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39

NCCN Guidelines for Patients

®

:

Waldenström’s Macroglobulinemia, Version 1.2017

4

Treatment guide

Review

If a stem cell transplant is an option for you, you will

get those drugs that are non-stem cell toxic. Any

primary treatment listed in

Guide 7

is an option for

people who have already been treated for WM. You

can also consider a clinical trial.

Next steps

The treatment, drugs, or combination of drugs listed

in

Guides 4 and 7

are not in any specific order.

They are options for your doctors to use when

considering your next steps. Your doctor will base

your next treatment, whether it is the 2

nd

, 3

rd

, or 4

th

drug, on many factors. The decision will be based on

things specific to you. He or she will also consider

how you handled the other treatment and how the

cancer is responding.

Your next steps will also depend on whether the

cancer is gone, stable, or growing. You can still get

treatment when the cancer is stable. You can get it

when you have no symptoms but had a very good

partial, partial, or minor response to treatment.

For example, it is recommended that rituximab be

given for maintenance. This is called maintenance

treatment. The goal of this treatment is to keep things

under control.

Follow-up care

Follow-up care is needed after any cancer treatment

is finished. Follow-up care includes a medical history,

physical exam, lab tests, and imaging tests. During

this time, you will have more than one doctor’s visit

to monitor your health. If the cancer re-appears,

a biopsy can be done to confirm there’s cancer. If

cancer is present, your doctor will try the drugs listed

in

Guide 7

or recommend a clinical trial.

Review

†

†

Discuss and decide on a treatment plan with

your doctor.

†

†

Your doctor may begin with plasmapheresis.

You can get this treatment before

chemotherapy, targeted therapy, or

immunotherapy.

†

†

You should get primary treatment if you have

symptoms of WM.

†

†

If needed, you can have further treatment after

primary treatment.

†

†

When your treatment is finished, testing will be

done to check treatment results.

†

†

Follow-up care is needed after any cancer

treatment is finished. Follow-up care includes

a medical history, physical exam, lab tests, and

imaging tests.