Fast Five Quiz: Can You Treat Waldenström Macroglobulinemia?

Emmanuel C. Besa, MD


March 22, 2022

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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