Survival trends in Waldenström macroglobulinemia and comparison of outcomes with the general United States population

Therapeutic options for Waldenström macroglobulinemia (WM) have expanded but improvements in overall survival (OS) are difficult to interpret due to competing non-WM mortality. Retrospective analysis of WM patients of Mayo Clinic (Rochester, MN) evaluated survival trends. The analysis included 1020 patients treated in two eras: 1996-2005 and post-2006. OS did not differ significantly across eras in the overall cohort (p=0.64). However. among patients aged <65 years at the time of active WM diagnosis, OS improved in the post-2006 era (median 18.8 versus 14.1 years; p=0.018). Cause-specific survival improved across eras, increasing from 15.6 years ub 1996-2005 to 18.9 years post-2006 (p<0.0001). Competing risk analysis demonstrated a reduction in WM-related mortality over time (p<0.001). However, excess mortality persisted, with a standardized mortality ratio of 2.79 (p<0.001) among patients aged <65 years compared with a matched US population. The authors conclude that these findings highlight improvement in WM-specific survival, while OS improvement is observed in younger patients.