Waldenström's macroglobulinemia medical therapy: Difference between revisions
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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> | 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=== | ||
Patients who do not have symptoms and whose cancer does not seem to be progressing often do not need treatment. | 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'.<ref name="BM">Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015</ref> | They can be monitored every 3-6 months - a 'wait and watch approach'.<ref name="BM">Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015</ref> | ||
==Symptomatic Waldenström's Macroglobulinemia== | ===Symptomatic Waldenström's Macroglobulinemia=== | ||
Symptomatic patients with | Symptomatic patients with waldenström macroglobulinemia are started on chemotherapy depending on the stage.<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> | ||
*Initial stage of waldenström's macroglobulinemia associated with | |||
*Neuropathy, | :*Neuropathy, | ||
*Anemia or cytopenias, | :*Anemia or cytopenias, | ||
*Low-volume nodal involvement, and | :*Low-volume nodal involvement, and | ||
*Asymptomatic splenomegaly | :*Asymptomatic splenomegaly | ||
'''Treatment:''' Single-agent Rituximab therapy | '''Treatment:''' Single-agent Rituximab therapy | ||
*Late stage of waldenström's macroglobulinemia associated with | |||
*Adenopathy, | :*Adenopathy, | ||
*Symptomatic splenomegaly, | :*Symptomatic splenomegaly, | ||
*Cytopenias, | :*Cytopenias, | ||
*Hyperviscosity syndrome, | :*Hyperviscosity syndrome, | ||
*Neuropathy, or | :*Neuropathy, or | ||
*Constitutional symptoms | :*Constitutional symptoms | ||
'''Treatment:'''<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> | '''Treatment:'''<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> | ||
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==Hyperviscosity syndrome== | ==Hyperviscosity syndrome== | ||
*Plasmapheresis is recommended emergent treatment option for patients with | *Plasmapheresis is recommended emergent treatment option for patients with waldenström macroglobulinemia who develop hyperviscosity symptoms.<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> | ||
*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. | ||
*However, plasmapheresis does not affect the lymphoma cells. | *However, plasmapheresis does not affect the lymphoma cells. | ||
Revision as of 07:03, 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]
| 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.
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