What are the IWWM8 recommendations for peripheral neuropathy treatment in Waldenström macroglobulinemia?

Updated: Feb 01, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Further IWWM8 recommendations include the following [24]

  • When treatment is indicated, patients require treatment of sufficient intensity to remit both the systemic disease and the neurological component
  • Appropriate precautions should be taken in patients considered at high risk of a flare (IgM > 40 g/L), such as deferring rituximab until cycle 2 of combination chemotherapy or performing prior plasma exchange
  • Neurotoxic agents should be avoided; in particular, the vinca alkaloids have no place in the management of Waldenström macroglobulinemia, particularly in patients with peripheral neuropathy
  • Plasmapheresis, corticosteroids, and intravenous immunoglobulin (IVIg) are of little or no value in the treatment of Waldenström macroglobulinemia–associated neuropathy

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