Bone marrow (BM) tumor burden was analyzed in 150 asymptomatic Waldenström macroglobulinemia (WM) patients. Using a 25% BM infiltration cut‑off, patients were divided into high (≥25%) and low (<25%) BM tumor burden subgroups. The primary outcomes were time to progression (TTP) and overall survival (OS). High burdens were associated with lower hemoglobin, higher serum IgM, higher monoclonal component and a lower prevalence of peripheral neuropathy. Median TTP was significantly shorter in the high‑burden group (64 vs. 137 months, p = 0.01). Multivariate analysis showed that elevated serum IgM was the only independent predictor of shorter TTP in high‑burden patients. No significant OS difference was observed between the groups.
This finding supports the use of BM infiltration as an independent prognostic factor and may guide risk stratification and monitoring for asymptomatic WM patients.
Evidence level: Állatkísérletes. Állatmodellben vizsgálták.
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