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 macroglobulinemia. There is no treatment for asymptomatic Waldenström macroglobulinemia. The mainstay of treatment for symptomatic Waldenström macroglobulinemia is [[Rituximab]] +/- [[Chemotherapy]]. [[Hyperviscosity syndrome]] is a medical emergency and requires prompt treatment with [[plasmapheresis]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
There are several different options for treating | There are several different options for treating Waldenström macroglobulinemia depending on stage of the disease:<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==== | ||
There is no treatment for asymptomatic waldenström's macroglobulinemia.<ref name="BM">Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015</ref> | There is no treatment for asymptomatic Waldenström macroglobulinemia. Asymptomatic waldenström's macroglobulinemia can be monitored every 3-6 months.<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==== | ||
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====Hyperviscosity syndrome==== | ====Hyperviscosity syndrome==== | ||
*Waldenström | *Waldenström macroglobulinemia complicated with [[hyperviscosity syndrome]] is a medical emergency and requires prompt treatment with [[plasmapheresis]].<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 blood thinner. | *Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes blood thinner. | ||
*Plasmapheresis is usually given until chemotherapy starts to work. | *Plasmapheresis is usually given until chemotherapy starts to work. | ||
Revision as of 15:16, 31 October 2018
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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 macroglobulinemia. There is no treatment for asymptomatic Waldenström macroglobulinemia. The mainstay of treatment for symptomatic Waldenström macroglobulinemia is Rituximab +/- Chemotherapy. Hyperviscosity syndrome is a medical emergency and requires prompt treatment with plasmapheresis.
Medical Therapy
There are several different options for treating Waldenström macroglobulinemia depending on stage of the disease:[1]
Asymptomatic/Smoldering Waldenström's Macroglobulinemia
There is no treatment for asymptomatic Waldenström macroglobulinemia. Asymptomatic waldenström's macroglobulinemia can be monitored every 3-6 months.[2]
Symptomatic Waldenström's Macroglobulinemia
Symptomatic patients with waldenström macroglobulinemia are started on chemotherapy depending on the stage.[3]
- 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:[3]
| 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
- Waldenström macroglobulinemia complicated with hyperviscosity syndrome is a medical emergency and requires prompt treatment with plasmapheresis.[3]
- Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes blood thinner.
- 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
- ↑ 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
- ↑ 3.0 3.1 3.2 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