Are New Treatment Options Shifting How and When We Treat Waldenström Macroglobulinemia

The introduction of new agents for the treatment of Waldenstrom macroglobulinemia has had a dramatic impact on survivorship in this disease. Earlier diagnosis has led to a reduced frequency of hyperviscosity. The MYD88 mutation appears to define 90% of patients with Waldenstrom macroglobulinemia and helps differentiate it from other disorders. Bendamustine and rituximab is a highly active regimen for the treatment of this disease as is cyclophosphamide, dexamethasone, and rituximab. Other agents that show high activity include purine nucleoside analogues, bortezomib, carfilzomib, everolimus, and ibrutinib.