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36

NCCN Guidelines for Patients

®

:

Waldenström’s Macroglobulinemia, Version 1.2017

4

Treatment guide

Primary treatment

Guide 5. Primary treatment response

Primary treatment

Response to any primary treatment

Plasmapheresis

and

Single agent (one drug)

or

Combination therapy

(multiple drugs)

or

Clinical trial

ª

• Complete response

◦◦ Normal level of IgM in your body

◦◦ If disease seen before on imaging- no enlarged lymph

nodes or organs

◦◦ No symptoms or signs of WM

ª

• Very good partial response

◦◦ A very small amount of IgM remains

◦◦ If disease seen before on imaging- decrease in enlarged

lymph nodes or organs

◦◦ No new symptoms or signs of WM

ª

• Partial response

◦◦ At least half or a little more than half of IgM remains

◦◦ If disease seen before on imaging- decrease in enlarged

lymph nodes or organs

◦◦ No new symptoms or signs of WM

ª

• Minor response

◦◦ Most of IgM is still in the blood

◦◦ No new symptoms or signs of WM

ª

• No response (stable)/disease progression

◦◦ Stable- disease is stable with continuing symptoms and

signs of WM

◦◦ Progression- disease, signs, and symptoms of WM are

getting worse

Guide 5

lists possible responses to any primary

treatment. The responses range from complete

response, which is no disease found, to disease

progression. For a complete response, you will need

to have a repeat test to check the IgM again. This will

confirm the treatment worked.

You can have other responses to treatment that

are very good partial, partial, or minor. If there is no

response to treatment, this means the IgM mostly

stayed the same. It is called stable disease. If your

disease gets worse (progresses), your doctor will

start treatment. When the cancer progresses, you

can have signs like anemia, low platelet counts, or

enlarged lymph nodes and organs. You can also

have symptoms like a fever of 101.1° or higher, night

sweats, weight loss, or the other symptoms of WM

(see Guide 2).