Alkylating agents and fludarabine for Waldenstrom's macroglobulinaemia
A Cochrane review 1 included 1 study with a total of 92 subjects. The effect of fludarabine was compared to the combination of cyclophosphamide (the alkylating agent), doxorubicin and prednisone (CAP) in patients with pretreated/relapsed WM. Compared to CAP, the Hazard ratio (HR) for deaths of treatment with fludarabine was estimated to be 1.04, with a standard error of 0.30 (95% CI 0.58 to 1.48) The mean difference of median survival time was -4.00 months, and 16.00 months for response duration in favour of fludarabine. The relative risks (RR) of response rate was 2.80 (95% CI 1.10 to 7.12).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (few patients and wide confidence intervals).
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