Waldenström's macroglobulinemia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

There are several different options for Waldenström Macroglobulinemia.[1]

Watchful Waiting

Patients who do not have symptoms and whose cancer does not seem to be progressing often do not need treatment. They can be monitored every 3-6 months - a 'wait and watch approach'.[2]

Plasmapheresis

  • Plasmapheresis is recommended in patients with Waldenström Macroglobulinemia who develop hyperviscosity symptoms.
  • Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes the blood thinner.
  • However, plasmapheresis does not affect the lymphoma cells.
  • Plasmapheresis is usually given until chemotherapy starts to work.
  • Plasmapheresis is combined with chemotherapy to control the disease for a longer period of time.

Chemotherapy

  • Patients with Waldenström Macroglobulinemia who symptomatic are started on chemotherapy.
  • Drgus:
    • chlorambucil or cyclophosphamide, with or without prednisone
    • fludarabine or cladribine

Biological therapy

  • Rituximab may be used alone or in combination with chemotherapy.

Stem cell transplant

  • Stem cell transplant is used in patients whose lymphoma relapses or is not responding to other treatments (refractory).

References

  1. Lymphoplasmacytic lymphoma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/lymphoplasmacytic-lymphoma/?region=ab Accessed on November 6 2015
  2. Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015

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