Document Detail

Soluble CD27 is a faithful marker of disease burden and is unaffected by the rituximab-induced IgM flare, as well as by plasmapheresis, in patients with Waldenström's macroglobulinemia.
MedLine Citation:
PMID:  19362974     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The assessment of disease burden is often difficult in patients with Waldenström's macroglobulinemia (WM) who receive rituximab due to the induction of an IgM flare, and following the removal of serum IgM by plasmapheresis. Soluble CD27 (sCD27) is a tumor necrosis factor family member secreted by WM cells which is strongly correlated with serum IgM levels and clinical responses in patients with WM. As such, we attempted to delineate its potential role in WM patients experiencing a rituximab-induced IgM flare and following plasmapheresis. PATIENTS AND METHODS: sCD27 levels were serially measured by serum-based ELISA in 8 patients who ultimately demonstrated a response to therapy, and in whom a rituximab-mediated IgM flare was observed, as well as in 3 WM patients undergoing plasmapheresis. RESULTS: Among the 8 patients who experienced a rituximab-mediated IgM flare, IgM levels rose from 3515 to a peak of 5270 mg/dL (P = .008), while sCD27 levels decreased from 174.1 to 155.9 U/mL (P = .012), with a decline observed in all patients. Among 3 patients undergoing plasmapheresis, IgM levels declined from a median of 6940 to 4770 mg/dL (P = .031), while median sCD27 levels remained without significant change (P = .317). CONCLUSION: sCD27 is a faithful marker of disease burden and is unaffected by the rituximab-induced IgM flare, as well as plasmapheresis in WM. The use of this marker may aid in correctly predicting clinical outcome in patients undergoing treatment with rituximab and/or plasmapheresis in WM.
Bryan T Ciccarelli; Guang Yang; Evdoxia Hatjiharissi; Leukothea Ioakimidis; Christopher J Patterson; Robert J Manning; Lian Xu; Xia Liu; Hsiuyi Tseng; Ping Gong; Jenny Sun; Yangsheng Zhou; Steven P Treon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical lymphoma & myeloma     Volume:  9     ISSN:  1557-9190     ISO Abbreviation:  -     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256500     Medline TA:  Clin Lymphoma Myeloma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-8     Citation Subset:  IM    
Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antigens, CD27 / blood*
Antineoplastic Agents / therapeutic use*
Enzyme-Linked Immunosorbent Assay
Immunoglobulin M / blood
Middle Aged
Tumor Markers, Biological / blood*
Waldenstrom Macroglobulinemia / blood*,  drug therapy*
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antigens, CD27; 0/Antineoplastic Agents; 0/Immunoglobulin M; 0/Tumor Markers, Biological; 0/rituximab

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