Treatment and Survival Outcomes of Waldenstrom Macroglobulinemia in Latin American Patients: A Multinational Retrospective Cohort Study


Eloísa Riva, Hematology Department, Hospital Británico & Hospital de Clinicas, Montevideo, Uruguay.
Patricio José Duarte, Hospital Universitario CEMIC, Buenos Aires, Argentina.
Bryan Valcárcel, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC.
Guillermina Remaggi, Fundaleu, Buenos Aires, Argentina.
Ivan Murrieta, Clínica Ruiz, Puebla, Mexico.
Ariel Corzo, Hospital de Clínicas de Buenos Aires, Buenos Aires, Argentina.
Daniel Del Carpio, Hospital Edgardo Rebagliati, Lima, Peru.
Camila Peña, Hospital del Salvador, Santiago de Chile, Chile.
Jule Vásquez, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Virginia Bove, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay.
Larissa Teixeira, Hospital Israelita Albert Einstein, San Pablo, Brazil.
Guilherme Fleury-Perini, Hospital Israelita Albert Einstein, San Pablo, Brazil.
Sebastian Yantorno, Hospital Italiano de La Plata, La Plata, Argentina.
César Samánez, Clinica Oncosalud-AUNA, Lima, Peru.
Sergio Lopresti, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.
Milagros Altamirano, Hospital Guillermo Almenara, Lima, Peru.
Luis Villela, Centro Médico Dr Ignacio Chavez, Hospital Fernando Ocaranza, Universidad del Valle, Mexico City, Mexico.
Guillermo J. Ruiz-Arguelles, Clínica Ruiz, Puebla, Mexico.
Guillermo J. Ruiz-Delgado, Clínica Ruiz, Puebla, Mexico.
Efreen Montaño, Hospital General de Mexico, Mexico City, Mexico.
Verónica Verri, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina.
Elia Zamora Pérez, Hospital Regional PEMEX de Ciudad Madero, Ciudad Madero, Mexico.
Fernando Pérez Jacobo, Hospital Central Norte PEMEX, Mexico City, Mexico.
Henry Idrobo, Centro Médico Julián Coronel, Cali, Colombia.
Humberto Martínez-Cordero, Instituto Nacional de Cancerología, Bogotá, Colombia.
Brady E. Beltran, Hospital Nacional Edgardo Rebagliati, Lima, Peru.
Jhoanna Ramírez, Hospital Teodoro Maldonado, Guayaquil, Ecuador.
Jorge J. Castillo, Bing Center for Waldenström Macroglobulinemia, Dana Farber Cancer Institute, Boston, MA.
Luis E. Malpica Castillo, Division of Cancer Medicine, Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX.

Document Type

Journal Article

Publication Date



JCO global oncology






PURPOSE: Waldenstrom Macroglobulinemia (WM) is a rare lymphoma with distinct clinical features, and data from Latin American patients are lacking. Therefore, we aim to investigate the clinical, therapy, and outcome patterns of WM in Latin America. METHODS: We retrospectively analyzed patients with WM diagnosed between 1991 and 2019 from 24 centers in seven Latin American countries. The study outcomes were overall survival (OS) and progression-free survival (PFS). RESULTS: We identified 159 cases (median age 67 years, male 62%). Most patients (95%) were symptomatic at diagnosis. The International Prognostic Scoring System for WM (IPSSWM) at diagnosis was available in 141 (89%) patients (high-risk 40%, intermediate-risk 37%, and low-risk 23%). Twenty-seven (17%) patients were tested for MYD88, with 89% (n = 24 of 27) carrying the mutation. First-line and second-line therapies were administered to 142 (89%) and 53 (33%) patients, respectively. Chemoimmunotherapy was the most commonly used first-line (66%) and second-line (45%) approach; only 18 (11%) patients received ibrutinib. With a median follow-up of 69 months, the 5-year OS rate was 81%. In treated patients, the 5-year OS and PFS rates were 78% and 59%, respectively. High-risk IPSSWM at treatment initiation was an independent risk factor for OS (adjusted hazard ratio: 4.73, 95% CI, 1.67 to 13.41, = .003) and PFS (adjusted hazard ratio: 2.43, 95% CI, 1.31 to 4.50, = .005). CONCLUSION: In Latin America, the management of WM is heterogeneous, with limited access to molecular testing and novel agents. However, outcomes were similar to those reported internationally. We validated the IPSSWM score as a prognostic factor for OS and PFS. There is an unmet need to improve access to recommended diagnostic approaches and therapies in Latin America.


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