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NCCN Guidelines for Patients



Waldenström’s Macroglobulinemia, Version 1.2017


Treatment guide

Treatment for relapsed or refractory WM

Treatment for relapsed or refractory WM

Guide 7

lists treatment options for WM that didn’t

respond to (refractory) or reappears (relapsed) after

the first treatment. If the disease comes back in less

than 2 years, you will try another treatment. If it is

2 years or more, you can get the same treatment you

had the first time or try a different drug. This might be

a new type of drug used alone or in combination with

other drugs.

Guide 7. Further treatment for WM

Relapsed or refractory treatment

• Drug – non-stem cell toxic treatment

◦◦ Alemtuzumab

◦◦ Bortezomib with or without rituximab

◦◦ Bortezomib / dexamethasone

◦◦ Bortezomib / dexamethasone / rituximab

◦◦ Cyclophosphamide / doxorubicin / vincristine / prednisone / rituximab

◦◦ Everolimus

◦◦ Ibrutinib

◦◦ Ofatumumab (given alone or with other drugs to people who can't tolerate rituximab)

◦◦ Rituximab

◦◦ Rituximab / cyclophosphamide / prednisone

◦◦ Rituximab / cyclophosphamide / dexamethasone

◦◦ Thalidomide with or without rituximab

• Drug – possible stem cell toxic and/or risk of transformation (or unknown)

◦◦ Bendamustine with or without rituximab

◦◦ Cladribine with or without rituximab

◦◦ Chlorambucil

◦◦ Fludarabine with or without rituximab

◦◦ Fludarabine / cyclophosphamide / rituximab

• Stem cell transplant

◦◦ High-dose therapy with stem cell rescue

◦◦ Allogeneic stem cell transplant (in a clinical trial)

• Clinical trial