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NCCN Guidelines for Patients



Waldenström’s Macroglobulinemia, Version 1.2017


Cancer treatments

Targeted therapy

Below are a few common targeted therapies for WM.

Your doctor will offer treatment options based on your

health and disease status. This includes your current

symptoms, IgM level, and extent of cancer in your



Rituximab is a monoclonal antibody that attaches

to an antigen called CD20. It is normally found on B


See Figure 5.

The attachment tells the cell

to die. Cell death is called apoptosis. Monoclonal

antibodies are man-made antibodies that mark cells

for destruction by your immune system. Rituximab

can be given alone, with chemotherapy, or another

cancer drug to treat WM. These drugs include

cyclophosphamide, bendamustine, bortezomib,

carfilzomib, fludarabine, or cladribine.

Rituximab is a liquid that is slowly injected into a

vein. It can take hours to receive the full dose. Your

doctor may give you medication beforehand to

prevent an allergic reaction. He or she will decide on

the dose (amount given), how long it is given, and

how often you get this drug.

Common side effects of rituximab are:



Extreme tiredness (fatigue)









Body aches



Low blood cell counts

Figure 5

Rituximab attaches to


Rituximab attaches to the

CD20 protein on a B-cell.

Derivative work of Rituximab Binding to CD20 on a B Cell Surface by NIAID available at


(6830897205).jpg under a Creative Commons Attribution 2.0 Generic license.