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Treatment Options for Waldenstrom Macroglobulinemia

Treatment Options for Waldenstrom Macroglobulinemia

Learn about the different therapies used to treat this rare form of non-Hodgkin lymphoma.

While there is no cure for Waldenstrom macroglobulinemia, there are a number of treatments available that can help slow progression, alleviate symptoms and reduce the risk of complications that can result from having this type of non-Hodgkin lymphoma. As with many other diseases, treatment for WM will be different for every patient, and there is no single treatment approach that is right for everyone. Deciding when and how you treat will be a decision you make with your healthcare provider, and will take into account numerous factors.

Here, we look at some of the therapies that are commonly used to treat WM.

Chemotherapy
WM can be treated with chemotherapy or “chemo” as it is often called. Chemotherapy uses drugs that destroy cancer cells and prevent cancer cells from growing. These medicines vary in the way they are administered—some are taken as pills, others as infusions. Different chemotherapy drugs may be used in combination with one another, as well as with other cancer treatments.

Targeted therapy
There are several targeted therapies that are used in the treatment of WM. Targeted therapies work similar to chemotherapy drugs, but are more specific in the cells that they target. They work by blocking the cellular processes that cancers depend on to survive, grow and spread. Targeted therapies can be used on their own or used in combination with chemotherapy drugs.

Biologic therapy
Also called immunotherapies, biologic therapies are drugs that help the body’s immune system fight cancer. There are several biologic therapies that are used to treat cancers that are similar to WM, such as chronic lymphocytic leukemia and multiple myeloma, and these drugs are being studied to see if they are effective treatments for WM.

Plasma exchange
You may also hear this treatment referred to by its clinical name, plasmapheresis. WM is associated with abnormally high levels of an antibody called immunoglobulin M (IgM). Too much IgM can thicken the blood, impeding normal circulation, a condition called hyperviscosity syndrome. This can lead to a number of symptoms and complications—such as abnormal bleeding, dizziness or confusion, stroke and congestive heart failure. Plasma exchange can be used to treat hyperviscosity syndrome. During the procedure, blood is drained from an IV line or catheter, and then travels into a machine that separates blood cells and plasma. The IgM is filtered out, the patient’s plasma is replaced with albumin (a protein solution), and the mixture is returned to the body through a different IV line. This process will be repeated daily until symptoms subside or the person’s serum viscosity level is normal.

Watchful waiting
Deciding when to treat can be as important as deciding how to treat. WM is often described as an indolent cancer, meaning it progresses slowly. It can take a while before a person has symptoms. If a person is found to have WM, but is not currently experiencing symptoms, a healthcare provider may recommend a “watchful waiting” approach where the condition is closely monitored, but not treated with the therapies described above. If symptoms do appear, a patient can then decide on treatment options with their healthcare provider.

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