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Blood. 2016 Sep 8;128(10):1321-8. doi: 10.1182/blood-2016-04-711234. Epub 2016 Jul 18.

Treatment recommendations from the Eighth International Workshop on Waldenström's Macroglobulinemia.

Author information

1
Assistance Publique-Hôpitaux de Paris Hôpital Pitié Salpêtrière, Groupe de Recherche Clinique Hémopathie, Pierre and Marie Curie University, Paris, France;
2
Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece;
3
Stanford Cancer Institute, Stanford, CA;
4
Division of Hematology, Mayo Clinic, Rochester, MN;
5
Comprehensive Cancer Center Ulm, Institute of Experimental Cancer Research, University Hospital Ulm, Ulm, Germany;
6
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA;
7
Servicio de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain;
8
Mayo Clinic, Rochester, MN;
9
Hematology Center, Department of Medicine, Karolinska Institute, Stockholm, Sweden;
10
University College London Hospital, London, United Kingdom;
11
Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Department of Molecular Medicine, University of Pavia, Pavia, Italy;
12
Department of Hematology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands;
13
Service d'Hématologie Clinique, Centre Hospitalier Schaffner, Lens, France;
14
Department of Hematology, Niguarda Ca' Granda Hospital, Milan, Italy;
15
Medizinische Klinik IV, Hospital of the Justus-Liebig-University Giessen, Giessen, Germany; and.
16
University College London (Royal Free Campus), London, United Kingdom.

Abstract

Waldenström macroglobulinemia (WM) is a distinct B-cell lymphoproliferative disorder for which clearly defined criteria for the diagnosis, initiation of therapy, and treatment strategy have been proposed as part of the consensus panels of the International Workshop on Waldenström's Macroglobulinemia (IWWM). At IWWM-8, a task force for treatment recommendations was impanelled to review recently published and ongoing clinical trial data as well as the impact of new mutations (MYD88 and CXCR4) on treatment decisions, indications for B-cell receptor and proteasome inhibitors, and future clinical trial initiatives for WM patients. The panel concluded that therapeutic strategies in WM should be based on individual patient and disease characteristics. Chemoimmunotherapy combinations with rituximab and cyclophosphamide-dexamethasone, bendamustine, or bortezomib-dexamethasone provide durable responses and are still indicated in most patients. Approval of the BTK inhibitor ibrutinib in the United States and Europe represents a novel and effective treatment option for both treatment-naive and relapsing patients. Other B-cell receptor inhibitors, second-generation proteasome inhibitors (eg, carfilzomib), and mammalian target of rapamycin inhibitors are promising and may increase future treatment options. Active enrollment in clinical trials whenever possible was endorsed by the panel for most patients with WM.

PMID:
27432877
DOI:
10.1182/blood-2016-04-711234
[Indexed for MEDLINE]
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