ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
This article is part of the Research TopicUpdates on the Management of Hematologic Malignancies from SOHO Italy: Educational Insights and Clinical PerspectivesView all 10 articles
A real-world 10-year follow-up analysis of survival and safety of CD20-targeted therapy in patients with Waldenstrom macroglobulinemia
Provisionally accepted
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Hematology Department, Fujian Medical University Union Hospital, Fuzhou, China
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Objective: To evaluate the long-term survival and safety outcomes of CD20-targeted chemoimmunotherapy regimens in patients with Waldenstrom macroglobulinemia (WM) in a real-world single-center cohort from China. Methods: We conducted a retrospective analysis of 128 patients with WM who received CD20-based regimens at a single center from 2014 to 2024. Baseline characteristics, treatment efficacy, survival outcomes (OS and PFS) and safety profiles were compared among the four treatment groups. Results: Significant differences were found in age, disease burden, and bone marrow infiltration. Patients in the R-CHOP group had higher IgM levels and bone marrow infiltration rates. The FCR group achieved the longest OS (75.86±22.05 months, P < 0.01). The RTX group showed the poorest outcomes, with a mortality rate of 75% within 12 months after relapse. ORR and consolidation therapy rates were similar across groups. The FCR group had the highest rate of grade ≥3 adverse events (60%), mainly leukopenia and thrombocytopenia. The R-CHOP group had a higher infection risk, while RTX was the safest. Conclusion: In this 10-year single-center real-world cohort from China, CD20-targeted chemoimmunotherapy achieved durable disease control with acceptable long-term safety in patients with WM. Differences in efficacy and toxicity profiles among FCR, BR, R-CHOP, and rituximab monotherapy support an individualized treatment approach that takes into account patient age, comorbidities, and tolerance. Because standardized quality-of-life instruments were not used in this retrospective study, our findings should be interpreted as reflecting survival and treatment-related toxicity rather than validated health-related quality of life.
Keywords: CD20-targeted therapy, Real-world study, Safety, Survival, Waldenstrom Macroglobulinemia
Received: 27 Oct 2025; Accepted: 09 Jan 2026.
Copyright: © 2026 Huang, Zheng, Zheng, Zhan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xufei Huang
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