Fast Five Quiz: Can You Treat Waldenström Macroglobulinemia?

Emmanuel C. Besa, MD


March 22, 2022

Patients with asymptomatic WM are managed by watchful waiting and monitoring every 3-6 months. Patients who meet the criteria for WM on the basis of elevated serum IgM and/or bone marrow lymphoplasmacytic infiltration but who do not have end-organ damage are considered to have smoldering WM (also referred to as "indolent WM"), for which no treatment is indicated. Repeat testing for IgM elevations, serum viscosity, and careful observation for symptom development will guide future management.

Treatment is indicated for patients who develop constitutional symptoms (eg, weakness, fatigue, weight loss, anorexia), cytopenia, hyperviscosity, neuropathy, amyloidosis, and/or Raynaud phenomenon.

A prednisone taper, angiotensin-converting enzyme inhibitor therapy with increased fluid intake, and high-dose combination chemotherapy are not appropriate treatment options for patients with asymptomatic WM.

Learn more about asymptomatic WM.


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