Abstract:
:Waldenström macroglobulinemia is a B-cell malignancy with lymphoplasmacytic infiltration in the bone marrow or lymphatic tissue and a monoclonal immunoglobulin M protein (IgM) in the serum. It is incurable with current therapy, and the decision to treat patients as well as the choice of treatment can be complex. Using a risk-adapted approach, we provide recommendations on timing and choice of therapy. Patients with smoldering or asymptomatic Waldenström macroglobulinemia and preserved hematologic function should be observed without therapy. Symptomatic patients with modest hematologic compromise, IgM-related neuropathy that requires therapy, or hemolytic anemia unresponsive to corticosteroids should receive standard doses of rituximab alone without maintenance therapy. Patients who have severe constitutional symptoms, profound hematologic compromise, symptomatic bulky disease, or hyperviscosity should be treated with the DRC (dexamethasone, rituximab, cyclophosphamide) regimen. Any patient with symptoms of hyperviscosity should first be treated with plasmapheresis. For patients who experience relapse after a response to initial therapy of more than 2 years' duration, the original therapy should be repeated. For patients who had an inadequate response to initial therapy or a response of less than 2 years' duration, an alternative agent or combination should be used. Autologous stem cell transplant should be considered in all eligible patients with relapsed disease.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Ansell SM,Kyle RA,Reeder CB,Fonseca R,Mikhael JR,Morice WG,Bergsagel PL,Buadi FK,Colgan JP,Dingli D,Dispenzieri A,Greipp PR,Habermann TM,Hayman SR,Inwards DJ,Johnston PB,Kumar SK,Lacy MQ,Lust JA,Markovic SN,Micalldoi
10.4065/mcp.2010.0304subject
Has Abstractpub_date
2010-09-01 00:00:00pages
824-33issue
9eissn
0025-6196issn
1942-5546pii
S0025-6196(11)60213-9journal_volume
85pub_type
杂志文章,评审abstract:OBJECTIVE:To review our institution's experience with patients who failed to benefit from septal artery ablation, which necessitated subsequent septal myectomy, and to examine reasons for ablation failure and outcome of myectomy after ablation. PARTICIPANTS AND METHODS:Of 550 patients who underwent septal myectomy at ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)61096-3
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009. PATIENTS AND METHODS:Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.06.028
更新日期:2016-11-01 00:00:00
abstract::The detection of monoclonal light chains in the urine by the Bence Jones heat test is a useful adjuvant to the diagnosis of myeloma and other related diseases. The test is particularly helpful when no serum spike is noted. Overall, it is positive in approximately half of all patients with myeloma. In order to assess t...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:To assess the potential electromagnetic interference (EMI) effects that new or current-generation cellular telephones have on medical devices. MATERIAL AND METHODS:For this study, performed at the Mayo Clinic in Rochester, Minn, between March 9, 2004, and April 24, 2004, we tested 16 different medical device...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/80.10.1286
更新日期:2005-10-01 00:00:00
abstract::At the McGill University neuro-ophthalmology unit, 52 patients with superior oblique palsy were seen during the 2-year period October 1973 to August 1975; these included patients with congenital, traumatic, vascular, and other more rare causes of trochlear paralysis. Half of the patients with congenital palsy had dipl...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::A prospective, stratified, randomized 3-year clinical trial was conducted on the effect of rigorous versus conventional glucose control on peripheral nerve function in 33 insulin-treated diabetic patients with a duration of diabetes of less than 2 years. The goals for conventional glucose control were the mean of fast...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-05-01 00:00:00
abstract::Considerable morbidity and mortality are associated with infections of vascular prosthetic grafts. Most vascular surgeons believe that once vascular prosthetic graft infections occur, any form of therapy short of removal of the prosthesis will fail. Although recent reports have noted the successful conservative treatm...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To estimate cancer risks for patients with myotonic dystrophy, given that increased risks for neoplasms in association with myotonic dystrophy type 1 and type 2 have been suggested in several studies but the risks of cancers have not been quantified. PATIENTS AND METHODS:A cohort of 307 patients with myotoni...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.09.005
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of treatment with fluticasone propionate vs placebo on bone, hypothalamic-pituitary-adrenal (HPA) axis function, and the eyes in patients with asthma. PATIENTS AND METHODS:This randomized, double-blind, placebo-controlled study of 160 patients with asthma who had minimal previous expo...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.4065/79.4.458
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). PATIENTS AND METHODS:Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and D...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.11.013
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To establish prognostic factors for recurrence and outcome of surgical treatment, with or without postoperative radiation therapy, in patients with meningiomas. MATERIAL AND METHODS:From 1978 through 1988, 581 patients underwent initial resection of a previously untreated primary meningioma at Mayo Clinic Ro...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/73.10.936
更新日期:1998-10-01 00:00:00
abstract::THE purpose of this study was to determine the difference in prognosis among patients with transient ischemic attacks (TIA) in the carotid arterial system and those with TIA in the vertebral-basilar arterial system. Nearly twice as many patients had TIA in the carotid system as had TIA in the vertebral-basilar system....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract::Advances in liver transplantation continue to evolve but are hampered by continued increasing shortages in donor organs. This has resulted in a high incidence of patients dying while on the United Network for Organ Sharing waiting list. Indeed, we continue to assess ways of expanding the donor pool by using marginal d...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/78.2.197
更新日期:2003-02-01 00:00:00
abstract::The clinical and morphologic findings of allergic granulomatosis and angiitis of Churg and Strauss in 21 men and 9 women were reviewed. The classic features are those of systemic vasculitis in a setting of bronchial asthma and eosinophilia. Pathologically there is necrotizing vasculitis of small arteries and veins wit...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To characterize the findings associated with acute febrile neutrophilic dermatosis (Sweet's syndrome [SS]) and the response of SS to treatment. DESIGN:We retrospectively reviewed 48 cases of SS encountered at the Mayo Clinic between 1980 and 1992. MATERIAL AND METHODS:Histopathologic specimens and medical r...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/70.3.234
更新日期:1995-03-01 00:00:00
abstract::As alternatives to transurethral resection of the prostate for treatment of benign prostatic hyperplasia, various types of laser prostatectomy-most notably, neodymium:yttrium-aluminum-garnet (YAG) and potassium titanyl phosphate laser procedures-have proved to be associated with considerably less morbidity (for exampl...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/73.8.792
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To study the direct physiological and emotional impact of an animal-assisted activity (AAA) session (a form of complementary and integrative medicine) in patients with fibromyalgia (FM). PATIENTS AND METHODS:The study population consisted of 221 participants with FM who were attending Mayo Clinic's Fibromyal...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.mayocp.2020.04.037
更新日期:2020-11-01 00:00:00
abstract::Hereditary causes due to mutations and defects in certain genes account for roughly 5% to 10% of all colorectal cancers. These inherited syndromes have been associated with a 60% to 100% lifetime risk for development of colorectal cancer, depending on the genetic syndrome, and many also carry an increased risk for mul...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2019.01.042
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To define mortality associated with isolated tricuspid regurgitation (TR) and identify risk factors associated with decreased survival. PATIENTS AND METHODS:We conducted a retrospective cohort study of residents of southeastern Minnesota with moderate-severe or more severe isolated TR diagnosed between Janua...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.04.036
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To determine the incidence and distribution of radical prostatectomy (RP) in the United States over time. PATIENTS AND METHODS:We conducted a serial cross-sectional analysis of time trends using the Nationwide Inpatient Sample of adult men older than 45 years who underwent RP between January 1, 1998, and Dec...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2015.09.018
更新日期:2016-01-01 00:00:00
abstract::Treatment of seniors with Parkinson disease is within the domain of primary care physicians and internists. A good working knowledge of carbidopa/levodopa principles should allow excellent care of most patients, at least during the early years of the disease. Even later, when levodopa responses become more complicated...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2011.0443
更新日期:2011-12-01 00:00:00
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.7.753
更新日期:2001-07-01 00:00:00
abstract::Nasal telangiectasias, a common condition, can be caused by chronic exposure to ultraviolet light, rosacea, topically applied corticosteroids, or rhinoplasty. Use of the argon laser for 15 to 45 minutes in a continuous mode over the entire involved area can produce considerable lightening of the nasal redness and impr...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62611-1
更新日期:1986-11-01 00:00:00
abstract::The two-column procedure for plasma catecholamine determination was adopted as a routine diagnostic test. It was found that the recovery of catecholamine added to properly preserved plasma was 65%. The most efficient recovery occurred when the water content of alumina used was above 23%. Both interassay and intra-assa...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1976-02-01 00:00:00
abstract::The increasing prevalence and far-reaching medical, social, and economical implications of obesity have made it a national health-care crisis in the United States. About one in every three persons is at least 20% above "ideal" body weight, and approximately 5% have direct weight-related serious health problems (morbid...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/72.6.551
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To determine whether sirolimus therapy is associated with neurologic complications, including stroke, among heart transplant recipients. PATIENTS AND METHODS:We retrospectively studied patients who underwent heart transplant at Mayo Clinic's site in Rochester, MN, from January 1, 1988, through June 30, 2006....
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/S0025-6196(11)60541-7
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To determine whether pancreas transplantation alters lipid and lipoprotein concentrations and whether peripheral hyperinsulinemia is always associated with altered lipid levels. DESIGN:We assessed the lipid profiles of seven pancreas-kidney recipients with insulin-dependent diabetes mellitus, seven kidney re...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61061-1
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:To analyze a large cohort of patients who underwent exercise testing and also report sex differences in other exercise heart rate (HR) parameters to determine whether separate sex-based equations to predict peak HR are indicated. PATIENTS AND METHODS:Patients aged 40 to 89 years who performed treadmill exerc...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2014.08.018
更新日期:2014-12-01 00:00:00
abstract::We describe three critically ill patients who displayed indirect evidence of transient corticotropin deficiency. All these patients were elderly, were poorly nourished, and had unexplained hypotension intraoperatively or immediately postoperatively. During the hypotensive episodes, they had inappropriately low plasma ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60188-8
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To assess presentation, imaging, treatment, and outcome of patients with myelopathy due to a dural arteriovenous fistula (DAVF). PATIENTS AND METHODS:This retrospective review identified 94 patients with DAVF surgically treated at our institution between June 1985 and December 1999. The mean ages of the 75 m...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.11.1120
更新日期:2001-11-01 00:00:00