0521779407-23 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:24
Waldenstrom’s Macroglobulinemia Warts 1549■Nucleoside analogs: high response rates, but prolonged immuno-
suppression
■Rituxan alone or with chemotherapy.
■Bortezomib.
follow-up
■Quantitative immunoglobulins and quantitation of monoclonal pro-
tein and serum viscosity every 2 cycles
■Complete blood count, differential, platelets
■CT scans (if abnormal at presentation) every 3–6 mo
complications and prognosis
Progressive Disease
■Nucleoside analogs
■in patients who progress despite treatment with alkylating agents
■in patients who respond to but relapse within 6 months after alky-
lating agent therapy
■in patients who relapse more than 6 months after treatment with
nucleoside analogs
■Alkylating agent therapy
■in patients who relapse more than 6 months after treatment with
alkylating agents
■in patients who progress despite treatment with nucleoside analogs
■in patients who respond to but relapse within 6 months after nucle-
oside analog therapy
Prognosis
■Median survival of 50 months, similar to best reported myeloma
series
■Prolonged indolent course not requiring therapy in some patients
■Higher risk with older age, male sex, general symptoms, and cytope-
niasWARTS
ROBERT T. BRODELL, MD and SANDRA MARCHESE JOHNSON, MD
history & physical
History
■Exposure to the Human Papillomavirus, direct contact
■2/3 of sexual contacts with genital warts develop genital warts
■Peak incidence: 12–16 years
■Incubation: few weeks to more than 1 year, average: 2.8 months