FLUDARABINE TREATMENT IN RESISTANT WALDENSTROMS MACROGLOBULINEMIA

Fludarabine (FLU) is a fluorinated purine analogue with a promising an tineoplastic activity in lymphoproliferative disorders. In this study, we evaluated the efficacy of FLU in 12 previously treated (primary re fractory and refractory relapse) patients with Waldenstrom's macroglob ulinemia. All patients were treated at a dosage of 25 mg/m(2) per day for 5 consecutive days for a total of six courses. Of the 12 patients, 5 (41%) achieved partial response (PR), and the remaining 7 showed no benefit from the treatment. An increased response rate was obtained i n the 4 primary refractory patients in which 2 PR were documented. Tre atment was well-tolerated and there were no Fludarabine-related fatali ties. With a mean follow-up of 10 months, only 1 PR patient has relaps ed, Fludarabine is an interesting new salvage agent effective against recurrent/resistant Waldenstrom's macroglobulinemia and should be eval uated in further studies in untreated patients with Fludarabine in mon ochemotherapy or in combination with other active modalities.