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Treatment recommendations for patients with Waldenström macroglobulinemia (WM) and related disorders: IWWM-7 consensus.
[waldenström macroglobulinemia]
Waldenström
macroglobulinemia
(
WM
)
is
a
distinct
B-
cell
lymphoproliferative
disorder
for
which
clearly
defined
criteria
for
the
diagnosis
,
initiation
of
therapy
,
and
treatment
strategy
have
been
proposed
as
part
of
the
consensus
panels
of
International
Workshops
on
WM
(
IWWM
)
.
As
part
of
the
IWWM-
7
and
based
on
recently
published
and
ongoing
clinical
trials
,
the
panels
updated
treatment
recommendations
.
Therapeutic
strategy
in
WM
should
be
based
on
individual
patient
and
disease
characteristics
(
age
,
comorbidities
,
need
for
rapid
disease
control
,
candidacy
for
autologous
transplantation
,
cytopenias
,
IgM-related
complications
,
hyperviscosity
,
and
neuropathy
)
.
Mature
data
show
that
rituximab
combinations
with
cyclophosphamide
/
dexamethasone
,
bendamustine
,
or
bortezomib
/
dexamethasone
provided
durable
responses
and
are
indicated
for
most
patients
.
New
monoclonal
antibodies
(
ofatumumab
)
,
second
-generation
proteasome
inhibitors
(
carfilzomib
)
,
mammalian
target
of
rapamycin
inhibitors
,
and
Bruton
's
tyrosine
kinase
inhibitors
are
promising
and
may
expand
future
treatment
options
.
A
different
regimen
is
typically
recommended
for
relapsed
or
refractory
disease
.
In
selected
patients
with
relapsed
disease
after
long
-lasting
remission
,
reuse
of
a
prior
effective
regimen
may
be
appropriate
.
Autologous
stem
cell
transplantation
may
be
considered
in
young
patients
with
chemosensitive
disease
and
in
newly
diagnosed
patients
with
very
-
high
-risk
features
.
Active
enrollment
of
patients
with
WM
in
clinical
trials
is
encouraged
.
Diseases
Validation
Diseases presenting
"clearly defined criteria for the diagnosis"
symptom
waldenström macroglobulinemia
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