Impact of Comorbidities on Patients With Waldenström Macroglobulinemia in Taiwan: A Multicenter Study.

Abstract

Purpose: Comorbidities adversely affect the prognosis of several low-grade B-cell lymphomas, yet their influence in Waldenström macroglobulinemia (WM) remains unexplored. This study aimed to comprehensively evaluate the clinical characteristics, treatment landscape, and survival outcomes in patients with WM, with a specific focus on the prognostic significance of comorbidities in an Asian cohort.

Materials and methods: This retrospective analysis included patients with WM from September 2002 to September 2023 using the Integrative Medical Data Center of National Taiwan University Hospital database. The primary end points were survival data stratified by prognostic factors.

Results: A total of 135 patients with WM were included, with a median age of 66.8 years. Sixty-eight percent had at least one comorbidity, with a median Charlson comorbidity index score of 5.5. The median overall survival (OS) was 9.2 years. Multivariable analysis revealed that high-risk International Prognostic Scoring System for Waldenström macroglobulinemia (IPSSWM; hazard ratio [HR], 3.84 [95% CI, 1.14 to 13.0]; P = .03) was significantly associated with a poor OS, while cytogenetic abnormalities (HR, 2.10 [95% CI, 0.92 to 4.82]; P = .08) and a high comorbidity burden (HR, 1.90 [95% CI, 0.96 to 3.74]; P = .065) demonstrated a notable trend toward worse outcomes. Among patients without anti-hepatitis B virus (HBV) prophylaxis, 100% of the HBV carriers experienced reactivation, compared with 17.5% of those with remote HBV infections.

Conclusion: Real-world WM data were used to validate the prognostic value of IPSSWM and revised IPSSWM in an Asian population. High comorbidity burden was associated with a poor survival, and the need for HBV prophylaxis was disclosed in patients with a history of HBV infection.