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28

NCCN Guidelines for Patients

®

:

Waldenström’s Macroglobulinemia, Version 1.2017

Common side effects of ibrutinib are:

†

†

Extreme tiredness (fatigue)

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†

Minor bleeding

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†

Edema (swelling in hands, feet, or lower legs)

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†

Diarrhea

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Low platelet count

Before you start ibrutinib, tell your doctor if you are

taking any blood thinners. Not all of the side effects

of ibrutinib are listed here. Ask your treatment team

for a complete list of side effects.

Other targeted therapy:

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†

Carfilzomib works like bortezomib and has

similar side effects. It stops the proteasome

machinery inside the cell.

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†

Alemtuzumab is a monoclonal antibody that

attaches to an antigen called CD52. This

attachment tells your immune system to destroy

the cells. Alemtuzumab is associated with both

short-term infections, immune complications,

and long-term risks of autoimmune decreases

in platelet counts.

†

†

Everolimus targets the mTOR (

m

echanistic

t

arget

o

f

r

apamycin) protein in cells. This

protein helps the cells divide and grow.

Carfilzomib is given in combination with rituximab

and dexamethasone to treat WM. Alemtuzumab

and everolimus are given as a single agent for WM.

Everolimus is prescribed as a pill. This is different

from the other targeted therapies mentioned above,

which are given in liquid form. These three targeted

therapies are usually given after other treatment was

tried.

Immunomodulators

The immune system is your body’s natural defense

against infection and disease. Immunomodulators

are drugs that modify different parts of your immune

system. The exact function of these drugs is not

known.

Lenalidomide and thalidomide treat cancer in more

than one way. As immunomodulators, they boost the

immune system. They also help stop cancer cells

from increasing in number.

Immunomodulators also work like a type of targeted

therapy called angiogenesis inhibitors. These drugs

stop the growth of new blood vessels. This process is

called angiogenesis.

Common side effects of immunomodulators are:

†

†

Extreme tiredness (fatigue)

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†

Constipation

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†

Itching and red rash of the skin

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†

Low blood cell counts

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†

Nerve damage (neuropathy)

Tell your doctor if you have any side effects and if

they get worse over time. Ask your treatment team

for a complete list of side effects.

3

Cancer treatments

Immunomodulators