Waldenström's macroglobulinemia medical therapy

Waldenström's macroglobulinemia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

There are several different options for Waldenström Macroglobulinemia.

Watchful Waiting

Patients who do not have symptoms and whose cancer does not seem to be progressing often do not need treatment.

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).