Waldenström Macroglobulinemia: Treatment Options
Although Waldenström macroglobulinemia (WM) is an incurable disease, it is treatable, and many patients have a long-term response to treatment. For patients with no symptoms, physicians may decide not to treat the disease right away, an approach referred to as An approach in which no immediate medical, surgical or radiation therapy is given. Patients are followed closely to make sure the cancer does not progress. (watch and wait). For patients who have symptoms, the type and severity of the symptoms (such as age, overall health and degree of thickness of the blood) help determine the type of treatment selected. Once treatment is deemed necessary, the choice of treatment is based on individual patient needs, as well as considerations for short-term and long-term side effects.
Some patients undergo a procedure called plasmapheresis to temporarily reverse or prevent the symptoms associated with the thickening of the blood. This procedure involves removing the patient’s blood, passing it through a machine that removes the part of the blood containing the IgM a substance made by B-lymphocytes that reacts with antigens on toxins, bacteria and some cancer cells and either kills or marks them for removal., and returning the remaining blood to the patient. Physicians often combine plasmapheresis with other more definitive treatments, such as Treatment with drugs to stop the growth of rapidly dividing cancer cells, including lymphoma cells..
In 2015, ibrutinib (Imbruvica) was the first therapy approved by the U.S. Food and Drug Administration (FDA) specifically for patients with Waldenström macroglobulinemia. There are many other drugs that can be used to manage this disease, alone and/or in various combinations, including the following:
- Bendamustine (Treanda)
- Cladribine (Leustatin)
- Bortezomib (Velcade)
- Fludarabine (Fludara)
- Chlorambucil (Leukeran)
- Rituximab (Rituxan) Other agents used alone or in combination for primary treatment are cyclophosphamide (Cytoxan), carfilzomib (Kyprolis), and thalidomide (Thalomid).
- Ibrutinib (Imbruvica) + Rituximab (Rituxan)
Treatments Under Investigation
Several promising new drugs and drug combinations are being studied in clinical trials for the treatment of patients with Waldenström macroglobulinemia (some for relapsed/refractory disease), including:
- Lenalidomide (Revlimid)
- Obinutuzumab (Gazyva)
- Idelalisib (Zydelig)*
- Panobinostat (Farydak)
- IMO-8400 • Venetoclax (Venclexta)
- Ixazomib (Ninlaro)
As of April 2016, certain clinical trials, in the front-line setting using idelalisib in combination with another therapy, for patients with indolent NHL and chronic lymphocytic Disease generally characterized by the overproduction of abnormal or immature white blood cells that circulate or are present in the blood./small lymphocytic lymphoma were stopped to further evaluate increased adverse events that appeared to be the result of combining idelalisib with other Abnormal cell growth that cannot be controlled by the body's natural defenses. Cancerous cells can grow and eventually form tumors. medicines. Further analysis is still needed, and patients should discuss options with their physician.
Chimeric Identifying proteins located on the surface of all cells. The immune system uses antigens to determine whether cells are a necessary part of the body or need to be destroyed. receptor-modified A type of white blood cell that participates in immune responses by destroying harmful substances or cells. therapy targeting CD19 is another promising therapy for patients with Waldenström macroglobulinemia. In this technique, a patient’s own T cells are removed and genetically reprogrammed to attack lymphoma cells. These clinical trials are in various phases of development. It is critical to remember that today’s scientific research is continuously evolving.