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Waldenstr?m macroglobulinemia (WM) is a slow-growing, chronic lymphoma. It cannot be cured, but it can be successfully managed. If you have been diagnosed with the disease, you will need care for the rest of your life.

Our team of experts will work with you to develop a treatment plan that controls the disease while minimizing side effects.

Treatments for Waldenstr?m macroglobulinemia include the following.

Active surveillance for Waldenstr?m macroglobulinemia

Because WM develops slowly, some patients may not need treatment right away. Instead, doctors will closely monitor the disease. Treatment will begin if the disease progresses to a pre-determined point.

Chemotherapy for Waldenstr?m macroglobulinemia

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Waldenstr?m macroglobulinemia patients usually receive chemotherapy along with monoclonal antibody drugs, a type of immunotherapy. Doctors call this combination chemoimmunotherapy. Research shows it is more effective than either treatment alone.

Learn more about chemotherapy.

Getting chemotherapy

Waldenstr?m macroglobulinemia patients get chemotherapy through IV infusions and/or injections under the skin. IV infusions usually last around 30 minutes.

The frequency of IV or injections depends on the exact drugs the doctor recommends. These treatments last for a set period, often around six months. If they are effective, patients can go a few years before needing further treatment.

Recovering from chemotherapy

Chemotherapy patients may experience fatigue and nausea, but many are able to continue working and performing daily activities such as driving, cooking and shopping after treatment.

Chemotherapy side effects

The side effects of chemotherapy depend on the exact drug the patient receives. They can include hair loss, nausea and fatigue, and infections.

Contact your care team when you start experiencing side effects. They can help you manage these conditions.

Learn more about chemotherapy side effects.

Monoclonal antibodies for Waldenstr?m macroglobulinemia

Monoclonal antibodies are a type of immunotherapy. These antibodies attach to specific proteins on the surface of cancer cells. They mark the cancer as a target for the immune system and boost the ability of immune cells to fight the cancer.

WM patients usually receive monoclonal antibodies in combination with chemotherapy. Research shows this is a more effective treatment than either drug on its own.

Getting monoclonal antibodies

Monoclonal antibodies are typically delivered through an IV infusion. Most WM patients get just one infusion per treatment cycle. The exact length of time for an infusion depends on how the patient reacts to the drug, and the speed of infusion can be changed if needed. The first infusion typically takes several hours, and it has highest chance of a negative reaction.

Recovering from monoclonal antibodies

Patients who get monoclonal antibodies may experience fatigue, fever, chills and nausea. Many can continue working and performing daily activities such as driving, cooking and shopping after an infusion, though.

Side effects of monoclonal antibodies

Side effects of monoclonal antibodies include fever, chills, nausea and low blood pressure. In rare cases, patients can have a serious immune system reaction to the treatment.

Blood tests may show a spike in IgM protein after the first infusion. This is a known side effect. It is not a sign that the disease is getting worse.

Your care team can help manage these side effects.

Targeted therapy for Waldenstr?m macroglobulinemia

Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.

Targeted therapy can be given on its own, or in combination with monoclonal antibodies.

Learn more about targeted therapy.

Getting targeted therapy

WM patients get targeted therapy through pills. Patients will take these pills for as long as the treatment is working.

Targeted therapy side effects

The side effects of targeted therapy depend on the exact drug the patient gets. They can include bleeding or bruising, diarrhea, muscle spasms and pneumonia.

Your care team can help you manage any side effects you experience.

Learn more about targeted therapy side effects.

Radiation therapy for Waldenstr?m macroglobulinemia

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to target a tumor accurately while limiting damage to healthy tissue.

Radiation is sometimes used to treat and eliminate a mass of cancer cells that is causing symptoms or potential organ damage.

Learn more about radiation therapy.

Getting radiation therapy

Patients typically get daily radiation treatment until the mass has been controlled. This usually takes 10 days or less. Each treatment session usually lasts around 30 minutes to 1 hour.

Recovering from radiation therapy

Lower doses of radiation are typically used to treat Waldenstrom macroglobulinemia. This treatment is often well tolerated, and patients do not need a recovery period.

Radiation therapy side effects

Side effects of radiation therapy depend on the treatment area but may include fatigue and skin irritation, such as itchy, dry or red skin.

Talk to your care team about any side effects you experience.

Learn more about radiation therapy side effects.

Stem cell transplantation for Waldenstr?m macroglobulinemia

A stem cell transplant (also known as a bone marrow transplant) is a procedure that replaces cancerous bone marrow with new, healthy bone marrow stem cells.

Stem cell transplants are not routinely used for Waldenstr?m macroglobulinemia. They are offered when other treatments have not successfully controlled the disease.

Most stem cell transplants for WM are autologous, meaning the healthy stem cells are taken from the patients themselves.

Learn more about stem cell transplants.

Getting a stem cell transplant

Stem cell transplants are usually given after an intense round of chemotherapy that kills the patient¡¯s existing bone marrow cells. WM patients usually stay in the hospital for around two weeks after the transplant.

Some patients are healthy enough that they do not need a long hospital stay. During the weeks immediately after the procedure, these patients must have a full-time caregiver and stay close to the hospital where they received the transplant.

Recovering from a stem cell transplant

Recovery from a stem cell transplant can take several weeks. Most patients can perform day-to-day tasks like cooking and cleaning within two to four weeks of the procedure. They may tire quickly and need frequent breaks to start.

Most patients can return to work four to eight weeks after the transplant, depending on their field of work and their other medical issues.

Stem cell transplant side effects

Stem cell transplant side effects can be caused by the preparative regimen or by the transplant itself.

Side effects can vary, but common ones include:

• Short-term: Fatigue, nausea, vomiting, mouth sores, hair loss and infections due to low immunity.
• Long-term: Weakened immune system, infertility, organ damage and a higher risk of developing another cancer.

Your care team can help you manage these side effects.

Learn more about stem cell transplant side effects.

Plasma exchange for Waldenstr?m macroglobulinemia

If you develop symptoms because your blood is too thick, plasma can be removed and replaced with normal plasma from a healthy donor. This quickly relieves the symptoms until chemotherapy or immunotherapy can destroy the Waldenstr?m cells that are causing the buildup of abnormal protein.

Getting a plasma exchange

A plasma exchange can take several hours. IV lines are inserted into the patient's arms. One line removes blood and sends it to a machine that replaces the patient¡¯s plasma with healthy plasma from a donor. The other line returns the blood to the patient. The procedure is not painful, but the IV lines may cause discomfort.

Plasma exchange side effects

Plasma exchange can cause patients to feel nauseous, cold or lightheaded. These side effects usually go away after a few hours.

Learn more about waldenstr?m¡¯s macroglobulinemia:

• Waldenstr?m¡¯s macroglobulinemia overview
• Waldenstr?m¡¯s macroglobulinemia symptoms
• Waldenstr?m¡¯s macroglobulinemia diagnosis