Treatment Options for Waldenstrom Macroglobulinemia
There is a rare form of blood cancer called waldstrom macroglobulinemia. Treatments for this condition include targeted therapy.
A type of blood cancer called waldstrom macroglobulinemia is a slow-growing type. People with this cancer have high levels of white blood cells and an atypical protein called IgM in their bone marrow.
WM is rare. According to the
There is no cure for WM, but there are many different treatments that can help manage symptoms and prevent problems. Continue reading to learn more.
Different types of doctors may provide care for you or your loved one. Doctors who treat cancer and blood and bone marrow disorders are some of the doctors who may be included in your healthcare team.
There are several treatment options for the disease. Treatments are focused on managing symptoms. Your symptoms, age, and overall health are some of the factors that can affect which one your healthcare team recommends.
Your doctor may request certain tests to help guide your treatment.
Watchful waiting
“If you don’t have any symptoms, you may not need treatment. Your doctor may suggest blood tests. This is called watching.”
Watchful waiting for WM includes doctor’s visits and blood tests about every
Some people with WM are closely monitored by their healthcare team for years without needing any treatment. Studies suggest that waiting to start treatment until you show symptoms won’t affect your condition’s outlook, according to the
Targeted therapy
“Targeted therapy uses drugs that are either inside or on the inside of cancer cells to stop them from growing. It doesn’t spare healthy cells. There are a number of types of targeted therapy for WM.”
Rituximab (Rituxan)
The drug targets a cancer cell. rituximab causes the destruction of cancer cells.
“The FDA hasn’t approved Rituximab for that purpose, but it is often an initial part of treatment for WM. This is a practice that is not labeled. The drug ibrutinib has FDA approval when used with Rituximab.”
The medication is given by infusion into a vein (IV), usually in your arm. It’s often used in combination with chemotherapy or other treatments. In fact, research published in 2019 shows that rituximab works better when you take it with chemotherapy drugs.
Other anti-CD20 drugs
If rituximab causes you serious side effects, your doctor may prescribe another drug that targets CD20.
Bruton tyrosine kinase (BTK) inhibitors
There are three drugs that are used to treat the disease. The drugs work by targeting a specific part of the body.
These drugs are prescribed by your doctor and you have to take them once or twice a day.
- Ibrutinib (Imbruvica). This is the first BTK inhibitor to receive FDA approval to treat WM. It may be prescribed alone or with rituximab.
- Zanubrutinib (Brukinsa). This newer drug was FDA-approved to treat WM in 2021. Clinical trials suggested that it may have less severe side effects compared to ibrutinib.
- Acalabrutinib (Calquence). This may be prescribed on its own or with other treatments. Because it is not FDA-approved to treat WM, this is an off-label use. A clinical trial examining the use of acalabrutinib for WM is currently underway.
Proteasome inhibitors
The drugs block the cancer cells from living. They can be helpful for people with the disease.
Two examples are carfilzomib and bortezomib. Both are given by IV. Bortezomib can be used as a shot under the skin. Ixazomib is a pill that is used with other treatments for wm.
mTOR inhibitors
“A pill called Everolimus blocks aProtein that cancer cells need to grow and divide. If other treatments for WM haven’t worked, your doctor may prescribe this.”
Chemotherapy
“Chemotherapy is the use of drugs to kill cancer cells. Chemo has a more general effect than targeted therapy and doesn’t seek out specific proteins on cancer cells. Some healthy cells are killed during the course of the treatment.”
Chemotherapy drugs have been used to treat the disease.
- bendamustine is a drug.
- cladribine is a drug.
- The cyclophosphamide is a drug.
- Doxorubicin is aamycin
- fludarabine is a drug.
- Oncovin is a drug called vincristine.
Your doctor may prescribe a combination of drugs, such as rituximab, for you.
If you are getting a bone marrow transplant, you may be given high dose first chemotherapy.
Immunotherapy
The drugs make your immune system stronger. People with WM will sometimes be prescribed immunotherapy drugs.
You can also see these drugs as ImiDs. Thalomid and pomalidomide are examples.
Plasmapheresis (plasma exchange)
Hyperviscosity is a common symptom of WM. Increased levels of IgM in the blood can cause stroke and organ damage.
If you have symptoms of this, you will need treatment to remove the toxins from your blood. This treatment is called a blood-pheresis.
During the procedure.
- A healthcare professional puts an IV line in you. The machine has an IV line.
- The IgM is removed from the IV as blood flows through it.
- The healthy blood is returned to you through an IV line.
It takes a few hours to do the procedure. You can lie down or recline. You may be given a blood thinner to prevent it.
Other options
Stem cell transplant (bone marrow transplant)
Stem cell transplant involves replacing bone marrow with healthy blood stem cells. The goal is for these stem cells to grow into healthy bone marrow. The first thing to do is to clear out the existing bone marrow.
“If you have a younger adult with a condition that hasn’t worked, your doctor may suggest a stem cell transplant.”
However, stem cell transplantation isn’t a common treatment for WM. According to the ACS, the average age at diagnosis is
Blood transfusions
A condition called Anemia. can occur in some people with wm if their red blood cells are low. If you develop Anemia. due to treatment for WM, your doctor may recommend blood transfusions.
Spleen removal (splenectomy)
“If your blood cancer is causing a swollen spleen and you have not been able to get it under control, your doctor may suggest removing it. This isn’t a common treatment for the disease.”
“There are a lot of things to consider when you are presented with different treatment options. Let’s look at these now.”
Side effects
There are different side effects of each type of treatment. The type of side effects that a person may experience can vary by individual and can also depend on other factors.
We will give a snapshot of the potential side effects of some of the treatment options. Your healthcare team can help you understand the types of side effects that you may experience and how to manage them.
Targeted therapy drugs
rituximab can raise the level of IgM in the blood. Other possible side effects can include:
- There is a high degree of fever.
- “It’s cold.”
- fatigue
- There are headaches.
- nausea
- There is a There is a There is a rash…
There are some side effects of the drug.
- low blood counts are a problem. are a problem., which can lead to:
- Anemia.
- There is an increased risk of infections.
- It is easy to bruise or bleed.
- There is a lot of There is a lot of There is a lot of diarrhea…
- There is pain in the muscles and bones.
- cough
- There is a There is a rash..
- A abnormal heartbeat.
Pain and numbness can be caused by nerve damage, which can be caused by panisome inhibitors. Once treatment is stopped, this side effect usually goes away. Other side effects may include:
- low blood counts are a problem. are a problem.
- nausea
- The appetite has been lost.
Side effects of mTOR are possible.
- fatigue
- infections
- There is a lot of There is a lot of There is a lot of diarrhea…
- The mouth hurts.
- There is a There is a rash..
Chemotherapy
Chemo can kill other types of cells in the body. The cells of the hair follicles, the bicyle, and the bone marrow can be included.
Some of the possible side effects of chemotherapy may include:
- hair loss
- appetite loss
- nausea
- vomiting
- There is a lot of There is a lot of There is a lot of diarrhea…
- It is a problem of the colon.
- There are mouth sores.
- low blood counts are a problem. are a problem.
Immunotherapy drugs
Side effects of thalidomide can be caused by the drugs.
- fatigue
- It is a problem of the colon.
- Nerve pain.
- There is an increased risk of serious blood clot.
If you take the drugs during your pregnancies, you can cause birth defects.
Cost of treatment
Cancer treatment can be expensive. If you need treatment for WM, you should talk to your doctor about the cost of your care.
Your doctor may be able to give you cost-saving tips or give you advice on how to get financial aid. It is always a good idea to check with your insurer before treatment to determine what is covered.
“If you can’t afford treatment, you should contact the drug manufacturer. Some companies offer assistance programs.”
Lifestyle tips
If you are receiving treatment for WM, your doctor may recommend lifestyle changes to help you feel better and Improve your quality of life.. This is sometimes referred to as palliative care. Any treatment that helps with the quality of life is called palliative care.
- It is helpful to ease your symptoms and treatment side effects.
- Improve your quality of life.
- Support you and your family during your cancer journey.
Diet changes and relaxation techniques are examples of lifestyle changes.
Diet changes
Cancer treatments can affect your appetite and cause you to lose weight. Eating may be uncomfortable due to mouth sores and nausea.
“Milkshakes and canned liquid supplements can provide important nutrition and restore energy. If you can’t eat big meals, try eating small snacks throughout the day, such as yogurt, cereals, or cheese and crackers.”
Avoid foods that can cause sore mouths.
Relaxation techniques
Relaxing activities such as yoga and tai chi can help manage stress and cancer pain. Taking a few deep breaths can help you sleep, reduce tension, and make some treatments work better.
Staying hydrated
“The side effects of cancer treatments can cause dehydration. You are more likely to feel tired and weak if you don’t have enough fluid in your body.”
It is important to avoid getting dehydrated if you have hyperviscosity caused by WM.
Ways to stay hydrated.
- drinking lots of fluids
- Eating foods with high liquid content are soups, fruits, and popsicles.
- treating the causes of dehydration, such as There is a high degree of fever., vomiting, and There is a lot of There is a lot of There is a lot of diarrhea…
Getting help and support through treatment
If you or a loved one is diagnosed with cancer, it is ok to feel stressed, anxious, or depressed. It is possible to connect and talk with others who are living with the same condition.
Ask your doctor about support groups in your area, or visit the
Choosing to stop treatment or choosing no treatment at all
“It is possible that treatment won’t stop the growth of the disease. After a successful treatment, it is possible that WM will return. You may not want to receive treatment in some cases.”
“It is important to talk with your healthcare team about your decision, regardless of whether you choose to stop treatment or refuse it. They can give you an idea of what will happen if you don’t get treatment.”
It’s possible that they may still recommend treatments that help to address symptoms and complications like pain, hyperviscosity, and Anemia.. This can help you feel more comfortable.
Discuss your decision with your family. It may be difficult to explain your decision, but try to do so in a way that makes sense. Those closest to you are there to support you on your journey.
There is no cure for the disease, but researchers are studying new ways to treat it. There are several new drugs in clinical trials. Clinical trials aim to test new treatments before they are used on a larger scale.
A clinical trial is where your doctor may suggest you receive treatment. Discuss your interest in a clinical trial with your healthcare team.
You can also find clinical trials for WM that are supported by the National Cancer Institute
“If you don’t have symptoms, you won’t need to take any treatments. Your doctor will likely recommend regular blood tests. If symptoms develop, treatment will be initiated.”
If you have symptoms of WM, you should start treatment right away to help you live longer. Chemotherapy is usually given with drugs.
The disease will return after the first treatment for this rare blood cancer. If this happens, you and your doctor have many options.
Expert Q&A: What complementary therapies might be effective for WM?
Researchers have not studied the effect of therapies on the rare type of lymphoma.
During and after treatment, alternative medication can support people with the disease.
There are some common symptoms related to the treatment of wm.
- fatigue (related to chemotherapy, Anemia., and thickening of the blood)
- Nerve damage caused by the cancer and treatment can cause pain.
- Chemtherapies cause nausea.
The symptoms and side effects affect your quality of life and ability to carry out your day-to-day activities.
These symptoms have been improved by therapies. Here are some therapies that have effects.
- Acupuncture. During acupuncture sessions, a trained specialist inserts fine needles into your skin to help ease specific symptoms. This may help with nausea and drowsiness in people undergoing cancer treatments, according to
2018 research . - Food, herbs, and supplements. While there are no specific foods that dramatically reduce your risk of getting WM or cure the cancer, the benefits of eating a nutrient-rich diet full of vegetables and fruit can help manage the condition and its side effects, 2017 research says. There is also growing evidence on vitamins and supplements, but you should discuss these with your medical team. Some common foods and supplements may interfere with WM treatments, as a 2009 study found.
- Mind-body practices. Therapeutic massage may improve individuals’ quality of life and stress levels, according to a
2014 study . Yoga and meditation may also be helpful, per studies from2019 and2016 , respectively. - Exercise. Light activity, if you’re able, may help with fatigue in people recovering from similar types of cancer, especially in people with high levels of fatigue, a
2019 research review suggests.
More research is needed to clarify what types of therapies can help. Many of the studies have few participants and their designs make it hard to determine the strength of the evidence for each therapy.
People are interested in these therapies and get a sense of empowerment from managing their own symptoms.
Many cancer centers have an integrated medicine group that can provide these services and recommendations with your cancer treatment. It is important to talk about these therapies with your healthcare team.
Answer by Teresa Thomas, PhD, RN
Answers are opinions of medical experts. All content is not a substitute for medical advice.
