Fast Five Quiz: Can You Treat Waldenström Macroglobulinemia?

Emmanuel C. Besa, MD


March 22, 2022

Although multiple treatment options are available for WM, the updated ESMO clinical practice guidelines recommends ibrutinib monotherapy as the treatment of choice for patients who experience a relapse within 12 months of chemoimmunotherapy, (rituximab plus alkylating agent or proteasome inhibitor), including patients with rituximab-refractory disease.

Ibrutinib, an oral BTK inhibitor, is used to treat patients with WM who have previously received treatment. However, its efficacy as a first-line therapy in treatment-naive patients is currently unknown.

Ibrutinib has been shown to effectively cause apoptosis of mutated WM cells. The role of BTK in oncogenic signaling through the B-lymphocyte surface receptors results in activation of pathways necessary for B-cell trafficking, chemotaxis, and adhesion. In certain cases, ibrutinib can also be given in combination with rituximab.

Plasmapheresis with no additional pharmacotherapy is not an appropriate treatment option for patients experiencing WM relapse within 12 months of chemoimmunotherapy.

As previously noted, multiple treatments options are available for WM.

Curcumin supplements may ameliorate issues associated with diabetes; sliding-scale insulin therapy is an individualized regimen for patients with diabetes.

Learn more about WM treatment.


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