Data from a real-world population-based analysis of frontline therapy with bendamustine-rituximab (BR) in patients with treatment-naïve (TN) Waldenstrom’s macroglobulinemia (WM) were presented at the 2021 American Society of Hematology (ASH) Annual Meeting to evaluate outcomes in TN-WM patients comparing BR with the combination of rituximab, cyclophosphamide, vincristine, and prednisone (RCVP).

A total of 111 patients with TN-WM treated with BR or RCVP as their first systemic therapy between August 1, 2004 and August 1, 2020 were identified using the BC Cancer Centre for Lymphoid Cancer Database. Patients were a median age of 69 years (range 33-89) and 57 were treated with BR, while 54 were treated with RCVP.

All patients had a median follow-up of 5.9 years (range 0.8-19.2) with a median of 4.4 years for BR and 9.8 years for RCVP. Event free survival (EFS) at 4 years was 57 percent with BR and 60 percent with RCVP (P=.05). Because of a longer duration of follow up with RCVP, median EFS was established and was 6.3 years.

“Overall survival (OS) estimates at 4-years were 74 percent (95% CI 57-85%) and 81 percent (95% CI 67-89%) for BR and RCVP patients, respectively (P=0.6). Worse performance status (≥2) was the only pre-treatment factor identified as significant for inferior EFS. A sub-analysis limited to patients that received >4 cycles of immunochemotherapy also showed no clear difference in outcomes between BR and RCVP,” explained Dr Jowon Laura Kim, MD, University of British Columbia, Vancouver, and colleagues.

Early progression occurred in 18 percent of patients and worse survival was observed in patients that had an early event.

“This population-based analysis of TN-WM patients treated with upfront immunochemotherapy confirms the excellent outcomes that can be achieved with a finite course of therapy. In contrast to prior studies, similar outcomes were observed with RCVP and BR. Further, regardless of front-line therapy, POD24 may be associated with inferior outcome but larger studies are needed,” concluded Dr Kim and colleagues.

Jowon K, Gerrie AS, Savage KJ, et al. Frontline Therapy with Bendamustine-Rituximab (BR) in Patients with Treatment-Naïve Waldenstrom’s Macroglobulinemia Confers Similar Long-Term Outcomes to R-CVP in a Real-World Setting: A Population-Based Analysis. Presented at: the 2021 ASH Annual Meeting; Dec. 11-14; 2021; Abstract 1353.