How is Waldenström macroglobulinemia managed?

Updated: Feb 01, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Waldenström macroglobulinemia is not curable, but a number of therapies have shown activity in the disease. Data from randomized trials remain sparse, however. [4, 5]

For asymptomatic patients without end-organ damage, management consists of careful observation. In symptomatic patients, monotherapy with rituximab is the usual choice, especially for nonbulky disease. Bulky symptomatic disease may require combination regimens, such as chemotherapy. [6] Ibrutinib has demonstrated efficacy as monotherapy for rituximab-resistant cases, especially those with mutations in the MYD88 gene. [7]  Hyperviscosity syndrome may mandate emergency plasmapheresis. Autologous stem cell transplantation is a consideration in select cases. (See Treatment.)

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