By Megan Martin, Communications Manager and Rashmi Kumar, PhD, Oncology Scientist/Senior Medical Writer
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) for Waldenström's Macroglobulinemia/Lymphoplasmacytic Lymphoma were recently published as an addition to the Complete Library of NCCN Guidelines™. Previously, information for treating Waldenström's Macroglobulinemia was included in the NCCN Guidelines for Multiple Myeloma.
One of the many revisions to the guidelines is a new diagnostic section which recommends a hematopathology review of all slides with at least one paraffin block representative of the tumor, as well as adequate immunophenotyping, to establish an accurate diagnosis. A new page detailing the World Health Organization (WHO) Criteria for Waldenström's Macroglobulinemia and Lymphoplasmacytic Lymphoma, along with the Waldenström's Macroglobulinemia International Workshop Criteria for diagnosis, has also been added. In addition, the work-up section is expanded to include essential tests and those that are considered useful in certain circumstances. These tests include: a neurology consult; anti-MAG antibodies/anti-GM1; electromyelogram; fat pad biopsy and/or congo red staining of bone marrow for amyloid; and retinal exam (if IgM > 3.0 gm/dL).
Lastly, a new page with suggested treatment regimens for primary and salvage therapies is included. The listed regimens are categorized based on whether or not they are toxic to stem cells and/or have the potential to cause disease transformation.
Waldenström's Macroglobulinemia is a B-cell disorder characterized by secretion of excess immunoglobulin M (IgM) in the serum and excess lymphoplasmacytic cells in the bone marrow. The WHO classification considers Waldenström's Macroglobulinemia to be a clinical syndrome occurring in a subset of patients with Lymphoplasmacytic Lymphoma.
The NCCN Guidelines for Waldenström's Macroglobulimenia/Lymphoplasmacytic Lymphoma can be accessed free of charge at NCCN.org.