Waldenström's macroglobulinemia medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Risk stratification determines the protocol of management used for | Risk stratification determines the protocol of management used for waldenström's macroglobulinemia patients. The mainstay of therapy for asymptomatic waldenström's macroglobulinemia is watchful waiting. Symptomatic waldenström's macroglobulinemia is treated with [[Rituximab]] +/- [[Chemotherapy]].<ref name="ADR">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</ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 06:53, 3 January 2016
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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. The mainstay of therapy for asymptomatic waldenström's macroglobulinemia is watchful waiting. 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:[1]
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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.
References
- ↑ 1.0 1.1 1.2 1.3 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
- ↑ 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