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Comparative response assessment by serum immunoglobulin M M-protein and total serum immunoglobulin M after treatment of patients with Waldenström macroglobulinemia.
[waldenström macroglobulinemia]
Serum
immunoglobulin
(
Ig
)
M
monoclonal
protein
determined
by
electrophoresis
(
sIgM-
MP
)
and
total
serum
IgM
(
sIgM
)
by
nephelometry
are
widely
used
for
response
assessment
in
Waldenström
macroglobulinemia
(
WM
)
,
although
have
not
been
compared
for
predicting
changes
in
underlying
disease
burden
.
We
,
therefore
,
compared
these
serum
markers
with
changes
in
bone
marrow
(
BM
)
and
extramedullary
disease
for
73
patients
who
were
rituximab
naive
and
treated
with
a
rituximab-containing
regimen
.
By
linear
regression
analysis
,
reductions
in
sIgM-
MP
and
sIgM
showed
moderate
correlation
with
BM
disease
involvement
(
r
=
0
.
4051
and
r
=
0
.
4490
,
respectively
)
,
and
did
not
differ
from
one
another
as
estimators
of
BM
disease
response
(
P
=
.
3745
)
.
Neither
sIgM-
MP
nor
sIgM
showed
a
strong
correlation
with
BM
disease
response
in
patients
with
low
(
<
1000
mg
/
dL
)
or
high
(
>
5000
mg
/
dL
)
IgM
levels
and
extramedullary
disease
response
.
sIgM-
MP
and
sIgM
,
therefore
,
are
comparable
response
markers
in
WM
.
Development
of
newer
,
more
accurate
surrogate
response
markers
are
needed
to
better
delineate
treatment
outcomes
in
patients
with
WM
and
with
low
or
high
IgM
levels
,
and
extramedullary
disease
.
Diseases
Validation
Diseases presenting
"accurate surrogate response markers"
symptom
waldenström macroglobulinemia
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