How I treat Waldenström macroglobulinemia

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Waldenström macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma.
• Characterized by bone marrow infiltration and monoclonal IgM production.
• Presents asymptomatically or with complications from infiltration or IgM properties.

Purpose of the Study:

• To review diagnostic criteria for WM.
• To discuss current and evolving treatment strategies for WM.
• To guide clinical decision-making in various WM patient scenarios.

Main Methods:

• Review of diagnostic criteria, including MYD88L265P mutation testing.
• Analysis of current therapeutic options for WM.
• Discussion of treatment selection based on clinical factors.

Main Results:

• WM diagnosis is well-defined, with genetic testing aiding differential diagnosis.
• Treatment landscape has evolved rapidly with anti-CD20 antibodies and BTK inhibitors.
• Therapy choice depends on disease control needs, complications, and patient age.

Conclusions:

• WM management requires tailored treatment strategies.
• BTK inhibitors offer new therapeutic avenues, including continuous therapy.
• This review provides guidance for managing WM in diverse clinical contexts.