Response to TreatMent

During your treatment your medical team will assess how the cancer is responding alongside any side effects you may have.

Measuring How Well TreatMent is Working

Your doctor will use tests—like blood tests and scans—along with your symptoms to check how well treatment is working. This is called your response to treatment. It helps your doctor decide whether you need more treatment or can return to active monitoring.

While Waldenstrom’s macroglobulinaemia can’t be cured, treatment can put it into remission, meaning symptoms are eliminated completely. Remission can last months or even years before the abnormal WM cells build up to a point where you need treatment again.

Common Phrases You'll Hear

There are a few ways doctors check how well treatment is working—both right after treatment and in the long term. Here are some terms you might hear:

Depth of response – Describes how much the WM has been affected by treatment. You might hear terms like complete or partial response.
Progression-free survival (PFS) – How long someone lives without their WM getting worse. Some treatments don’t get rid of all the WM cells but can keep it stable for a long time. For some people with WM, this preferable to other treatments that might kill more abnormal cells but make them very ill in the process.
Time to next treatment – How long a treatment lasts before you need another one.
Overall survival (OS) – How long people live after treatment. For example, “5-year survival” means how many people are still alive five years after treatment.

What Does ‘Depth of Response’ Mean?

You may hear the term ‘depth of response’ used to describe how effective the treatment is at getting rid of the WM (the abnormal B-cells in your body). This is calculated by measuring the IgM levels in your blood. Terms like complete or partial response are often used and you can read more about what these terms really mean below.

Numbers and percentages are often used alongside these terms, but it’s important to that they’re not viewed in isolation. For example, someone whose IgM levels drop by 49% is considered to have a ‘minor response,’ while someone whose levels drop by 51% is said to have a ‘partial response.’ Even though the second person is technically in a better category, the real difference between the two is very small.

Key Phrases You May Hear

Can sometimes be called ‘No Evidence of Disease’ (NED)
Blood tests show no sign of abnormal IgM
Your levels of IgM are normal
If you had swelling in the lymph nodes or spleen, this has gone
Bone marrow biopsy results are normal

Abnormal IgM proteins show up in your blood tests
Your levels of IgM are at least 90% lower than they were at the start of treatment
If you had swelling in the lymph nodes or spleen, this has gone
You have no new signs or symptoms of Waldenstrom’s macroglobulinaemia

Abnormal IgM proteins show up in your blood tests
Your levels of IgM have been reduced by at least 50% but no more than 90% from the start of treatment
If you had swelling in your lymph nodes or spleen, this may still be present but reduced
You have no new signs or symptoms of Waldenstrom’s macroglobulinaemia

Abnormal IgM proteins show up in your blood tests
Your levels of IgM have been reduced by at least 25% but no greater than 50% from the start of treatment
You have no new signs or symptoms of Waldenstrom’s macroglobulinaemia

Abnormal IgM proteins show up in your blood tests
Your levels of IgM have been reduced by less than 25%, or haven’t increased by more than 25% from the start of treatment
Any swelling you had in your lymph nodes or spleen hasn’t reduced but it hasn’t progressed (become more swollen) either
You have no new signs or symptoms of Waldenstrom’s macroglobulinaemia

Your levels of IgM have increased by 25% or more from their lowest point
Your signs and symptoms have progressed (become worse)