Materiały źródłowe

• #1 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia

  https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits

  Waldenstrom macroglobulinemia (WM) is a rare form of blood cancer. In the United States, around 1,000 to 1,500 people receive a WM diagnosis each year. […] While there is no cure, a variety of treatments can help you manage symptoms and prevent complications. Practicing healthy lifestyle habits can also help you feel better and gain a sense of empowerment over your health. […] Your meals should have a good balance of fruits, vegetables, protein, and whole grains. You should also limit how much red meat and fatty foods you consume. […] Talk with your doctor about any specific dietary changes you should make. They may also want you to speak with a registered dietitian for extra nutrition support, if possible. […] Cancer-related fatigue can relate to pain, anxiety, medications, nutritional deficiencies, and inactivity. Speak with your doctor to see if medication, pain management, or meal planning changes could help.

• #2 Waldenstrom macroglobulinemia: prognosis and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4382666/

  Waldenstrom macroglobulinemia (WM) is a B-cell lymphoplasmacytic lymphoma characterized by monoclonal immunoglobulin M protein in the serum and infiltration of bone marrow with lymphoplasmacytic cells. Asymptomatic patients can be observed without therapy. First-line therapy should consist of the monoclonal anti-CD20 antibody, rituximab, given typically in combination with other agents. We prefer dexamethasone, rituximab, cyclophosphamide (DRC) as initial therapy for most patients with symptomatic WM. Other reasonable options are bortezomib, rituximab, dexamethasone (BoRD) or bendamustine plus rituximab (BR). All of these regimens are associated with excellent response and tolerability. Initial therapy is usually administered for 6 months, followed by observation. Response to therapy is assessed using the standard response criteria developed by the International Working Group on Waldenstrom macroglobulinemia. Relapse is almost inevitable in WM but may occur years after initial therapy. In symptomatic patients relapsing more than 12 years after initial therapy, the original treatment can be repeated. For relapse occurring sooner, an alternative regimen is used. In select patients, high-dose chemotherapy followed by autologous hematopoietic cell transplantation may be an option at relapse. Options for therapy of relapsed WM besides regimens used in the front-line setting include ibrutinib, purine nucleoside analogs (cladribine, fludarabine), carfilzomib and immunomodulatory agents (thalidomide, lenalidomide).

• #3 Waldenstrom macroglobulinemia: prognosis and management | Blood Cancer Journal

  https://www.nature.com/articles/bcj201528

  Waldenstrom macroglobulinemia (WM) is a B-cell lymphoplasmacytic lymphoma characterized by monoclonal immunoglobulin M protein in the serum and infiltration of bone marrow with lymphoplasmacytic cells. Asymptomatic patients can be observed without therapy. First-line therapy should consist of the monoclonal anti-CD20 antibody, rituximab, given typically in combination with other agents. We prefer dexamethasone, rituximab, cyclophosphamide (DRC) as initial therapy for most patients with symptomatic WM. Other reasonable options are bortezomib, rituximab, dexamethasone (BoRD) or bendamustine plus rituximab (BR). All of these regimens are associated with excellent response and tolerability. Initial therapy is usually administered for 6 months, followed by observation. Response to therapy is assessed using the standard response criteria developed by the International Working Group on Waldenstrom macroglobulinemia. Relapse is almost inevitable in WM but may occur years after initial therapy. In symptomatic patients relapsing more than 12 years after initial therapy, the original treatment can be repeated. For relapse occurring sooner, an alternative regimen is used. In select patients, high-dose chemotherapy followed by autologous hematopoietic cell transplantation may be an option at relapse. Options for therapy of relapsed WM besides regimens used in the front-line setting include ibrutinib, purine nucleoside analogs (cladribine, fludarabine), carfilzomib and immunomodulatory agents (thalidomide, lenalidomide).

• #4 Waldenstrom Macroglobulinemia: Symptoms, Treatments & More

  https://www.cancercenter.com/cancer-types/non-hodgkin-lymphoma/types/waldenstrom-macroglobulinemia

  WM is a rare cancerit accounts for only 1 to 2 percent of patients with non-Hodgkin lymphoma, according to the American Cancer Society. […] WM is not only rare, but it is also a slow-growing cancer that can take years for symptoms to appear. […] While WM is generally considered an „incurable” condition, people can often live with the disease for many yearssometimes without treatment (if they aren’t experiencing problematic symptoms). […] Treatment for WM is intended to keep symptoms at bay and guard against complications of the disease. […] However, treatment will likely be initiated right away for people with WM who are experiencing symptoms or problems including (but not limited to): […] For those who are symptomatic, treatment typically includes chemotherapy and immunotherapy (a therapy that harnesses the power of the immune system to fight cancer)either on their own or in combination. […] The best treatment for an individual with WM can vary depending on their age, other health issues, symptoms and personal preference. […] Besides chemotherapy and immunotherapy, other potential treatment options for WM include:

• #5 About Waldenström’s macroglobulinaemia (WM) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/non-hodgkin/types/waldenstroms-macroglobulinaemia

  Waldenstrms macroglobulinaemia (WM) is a type of non-Hodgkin lymphoma. It is sometimes called lymphoplasmacytic lymphoma. […] WM develops when lymphoplasmacytic cells (LPL cells) become abnormal (cancerous). LPL cells are a type of B-cell. B-cells are white blood cells that normally help fight infection. B-cells are sometimes called B-lymphocytes. […] The abnormal LPL cells (lymphoma cells) usually build up in the bone marrow, lymph nodes, spleen and other organs. Sometimes, this can make the spleen or lymph nodes become bigger. […] As the lymphoma cells build up in the body, they make large amounts of a protein called immunoglobulin M (IgM). […] Symptoms can be caused by lymphoma cells building up in the bone marrow. The lymphoma cells take up space, which makes it difficult for the bone marrow to make enough normal blood cells.

• #6 Waldenström Macroglobulinemia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17951-waldenstrom-macroglobulinemia

  Waldenstrm macroglobulinemia (WM) also known as lymphoplasmacytic lymphoma is a rare, slow-growing cancer that affects your blood cells. Healthcare providers cant cure this condition, but they do have treatments that can manage symptoms. […] Theres no cure for Waldenstrm macroglobulinemia. But there are treatments that ease and sometimes eliminate symptoms. As WM tends to progress slowly, its possible that youll live many years with this condition. […] As there isnt a cure for this condition, the best treatment is one that relieves symptoms with the least amount of side effects. Your healthcare provider will work with you to customize treatment. Options for WM include: […] Contact your healthcare provider if youve been diagnosed with WM and have a symptom thats new or bothering you. If you learn you have this condition, its important to ask questions so you know what to expect.

• #7 About Waldenström’s macroglobulinaemia (WM) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/lymphoma/non-hodgkin/types/waldenstroms-macroglobulinaemia

  The most common symptoms are: feeling weak and tired (fatigue), looking very pale or feeling breathless because of a lack of red blood cells (anaemia), repeated infections because of a lack of healthy white blood cells (which help fight infection), bruising or bleeding easily, heavy, drenching night sweats, weight loss. […] WM is sometimes linked to cases of monoclonal gammopathy of unknown significance (MGUS). This is a condition where there is abnormal IgM in the blood. […] People who have a family member with lymphoma have a higher than average risk of developing WM. […] The most common tests for diagnosing Waldenstrms macroglobulinaemia (WM) are: blood tests, bone marrow tests. […] Your doctor may start treatment if: you have troublesome symptoms, the level of IgM protein in your blood is increasing, your blood count changes for example, if you have low levels of red blood cells (anaemia).

• #8 Waldenstrom macroglobulinemia: prognosis and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4382666/

  WM is incurable with currently available therapies. Treatment is instead focused on symptom-control and prevention of end-organ damage. There is no standard therapy for WM, but rather various drugs that have been shown to be effective either alone or in combinations. Asymptomatic patients should be followed with surveillance, while symptomatic patients should be considered for treatment. The severity of symptoms dictates the intensity of the treatment regimen, however, several factors, such as age, cytopenias, need for quick disease control and potential candidacy for stem cell transplant, should be considered. Care should be given to avoid treatments that may compromise stem-cell collection in patients who are candidates for autologous hematopoietic cell transplantation (HCT). […] Hyperviscosity is a clinical emergency. Manifestations are the result of shear forces which cause venous damage, and include visual changes resulting from retinal flame-shaped hemorrhages, epistaxis, gingival bleeding, headaches and dizziness; more severe manifestations include stupor and coma. Hyperviscosity syndrome occurs when the serum viscosity is 4 (viscosity of water is 1), which corresponds to serum IgM of at least roughly 4000mg/dl. Immediate management is the removal of IgM from systemic circulation, via plasmapheresis.

• #9 Waldenstrom macroglobulinemia: prognosis and management | Blood Cancer Journal

  https://www.nature.com/articles/bcj201528

  WM is incurable with currently available therapies. Treatment is instead focused on symptom-control and prevention of end-organ damage. There is no standard therapy for WM, but rather various drugs that have been shown to be effective either alone or in combinations. Asymptomatic patients should be followed with surveillance, while symptomatic patients should be considered for treatment. The severity of symptoms dictates the intensity of the treatment regimen, however, several factors, such as age, cytopenias, need for quick disease control and potential candidacy for stem cell transplant, should be considered. Care should be given to avoid treatments that may compromise stem-cell collection in patients who are candidates for autologous hematopoietic cell transplantation (HCT). […] Hyperviscosity is a clinical emergency. Manifestations are the result of shear forces which cause venous damage, and include visual changes resulting from retinal flame-shaped hemorrhages, epistaxis, gingival bleeding, headaches and dizziness; more severe manifestations include stupor and coma. Hyperviscosity syndrome occurs when the serum viscosity is 4 (viscosity of water is 1), which corresponds to serum IgM of at least roughly 4000mg/dl. Immediate management is the removal of IgM from systemic circulation, via plasmapheresis.

• #10 Treating Waldenstrom Macroglobulinemia | American Cancer Society

  https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/treating.html

  If youve been diagnosed with Waldenstrom macroglobulinemia, your treatment team will discuss your options with you. Its important to weigh the benefits of each treatment option against the possible risks and side effects. […] If treatment is needed for Waldenstrom macroglobulinemia (WM), several types can be used: […] Not everyone with WM needs to be treated right away. People who dont have serious or bothersome symptoms can often be watched closely, and then treated later if needed. […] The 2 main ways to treat WM are chemotherapy and different types of biological therapy (immunotherapy). One or both of these types of treatments might be used. […] Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs.

• #11 Waldenstrom’s macroglobulinemia – Overview of Information and Clinical Research

  https://clinicaltrials.eu/disease/waldenstroms-macroglobulinemia-2/

  Waldenstrom macroglobulinemia (WM) is a complex and chronic type of lymphoma that requires a personalized approach to treatment. The primary methods for treating WM include chemotherapy and biological therapy (immunotherapy), with the possibility of using one or both methods depending on the patient’s condition. Recent advancements have introduced a variety of new drugs, although no single standard treatment exists for all patients. The choice of treatment is influenced by factors such as the extent of the disease, the patient’s overall health, and the presence of symptoms. […] For patients who have IgM proteins in their blood but no symptoms, a strategy known as “watchful waiting” may be employed. This involves regular monitoring through blood tests every few months, as treatment might not be necessary for years. This approach is suitable for those with indolent or smoldering WM, where no immediate treatment is indicated.

• #12 Lymphoplasmacytic Lymphoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513356/

  Lymphoplasmacytic lymphoma management is similar to other indolent small B cell lymphomas. […] An interprofessional team that includes oncology nurses is recommended for treating and monitoring these patients. […] Treatment of Waldenstrom macroglobulinemia depends on the extent of end-organ involvement and symptoms. […] Asymptomatic patients are managed by close follow-up every 1 to 2 months including serial IgM measurements and assessment of serum viscosity. […] Symptomatic patients are managed by chemotherapy, immunotherapy, and/or an autologous bone marrow stem cell transplant. […] Even though lymphoplasmacytic lymphoma is a low-grade lymphoma, survival rates have not improved drastically over the past few decades. […] Symptomatic patients undergoing chemotherapy still develop a number of adverse effects which affect the quality of life.

• #13 Management of Waldenstrom’s macroglobulinaemia – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/management-of-waldenstroms-macroglobulinaemia

  Patients with asymptomatic disease should be managed with an active surveillance strategy, which includes monitoring of clinical and laboratory findings every three to six months and appropriate immunisations. […] Indications for treatment include clinical and laboratory parameters. Clinical indications include constitutional symptoms (fever, night sweats, weight loss, severe fatigue), symptomatic hyperviscosity, symptomatic lymphadenopathy or hepatosplenomegaly, or peripheral neuropathy related to the IgM paraprotein. […] Once patients have symptoms of disease, consideration should be given to patient-related factors, including fitness to receive treatment, comorbidities and preference for fixed-duration versus continuous treatment, and to disease-related characteristics, including the tempo of the disease and its molecular features.

• #14 Waldenstrom’s Macroglobulinemia | University of Iowa Health Care

  https://uihc.org/health-topics/waldenstroms-macroglobulinemia

  Waldenstrom’s macroglobulinemia is a rare disorder that causes the production of abnormal B-lymphocytes, white blood cells. […] The main goal of treatment is to reduce the amount of abnormal blood/bone marrow cells and protein in the blood. […] In addition to the treatment recommended by your doctor, there are steps you can take to help reduce or prevent the symptoms of macroglobulinemia: […] It is important that you be alert for any change or increase in symptoms. If this occurs, it may mean that you need additional or different treatments, and you should contact your doctor right away. […] Waldenstrom’s macroglobulinemia requires regular appointments with your doctor. He or she will want to discuss your symptoms and do periodic blood counts to evaluate your response to treatment. […] Prognosis depends upon the symptoms you may have, your age, and the treatment you receive. Some patients need minimal supportive care and observation, while other patients may require more intensive treatment.

• #15 Waldenstrom macroglobulinemia | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/non-hodgkin-lymphoma/treatment/treatment-by-type/waldenstrom-macroglobulinemia

  Targeted therapy drugs used to treat Waldenstrom macroglobulinemia include: rituximab (Rituxan and biosimilars), ibrutinib (Imbruvica), acalabrutinib (Calquence), zanubrutinib (Brukinsa), bortezomib (Velcade), lenalidomide (Revlimid). […] Chemotherapy uses drugs to destroy cancer cells. The drugs that may be used for Waldenstrom macroglobulinemia include: bendamustine (Treanda, Benvyon, Esamuze), fludarabine (Fludara), cyclophosphamide (Procytox), chlorambucil (Leukeran), cladribine. […] Targeted therapy drugs or immunotherapy drugs may be used along with chemotherapy drugs. Corticosteroids, such as dexamethasone or prednisone, may also be given. […] Plasma exchange (also called plasmapheresis) involves removing plasma from the blood and replacing it with a substitute. Plasma exchange can be used to treat hyperviscosity syndrome. […] A stem cell transplant replaces stem cells. If you are healthy enough, you may be offered a stem cell transplant for Waldenstrom macroglobulinemia that comes back (relapses) after treatment or doesn’t respond to other treatments (called refractory disease).

• #16 Waldenstrom’s macroglobulinemia – Overview of Information and Clinical Research

  https://clinicaltrials.eu/disease/waldenstroms-macroglobulinemia-2/

  Plasma exchange, or plasmapheresis, is a procedure used to remove excess IgM proteins from the blood, replacing them with healthy plasma. This treatment can quickly relieve symptoms caused by blood thickening, such as hyperviscosity. It is often used as a temporary measure until other treatments, like chemotherapy or immunotherapy, can take effect. […] Chemotherapy is a cornerstone treatment for WM, utilizing strong medicines to kill cancer cells throughout the body. It can be used alone or in combination with other drugs, and is often the first line of treatment for symptomatic patients. High-dose chemotherapy may also be used to prepare for a bone marrow transplant. […] Targeted therapy involves medicines that specifically attack chemicals within cancer cells, causing them to die. These treatments can be combined with chemotherapy or immunotherapy to enhance their effectiveness. Notable targeted therapies include BTK inhibitors like ibrutinib and zanubrutinib, which have shown promise in treating WM.

• #17 Waldenstrom macroglobulinemia: prognosis and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4382666/

  Select patients, who have good performance status and whose disease is chemo-sensitive at the time of transplant, may be candidates for high-dose chemotherapy followed by autologous HCT at first relapse. Studies have shown good outcomes with autologous HCT in previously treated and treatment-nave patients.

• #18 Waldenstrom macroglobulinemia: prognosis and management | Blood Cancer Journal

  https://www.nature.com/articles/bcj201528

  The decision to resume therapy should be based on recurrence of cytopenias or symptoms, rather than monoclonal protein levels alone. Type of therapy used at the time of relapse is determined by the response to initial therapy. In symptomatic patients relapsing 12 years after initial therapy, the original treatment can be repeated. On the other hand, for relapse occurring 12 years after initial treatment, an alternative regimen is used. […] Select patients, who have good performance status and whose disease is chemo-sensitive at the time of transplant, may be candidates for high-dose chemotherapy followed by autologous HCT at first relapse. Studies have shown good outcomes with autologous HCT in previously treated and treatment-nave patients.

• #19 Waldenstrom macroglobulinemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/waldenstrom-macroglobulinemia/diagnosis-treatment/drc-20359986

  Our caring team of Mayo Clinic experts can help you with your Waldenstrom macroglobulinemia-related health concerns […] Treatment options for Waldenstrom macroglobulinemia may include: […] Supportive care, which is also called palliative care, focuses on relieving pain and other symptoms of serious illness. This extra layer of care can support you as you undergo other treatments, such as chemotherapy. […] If you have symptoms that worry you, make an appointment with your primary care provider. […] If your primary care provider thinks you have Waldenstrom macroglobulinemia, you might be referred to a specialist in treating blood and bone marrow conditions, also known as a hematologist. […] Take a family member or friend along to help you remember the information you get. […] Be sure to ask any other questions you have. […] Your provider is likely to ask you questions, such as: […] Connect with others like you for support and answers to your questions in the Blood Cancers Disorders support group on Mayo Clinic Connect, a patient community.

• #20 Treating Waldenstrom Macroglobulinemia | American Cancer Society

  https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/treating.html

  Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. […] People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care. […] Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] You and your family are encouraged to talk with your doctor or a member of your supportive care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families.

• #21 Management of Waldenstrom’s macroglobulinaemia – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/management-of-waldenstroms-macroglobulinaemia

  Patients with hyperviscosity syndrome should be managed with urgent plasmapheresis followed by systemic therapy. […] Owing to the rarity of WM, therapeutic options are usually based on single-arm phase 2 studies. […] In the absence of appropriate clinical trials, upfront treatment options include rituximab in combination with chemotherapy or bortezomib, or a BTK-I. […] Patients considered to be unfit to receive chemo-immunotherapy may be treated with oral chlorambucil or rituximab monotherapy (four to eight doses per month). […] Patients with WM are at increased risk of infection and should receive appropriate vaccinations and anti-microbial prophylaxis according to the treatment regimen. […] Prophylaxis against Pneumocystis jirovecii is recommended in patients requiring intensive and/or immunosuppressive treatment, including BTKis. […] All patients with WM should be offered seasonal influenza and SARS-CoV-2 vaccinations. […] Patients may benefit from support at all phases of their disease pathway and should have access to a clinical nurse specialist.

• #22 Waldenstrom macroglobulinemia – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/waldenstrom-macroglobulinemia/care-at-mayo-clinic/mac-20360009

  At Mayo Clinic, different types of health care providers work together with you to understand your condition and create a treatment plan that meets your needs and goals. Though this rare disease can’t be cured, Waldenstrom macroglobulinemia can be controlled. Mayo Clinic doctors draw on their wide experience to provide you with expert, personalized care. […] At Mayo Clinic, a team of experts in a variety of areas provides comprehensive care to those with Waldenstrom macroglobulinemia. Your care team may include hematologists, pathologists, radiologists, nephrologists and neurologists. Other experts are included as needed. […] People who seek care at Mayo Clinic have access to all the treatment options for Waldenstrom macroglobulinemia. These include autologous stem cell transplant and clinical trials. Your care team works with you to understand your needs and goals and to create a treatment plan just for you.

• #23 Recognizing Hyperviscosity Syndrome in Patients With Waldenstrom Macroglobulinemia | Oncology Nursing Society

  https://onf.ons.org/publications-research/cjon/11/1/recognizing-hyperviscosity-syndrome-patients-waldenstrom

  Hyperviscosity syndrome can develop in patients with plasma cell dyscrasias, particularly Waldenstrom macroglobulinemia (WM). […] Because hyperviscosity syndrome can be lethal, it must be recognized and managed early. […] Although hyperviscosity syndrome is not one of the most common conditions, when it does occur, oncology nurses play a critical role in patients’ assessment and care.

• #24 Living with Waldenstrom’s Macroglobulinemia – International Waldenstrom’s Macroglobulinemia Foundation

  https://iwmf.com/living-with-wm/

  It is important for you to talk with your doctors, nurses and other members of your healthcare team if you experience signs of fatigue before, during, or after treatment. Treatment, along with lifestyle changes, can make an big difference and help improve your energy level. […] If you are investigating the use of complementary and integrative medicine as an adjunct to conventional treatment, be cautious. While a general-purpose multivitamin should be safe, mega-vitamins, over-the-counter medications, and so-called health food remedies should always be discussed with your physician. Some of these substances may alter the effectiveness of conventional treatment for the disease or may worsen certain side effects from treatment. […] Make sure that your caregiver has as much knowledge about your condition as you do. At times of treatment particularly, you may become stressed and fatigued or experience other side effects, and your caregiver is your lifeline to obtaining help and communicating with your healthcare team, especially in emergency situations.

• #25 Waldenstrom Macroglobulinemia Caregiver | Waldenstrom Macroglobulinemia

  https://resources.healthgrades.com/right-care/leukemia/what-caregivers-of-people-with-waldenstrom-macroglobulinemia-should-know

  Learning about Waldenstrom macroglobulinemia (WM) is a good way to become a more informed, supportive caregiver of a person who has the condition. By watching for symptoms, understanding the treatment process, and finding support for yourself as well as your loved one, you’ll be able to provide the best care possible. […] Encourage the person you’re caring for to write down symptoms as they occur in a symptom diary and bring it with them to their doctor’s appointments. It can also be helpful for them to note questions as they come to mind, as well as any side effects once treatment starts. […] Taking on a caregiver role requires a significant amount of time, energy, and patience. The person you care for may need extensive physical and emotional support, depending on how their WM progresses. You might find yourself providing round-the-clock care, which can be difficult to cope with as time passes. Make sure you line up enough additional resources to take care of both of you. […] By finding support, you’ll be better able to care for your loved one with WM.

• #26 Living with Waldenstrom’s Macroglobulinemia – International Waldenstrom’s Macroglobulinemia Foundation

  https://iwmf.com/living-with-wm/

  Because Waldenstrom’s macroglobulinemia (WM) is typically an indolent (slow growing) cancer, it is possible to achieve a good quality of life for long periods while living with the disease. The following are useful suggestions, many of them common-sense items, to help patients cope physically and emotionally with WM and improve their overall health status while doing so. […] WM patients have suppressed immune systems, and treatments for WM may temporarily suppress those systems even more. That translates into increased vulnerability to infections and may require more intensive medical treatment to facilitate recovery. What may be a minor respiratory or wound infection in a healthy person can become a major medical event for a WM patient – so be vigilant and alert your healthcare team to a potential problem. Make it a habit to wash your hands frequently with soap and water and carry antibacterial cleanser and antibacterial wipes in case you don’t have access to soap and water. Try to avoid close contact with others who may be exhibiting symptoms of a cold or the flu.

• #27 Living with Waldenstrom’s Macroglobulinemia – International Waldenstrom’s Macroglobulinemia Foundation

  https://iwmf.com/living-with-wm/

  To maintain proper hydration, drink lots of water and other non-carbonated, decaffeinated, non-alcoholic liquids every day. Drink electrolyte beverages as they contain water enhanced with minerals like sodium, potassium, and calcium. Choose juices, milks, lemonade, iced tea and even popsicles that are either unsweetened or lightly sweetened. […] There are no special diets or dietary substances that can be used to treat WM. Instead, follow recommended guidelines for optimal health, including a healthy balanced diet, high in fruits, vegetables, and whole grains and low in fatty foods and red meat. Adopt a regular program of exercise in keeping with your abilities and in consultation with your physician. […] Guidelines recommend regular aerobic exercise – such as walking, jogging or cycling, and strength training – such as lifting weights or using resistance bands, for patients whose cancer has not spread beyond its initial site. Aerobic exercise helps strengthen the heart and lungs. Resistance exercise strengthens the muscles.

• #28 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia

  https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits

  Its completely expected that youll feel fatigued from WM. Being realistic about your energy levels can provide a sense of empowerment and help you feel more encouraged throughout the week. […] Avoiding the use of tobacco products and second-hand smoke can help reduce your risk of getting many types of cancers. Not smoking is also part of an overall healthy lifestyle. […] Just like smoking, alcohol also increases your risk of some cancers, according to the Centers for Disease Control and Prevention (CDC). So its especially important to limit alcohol use if you have WM. […] Work with your healthcare team to figure out the most appropriate types of activity for you. They may recommend low intensity activities, like slow walks and stretching, especially if you were relatively sedentary prior to your treatment.

• #29 Living as a Waldenstrom Macroglobulinemia Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/after-treatment/followup.html

  During and after treatment, its very important to go to all follow-up appointments. […] Follow-up is needed to see if the cancer has come back, if more treatment is needed, and to check for any side effects. […] Almost any cancer treatment can have side effects. […] Talk with your doctor about developing a survivorship care plan for you. […] Even after treatment, its very important to keep health insurance. […] Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. […] If you have (or have had) WM, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. […] Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure.

• #30 Waldenstrom macroglobulinemia: prognosis and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4382666/

  As it may take several months to achieve the maximum response to rituximab, it is a poor choice as single-agent therapy in patients in whom a rapid response is needed, or in patients with IgM levels above 3 g/dl. However, in selected patients, it has been shown to reduce neurologic symptoms, improve cytopenias and bone marrow involvement, while still being fairly well tolerated without damaging stem cells. […] The primary factors influencing selection among the available regimens are drug toxicities and individual patient characteristics. For example, in a patient with peripheral neuropathy, DRC may be preferred because of the high incidence of neuropathy associated with bortezomib. In patients with bulky disease, BR may be preferred for rapid control. […] In patients who achieve an initial major response, the decision to resume therapy should be based on recurrence of cytopenias or symptoms, rather than monoclonal protein levels alone. Type of therapy used at the time of relapse is determined by the response to initial therapy.

• #31 Living as a Waldenstrom Macroglobulinemia Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/after-treatment/followup.html

  If the cancer does recur at some point, your treatment options will depend on where the cancer is located, what treatments youve had before, and your health. […] People whove had WM can still get other cancers. […] Some amount of feeling depressed, anxious, or worried is normal when WM is a part of your life.

• #32 Waldenström Macroglobulinemia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17951-waldenstrom-macroglobulinemia

  Living with a lymphoma like Waldenstrm macroglobulinemia often requires major life adjustments. Its important to take advantage of every resource you can. Talk with your healthcare provider about what foods to eat and what activities will promote self-care. […] Researchers havent discovered a cure for Waldenstrm macroglobulinemia (WM) yet. But theyve found several treatments that can make living with it more manageable. Many people live with this condition for years without symptoms. Treatments are helping people with WM live longer than ever without sacrificing their quality of life. If you receive this diagnosis, ask your healthcare provider about your short-term and long-term outlook. They can help you decide on the best care plan. […] We offer comprehensive Waldenstrom macroglobulinemia care. Our experts use the latest tests and treatments to offer the most personalized care.

• #33 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia

  https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits

  Follow-up care is an important part of evaluating the efficacy of your treatments and managing your symptoms. Do your best to keep up with all follow-up appointments. […] Its recommended to work with your doctor to develop a survivorship care plan. […] Joining an online or in-person support group specifically for cancer survivors can help fill the gap and make you feel supported by people whove had a similar experience with their health. […] Counseling can offer relief from the emotional toll that comes along with having a rare disease like WM. A mental health professional can provide one-on-one attention and help you develop coping skills. […] Taking care of yourself is an important component of feeling your best when you have WM. Making lifestyle changes, like eating a nutritious diet and exercising regularly, can help keep your body healthy and make you feel more in control of your health.

• #34 Waldenstrom’s macroglobulinemia – Overview of Information and Clinical Research

  https://clinicaltrials.eu/disease/waldenstroms-macroglobulinemia-2/

  Immunotherapy helps the body’s immune system recognize and kill cancer cells. This treatment is particularly effective in WM, where cancer cells often evade immune detection. Monoclonal antibodies, such as rituximab, are commonly used in combination with other therapies. […] Supportive care, also known as palliative care, focuses on relieving symptoms and improving quality of life for patients undergoing treatment. This care can be provided alongside other treatments like chemotherapy. Even if a patient opts not to pursue aggressive treatment, supportive care remains an option to manage pain and other symptoms. […] Participation in clinical trials offers patients access to cutting-edge treatments that are not yet widely available. These trials are crucial for advancing WM treatment and may provide new options for patients with relapsed or refractory disease. Ongoing research includes promising therapies like CAR T-cell therapy and new drug combinations.

• #35 Waldenström Macroglobulinemia | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/waldenstrom-macroglobulinemia.html

  For WM patients, this means more treatment options at Fred Hutch than you might find elsewhere, including the chance to participate in one of many ongoing clinical trials conducted at Fred Hutch and UW Medicine. […] Many patients at Fred Hutch receive promising therapies by taking part in clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine. They test new treatments or new ways to use current treatments. We have participated in and contributed to many studies testing new medicines with unique ways to suppress or kill WM cells. […] Every advance in cancer treatment in recent years has come out of clinical trials. We offer more active clinical trials than anywhere else, which means more treatment options for patients like you.

• #36 Waldenström Macroglobulinemia Treatment Moves Away From Chemotherapy

  https://www.onclive.com/view/waldenstr-m-macroglobulinemia-treatment-moves-away-from-chemotherapy

  The past decade has been a time of great progress in the research of Waldenstrm macroglobulinemia and the care of patients with the rare form of non-Hodgkin lymphoma. […] What we have been doing more frequently over the past 10 years is focusing on nonchemotherapeutic approaches to treat patients with Waldenstrm macroglobulinemia, Castillo said. […] Yin et al concluded that improvements in supportive care, particularly in the management of infections, cardiovascular disease, and Waldenstrm macroglobulinemia-related comorbidities such as hyperviscosity; have significantly reduced treatment-related mortality. […] Even with more effective treatments, observation remains a viable strategy for some patients. Castillo said that asymptomatic patients should not receive treatment. […] But when the patient becomes symptomatic to the point that the symptoms affect the patients activities or daily living and we do have a high suspicion that the symptoms are related to the disease, then we can treat. […] Castillo takes great pride in leading a robust clinical trial program at Dana-Farber Cancer Institute. […] The future is looking very optimistic in terms of treatments for patients with Waldenstrm macroglobulinemia.

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