The UK charity for Waldenstrom’s macroglobulinaemia – a rare type of blood cancer
Support Line: 0300 373 8500

Treatment for Waldenstrom's macroglobulinaemia

Waldenstrom’s macroglobulinaemia responds well to treatment. The type of treatment you’re offered, and when you have it, will depend on your individual circumstances.

What do WM treatments do?

There is no cure for WM Instead, the aim of WM treatment is to send the disease into what is known as ‘remission’. This is when the cells that cause your WM have been reduced, leading to a reduction or improvement in your WM symptoms. This might help you to feel better than before you went on treatment.

Your first course of treatment is called a ‘first-line’ treatment. This is usually chemotherapy, but your healthcare team will talk through the options that best suit you. Over time, the abnormal cells in your body may start to increase again, and you might need a second, or even third, course of treatment. These courses are known as ‘second-line’ and ‘third-line’.

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Treatment for WM

How does a doctor decide when I need to start treatment?

WM is a slow growing cancer, so you might not need treatment immediately after your diagnosis. Some people will remain on active monitoring for years.

The abnormal cells that cause your Waldenstrom’s macroglobulinaemia may gradually increase over time. When this happens, symptoms related to WM will become more noticeable.

By monitoring your symptoms and looking at the levels of abnormal IgM protein in your blood, your doctor can see whether your WM has grown to a point where you need treatment.

Every patient is unique, so it’s important to speak with your doctor about your symptoms. When deciding your treatment, they’ll take this into consideration along with your age, general health and fitness, and what treatment you’ve had before.

Types of treatment

Chemotherapy

Chemotherapy is a type of drug, or combination of drugs, that kills cancer cells. When treating WM, it is often combined with a type of drug known as a monoclonal antibody, such as Rituximab. The most common combinations of chemotherapy that have proven to be effective in treating WM are known as DRC (which contains the drugs dexamethasone, rituximab and cyclophosphamide) and BR (bendamustine and rituximab).

Monoclonal antibody therapies

Chemotherapy is a type of drug, or combination of drugs, that kills cancer cells. When treating WM, it is often combined with a type of drug known as a monoclonal antibody, such as Rituximab. The most common combinations of chemotherapy that have proven to be effective in treating WM are known as DRC (which contains the drugs dexamethasone, rituximab and cyclophosphamide) and BR (bendamustine and rituximab).

Targeted treatments

These treatments target proteins in cancer cells to kill them or stop them from growing. Unlike chemotherapy – which kills cancerous and healthy cells – targeted therapies have been designed to destroy only the cancer cells. This can lead to fewer side effects. The most common targeted therapies you might hear about are BTK inhibitors like zanubrutinib and ibrutinib.

Stem cell transplants

This procedure replaces damaged cells in your body with healthy cells. It is an intensive treatment that is only offered as a second- or third-line treatment. A stem cell transplant requires a long stay in hospital and carries a risk of severe side effects. Recovery time can take up to a year.

CAR T-cell therapy

This procedure replaces damaged cells in your body with healthy cells. It is an intensive treatment that is only offered as a second- or third-line treatment. A stem cell transplant requires a long stay in hospital and carries a risk of severe side effects. Recovery time can take up to a year.

Steroids

This procedure replaces damaged cells in your body with healthy cells. It is an intensive treatment that is only offered as a second- or third-line treatment. A stem cell transplant requires a long stay in hospital and carries a risk of severe side effects. Recovery time can take up to a year.

Treatment regimens

Sometimes you’ll receive a combination of drugs. These are known as regimens. You’ll have the drugs at one point in the cycle, before having a period of not taking them. Because treatment can have side effects or be harsh on your body, cycles give your body time to recover. Cycles vary in length depending on what drugs you are taking.

When WM Comes Back

Sometimes you’ll receive a combination of drugs. These are known as regimens. You’ll have the drugs at one point in the cycle, before having a period of not taking them. Because treatment can have side effects or be harsh on your body, cycles give your body time to recover. Cycles vary in length depending on what drugs you are taking.

Support for WM

We’re here to help you through your WM journey, so contact our Support Line if you’ve got any questions regarding your treatment or any other aspect of WM. 

You can call us on 0300 303 5870, or view our other support options.