The updated ESMO clinical practice guidelines released October 1, 2018, recommend rituximab plus an alkylating agent (bendamustine or cyclophosphamide) or proteasome inhibitor as the initial treatment for WM.
Rituximab is a monoclonal antibody that binds to the CD20 antigen, causing antibody-mediated cytolysis. Patients with WM are administered one infusion of rituximab weekly for 4 consecutive weeks. The typical response time of patients with WM receiving rituximab tends to be > 3 months, during which time patients are at risk for paraprotein flare and HVS. Current guidelines do not recommend rituximab as a maintenance therapy. On maintenance rituximab, patients should be cautioned regarding the risk for serious infection with prolonged immunosuppression.
Gemcitabine and paclitaxel is a combined chemotherapy for treating pancreatic cancer, and carbidopa/levodopa 10/100 orally 3 times a day is a treatment for Parkinson’s disease. Neither of these agents is an appropriate treatment for WM.
Learn more about pharmacologic therapy options for WM.
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Cite this: Emmanuel C. Besa. Fast Five Quiz: Can You Treat Waldenström Macroglobulinemia? - Medscape - Mar 22, 2022.