Waldenström's macroglobulinemia medical therapy: Difference between revisions
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{{Waldenström's macroglobulinemia}} | {{Waldenström's macroglobulinemia}} | ||
{{CMG}}{{AE}}{{MGS}} | {{CMG}}{{AE}}{{MGS}} | ||
==Overview== | ==Overview== | ||
Risk stratification determines the protocol of management used for Waldenström's macroglobulinemia patients. Watchful waiting is recommended for asymptomatic Waldenström's macroglobulinemia. Symptomatic Waldenström's macroglobulinemia is treated with [[Rituximab]] +/- [[Chemotherapy]].<ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | Risk stratification determines the protocol of management used for Waldenström's macroglobulinemia patients. Watchful waiting is recommended for asymptomatic Waldenström's macroglobulinemia. Symptomatic Waldenström's macroglobulinemia is treated with [[Rituximab]] +/- [[Chemotherapy]].<ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
There are several different options for treating Waldenström Macroglobulinemia.<ref name=Tx>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 </ref> | There are several different options for treating Waldenström Macroglobulinemia depending on the disease stage.<ref name=Tx>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 </ref> | ||
==Asymptomatic/Smoldering Waldenström's macroglobulinemia== | ==Asymptomatic/Smoldering Waldenström's macroglobulinemia== | ||
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==Hyperviscosity syndrome== | |||
*Plasmapheresis is recommended emergent treatment option for patients with Waldenström Macroglobulinemia who develop hyperviscosity symptoms.<ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | *Plasmapheresis is recommended emergent treatment option for patients with Waldenström Macroglobulinemia who develop hyperviscosity symptoms.<ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | ||
*Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes the blood thinner. | *Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes the blood thinner. | ||
| Line 117: | Line 119: | ||
==Salvage approach== | ==Salvage approach== | ||
*Stem cell transplant is used in patients whose lymphoma relapses or is not responding to other treatments (refractory). <ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | *Stem cell transplant is used in patients whose lymphoma relapses or is not responding to other treatments (refractory). <ref name="PHARM">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 20:16, 17 November 2015
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Waldenström's macroglobulinemia Microchapters |
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Differentiating Waldenström's macroglobulinemia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Waldenström's macroglobulinemia medical therapy On the Web |
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American Roentgen Ray Society Images of Waldenström's macroglobulinemia medical therapy |
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Directions to Hospitals Treating Waldenström's macroglobulinemia |
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Risk calculators and risk factors for Waldenström's macroglobulinemia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]
Overview
Risk stratification determines the protocol of management used for Waldenström's macroglobulinemia patients. Watchful waiting is recommended for asymptomatic Waldenström's macroglobulinemia. Symptomatic Waldenström's macroglobulinemia is treated with Rituximab +/- Chemotherapy.[1]
Medical Therapy
There are several different options for treating Waldenström Macroglobulinemia depending on the disease stage.[2]
Asymptomatic/Smoldering Waldenström's macroglobulinemia
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'.[3]
Symptomatic Waldenström's macroglobulinemia
Symptomatic patients with Waldenström Macroglobulinemia are started on chemotherapy depending on the stage.[1]
Initial stage of Waldenström's macroglobulinemia associated with
- Neuropathy,
- Anemia or cytopenias,
- Low-volume nodal involvement, and
- Asymptomatic splenomegaly
Treatment: Single-agent Rituximab therapy
Late stage of Waldenström's macroglobulinemia associated with
- Adenopathy,
- Symptomatic splenomegaly,
- Cytopenias,
- Hyperviscosity syndrome,
- Neuropathy, or
- Constitutional symptoms
| Treatment Regimen | Drugs | Side effects |
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CHOP-R regimen |
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Ibrutinib |
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Rituximab |
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FR regimen |
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BDR regimen |
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DRC regimen |
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CR regimen |
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Hyperviscosity syndrome
- Plasmapheresis is recommended emergent treatment option for patients with Waldenström Macroglobulinemia who develop hyperviscosity symptoms.[1]
- 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.
Salvage approach
- Stem cell transplant is used in patients whose lymphoma relapses or is not responding to other treatments (refractory). [1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/2057687-overview Accessed on November 11, 2015
- ↑ 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
- ↑ Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015
- ↑ Waldenström's macroglobulinemia: prognosis and management. Blood Cancer Journal (2015)http://www.nature.com/bcj/journal/v5/n3/full/bcj201528a.html Accessed on November 13, 2015