Chłoniak waldenströma
Zapobieganie i profilaktyka

Chłoniak Waldenströma (WM) to rzadki nowotwór układu chłonnego, którego czynniki ryzyka, takie jak podeszły wiek czy MGUS, są niemodyfikowalne, co wyklucza skuteczną prewencję pierwotną. Zwiększone ryzyko WM obserwuje się u pacjentów z wirusowym zapaleniem wątroby typu C, dlatego zaleca się unikanie czynników ryzyka zakażenia WZW C. WM prowadzi do immunosupresji, nasilanej przez terapię, co wymaga rygorystycznej profilaktyki zakażeń: higieny rąk, unikania kontaktu z chorymi oraz szczepień ochronnych zarówno pacjenta, jak i jego otoczenia. W trakcie leczenia wskazane jest stosowanie profilaktyki zakażeń oportunistycznych, w tym szczepienia przeciw półpaścowi oraz ewentualne podawanie leków przeciwwirusowych (acyklowir, walacyklowir). Profilaktyka PJP może być konieczna przy niektórych schematach terapeutycznych. Monitorowanie immunoglobulin IgA, IgG oraz IgM (szczególnie przy stężeniach IgM > 4000 mg/dl) jest kluczowe dla oceny ryzyka zakażeń i decyzji terapeutycznych, np. dotyczących stosowania rytuksymabu ze względu na ryzyko zjawiska flare.

  1. Profilaktyka w chłoniaku Waldenströma
  2. Profilaktyka zakażeń w chłoniaku Waldenströma
    1. Profilaktyka polekowa zakażeń oportunistycznych
    2. Monitorowanie zaburzeń immunologicznych
  3. Profilaktyka w kontekście strategii terapeutycznych
  4. Styl życia jako element profilaktyki
  5. Badania nad odpowiedzią immunologiczną po szczepieniach
    1. Kolejne rozdziały

Profilaktyka w chłoniaku Waldenströma

Chłoniak Waldenströma (makroglobulinemia Waldenströma, WM) to rzadki nowotwór złośliwy układu chłonnego, w przypadku którego większość czynników ryzyka, takich jak podeszły wiek czy gammapatia monoklonalna o nieokreślonym znaczeniu (MGUS), nie podlega modyfikacji. W związku z tym nie istnieją skuteczne metody zapobiegania rozwojowi tego nowotworu.1 Niemniej jednak, niektóre badania sugerują zwiększone ryzyko WM u osób z wirusowym zapaleniem wątroby typu C. Chociaż nie ma szczepionki przeciwko WZW C, można zmniejszyć ryzyko zakażenia unikając czynników ryzyka, takich jak używanie narkotyków dożylnych czy niezabezpieczony kontakt seksualny z wieloma partnerami.2

Profilaktyka zakażeń w chłoniaku Waldenströma

WM sam w sobie prowadzi do osłabienia układu odpornościowego, co dodatkowo może być pogłębione przez stosowane leczenie. Z tego powodu kluczowe znaczenie ma profilaktyka zakażeń.34 W ramach kompleksowej opieki nad pacjentami z WM należy uwzględnić:

  • Regularne mycie rąk
  • Unikanie kontaktu z osobami chorymi
  • Szczepienia ochronne zalecane przez lekarza prowadzącego
  • Szczepienia dla osób z otoczenia pacjenta w celu dodatkowej ochrony

5

Profilaktyka polekowa zakażeń oportunistycznych

W trakcie leczenia chłoniaka Waldenströma konieczne jest stosowanie dodatkowej profilaktyki zakażeń oportunistycznych. Szczególną uwagę należy zwrócić na:6

Profilaktyka polekowa półpaśca

W celu zmniejszenia ryzyka wystąpienia półpaśca u pacjentów z WM, lekarz prowadzący może zalecić:7

8

Profilaktyka PJP

W przypadku stosowania niektórych schematów terapeutycznych, lekarz może zalecić leki zmniejszające ryzyko zapalenia płuc wywołanego przez Pneumocystis jirovecii (PJP).9

Monitorowanie zaburzeń immunologicznych

Podczas leczenia chłoniaka Waldenströma konieczne jest regularne monitorowanie parametrów immunologicznych, w szczególności:10

  • Poziomów przeciwciał klasy IgA i IgG, których zbyt niskie stężenie może predysponować do zakażeń
  • Poziomu IgM, który przy wartościach powyżej 4000 mg/dl może stanowić przeciwwskazanie do terapii rytuksymabem, ze względu na ryzyko gwałtownego wzrostu IgM (zjawisko flare)

11

Profilaktyka w kontekście strategii terapeutycznych

Przy planowaniu leczenia chłoniaka Waldenströma należy wziąć pod uwagę możliwości przyszłych terapii. W szczególności warto pamiętać, że niektóre leki mogą ograniczać możliwość przeprowadzenia przeszczepienia komórek macierzystych w przyszłości.12 Istotne jest szczegółowe omówienie z hematologiem/onkologiem planu terapeutycznego z uwzględnieniem stosunku korzyści do ryzyka stosowanych leków.13

Styl życia jako element profilaktyki

Pomimo braku możliwości prewencji pierwotnej chłoniaka Waldenströma, zdrowy styl życia może wpływać na ogólny stan zdrowia pacjentów i zapobiegać powikłaniom choroby.14 Zaleca się:

  • Unikanie wyrobów tytoniowych i dymu papierosowego – palenie zwiększa ryzyko wielu typów nowotworów i negatywnie wpływa na ogólny stan zdrowia15
  • Ograniczenie spożycia alkoholu – zgodnie z zaleceniami Centers for Disease Control and Prevention (CDC), alkohol zwiększa ryzyko niektórych nowotworów, więc jego ograniczenie jest szczególnie istotne u pacjentów z WM16
  • Zbilansowana, odżywcza dieta – wspomaga ogólny stan organizmu
  • Regularna aktywność fizyczna – dostosowana do możliwości pacjenta

17

Zindywidualizowane podejście do pacjenta z chłoniakiem Waldenströma, uwzględniające zarówno aspekty ściśle medyczne (profilaktyka zakażeń, monitorowanie parametrów immunologicznych), jak i elementy stylu życia, pozwala na optymalizację jakości życia i zmniejszenie ryzyka powikłań związanych z chorobą i jej leczeniem.18

Badania nad odpowiedzią immunologiczną po szczepieniach

W kontekście profilaktyki zakażeń u pacjentów z chłoniakiem Waldenströma, prowadzone są badania naukowe mające na celu ocenę i poprawę odpowiedzi immunologicznej na szczepienia, ze szczególnym uwzględnieniem szczepień przeciwko COVID-19.19 Wyniki tych badań mogą w przyszłości przyczynić się do opracowania zoptymalizowanych protokołów szczepień dla pacjentów z WM, uwzględniających specyfikę zaburzeń immunologicznych towarzyszących tej chorobie.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 12.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Can Waldenstrom Macroglobulinemia Be Prevented? | American Cancer Society
    https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/causes-risks-prevention/prevention.html
    Most of the risk factors for Waldenstrom macroglobulinemia (WM), such as older age or monoclonal gammopathy of undetermined significance (MGUS), cant be changed or controlled, so there is no way to prevent cancers that might be related to these risk factors. […] Some research suggests that people with hepatitis C might be more likely to develop WM. There is currently no vaccine to prevent hepatitis C, but there are ways to lower your risk of getting it, such as avoiding known risk factors like injection drug use or unprotected sex with many partners.
  • #2 Can Waldenstrom Macroglobulinemia Be Prevented? | American Cancer Society
    https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia/causes-risks-prevention/prevention.html
    Most of the risk factors for Waldenstrom macroglobulinemia (WM), such as older age or monoclonal gammopathy of undetermined significance (MGUS), cant be changed or controlled, so there is no way to prevent cancers that might be related to these risk factors. […] Some research suggests that people with hepatitis C might be more likely to develop WM. There is currently no vaccine to prevent hepatitis C, but there are ways to lower your risk of getting it, such as avoiding known risk factors like injection drug use or unprotected sex with many partners.
  • #3
    https://www.janssenwithme.com/en/blood-cancer/waldenstroms-macroglobulinemia
    WM suppresses the immune system, which can be further worsened by treatment, so its important to look after yourself and minimise the chance of getting an infection. Wash your hands regularly and try to avoid contact with people who are unwell. You can also ask your doctor about possible vaccinations that could help prevent infections and diseases, or that your loved ones can get to protect your health. […] Its important that you follow a treatment plan with which you are fully comfortable and that is tailored to your unique needs, to optimise your quality of life as much as possible.
  • #4 Bing Center for Waldenstrom’s Macroglobulinemia – Infection Prevention Strategies for Waldenstrom’s Macroglobulinemia
    http://waldenstroms.com/news/689-infection-prevention-strategies-for-waldenstrom-s-macroglobulinemia
    Infection Prevention Strategies for Waldenstrom’s Macroglobulinemia […] Review infection prophylaxis strategies in WM […] Highlight ongoing research efforts designed to study and improve immune responses to COVID-19 vaccination in WM.
  • #5
    https://www.janssenwithme.com/en/blood-cancer/waldenstroms-macroglobulinemia
    WM suppresses the immune system, which can be further worsened by treatment, so its important to look after yourself and minimise the chance of getting an infection. Wash your hands regularly and try to avoid contact with people who are unwell. You can also ask your doctor about possible vaccinations that could help prevent infections and diseases, or that your loved ones can get to protect your health. […] Its important that you follow a treatment plan with which you are fully comfortable and that is tailored to your unique needs, to optimise your quality of life as much as possible.
  • #6 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    There are many different treatment options available to people with Waldenstrom macroglobulinemia (WM). If you’re having WM-related symptoms that require treatment, your hematologist/oncologist will recommend a treatment plan tailored to your specific medical situation. […] As noted in the previous two charts, some treatment regimens call for related medical care. This includes the prevention of shingles and pneumocystis pneumonia, and making sure the levels of two antibodies, IgA and IgG, don’t get too low. Additional blood tests will be taken at intervals to prevent other side effects of treatment. […] To reduce this risk, your doctor may recommend you get the shingles vaccine and/or take the antiviral medicine acyclovir (Zovirax®) or valacyclovir (Valtrex®) before starting treatment.
  • #7 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    There are many different treatment options available to people with Waldenstrom macroglobulinemia (WM). If you’re having WM-related symptoms that require treatment, your hematologist/oncologist will recommend a treatment plan tailored to your specific medical situation. […] As noted in the previous two charts, some treatment regimens call for related medical care. This includes the prevention of shingles and pneumocystis pneumonia, and making sure the levels of two antibodies, IgA and IgG, don’t get too low. Additional blood tests will be taken at intervals to prevent other side effects of treatment. […] To reduce this risk, your doctor may recommend you get the shingles vaccine and/or take the antiviral medicine acyclovir (Zovirax®) or valacyclovir (Valtrex®) before starting treatment.
  • #8 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    There are many different treatment options available to people with Waldenstrom macroglobulinemia (WM). If you’re having WM-related symptoms that require treatment, your hematologist/oncologist will recommend a treatment plan tailored to your specific medical situation. […] As noted in the previous two charts, some treatment regimens call for related medical care. This includes the prevention of shingles and pneumocystis pneumonia, and making sure the levels of two antibodies, IgA and IgG, don’t get too low. Additional blood tests will be taken at intervals to prevent other side effects of treatment. […] To reduce this risk, your doctor may recommend you get the shingles vaccine and/or take the antiviral medicine acyclovir (Zovirax®) or valacyclovir (Valtrex®) before starting treatment.
  • #9 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    Your doctor may order a medication to lower the risk of PJP when using certain therapy regimens. […] Blood tests are used to monitor the levels of these antibodies. […] It’s generally recommended that treatment with rituximab be withheld in people whose blood levels of IgM is greater than 4000mg/dL to minimize the risk of an IgM flare. […] Your doctor will limit the use of these drugs if a stem cell transplant is a possibility. […] Discuss any concerns you have with your hematologist/oncologist, who will help you weigh the risks versus benefits of these particular agents.
  • #10 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    Your doctor may order a medication to lower the risk of PJP when using certain therapy regimens. […] Blood tests are used to monitor the levels of these antibodies. […] It’s generally recommended that treatment with rituximab be withheld in people whose blood levels of IgM is greater than 4000mg/dL to minimize the risk of an IgM flare. […] Your doctor will limit the use of these drugs if a stem cell transplant is a possibility. […] Discuss any concerns you have with your hematologist/oncologist, who will help you weigh the risks versus benefits of these particular agents.
  • #11 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    Your doctor may order a medication to lower the risk of PJP when using certain therapy regimens. […] Blood tests are used to monitor the levels of these antibodies. […] It’s generally recommended that treatment with rituximab be withheld in people whose blood levels of IgM is greater than 4000mg/dL to minimize the risk of an IgM flare. […] Your doctor will limit the use of these drugs if a stem cell transplant is a possibility. […] Discuss any concerns you have with your hematologist/oncologist, who will help you weigh the risks versus benefits of these particular agents.
  • #12 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    Your doctor may order a medication to lower the risk of PJP when using certain therapy regimens. […] Blood tests are used to monitor the levels of these antibodies. […] It’s generally recommended that treatment with rituximab be withheld in people whose blood levels of IgM is greater than 4000mg/dL to minimize the risk of an IgM flare. […] Your doctor will limit the use of these drugs if a stem cell transplant is a possibility. […] Discuss any concerns you have with your hematologist/oncologist, who will help you weigh the risks versus benefits of these particular agents.
  • #13 Treatment Regimens and Considerations – International Waldenstrom’s Macroglobulinemia Foundation
    https://iwmf.com/treatment-regimens-and-considerations-1/
    Your doctor may order a medication to lower the risk of PJP when using certain therapy regimens. […] Blood tests are used to monitor the levels of these antibodies. […] It’s generally recommended that treatment with rituximab be withheld in people whose blood levels of IgM is greater than 4000mg/dL to minimize the risk of an IgM flare. […] Your doctor will limit the use of these drugs if a stem cell transplant is a possibility. […] Discuss any concerns you have with your hematologist/oncologist, who will help you weigh the risks versus benefits of these particular agents.
  • #14 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia
    https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits
    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. […] 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. […] 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.
  • #15 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia
    https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits
    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. […] 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. […] 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.
  • #16 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia
    https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits
    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. […] 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. […] 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.
  • #17 Healthy Lifestyle Habits for Waldenstrom Macroglobulinemia
    https://www.healthline.com/health/waldenstrom-macroglobulinemia/10-habits
    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. […] 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. […] 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.
  • #18
    https://www.janssenwithme.com/en/blood-cancer/waldenstroms-macroglobulinemia
    WM suppresses the immune system, which can be further worsened by treatment, so its important to look after yourself and minimise the chance of getting an infection. Wash your hands regularly and try to avoid contact with people who are unwell. You can also ask your doctor about possible vaccinations that could help prevent infections and diseases, or that your loved ones can get to protect your health. […] Its important that you follow a treatment plan with which you are fully comfortable and that is tailored to your unique needs, to optimise your quality of life as much as possible.
  • #19 Bing Center for Waldenstrom’s Macroglobulinemia – Infection Prevention Strategies for Waldenstrom’s Macroglobulinemia
    http://waldenstroms.com/news/689-infection-prevention-strategies-for-waldenstrom-s-macroglobulinemia
    Infection Prevention Strategies for Waldenstrom’s Macroglobulinemia […] Review infection prophylaxis strategies in WM […] Highlight ongoing research efforts designed to study and improve immune responses to COVID-19 vaccination in WM.

Zobacz więcej

profilaktyka półpaśca przeciwciało IgA zapalenie płuc zaburzenie immunologiczne przeszczepienie komórek macierzystych PJP WZW C rytuksymab profilaktyka zakażeń walacyklowir chłoniak Waldenströma osłabienie układu odpornościowego acyklowir immunoglobulina M hematolog gammapatia monoklonalna szczepienie ochronne wirusowe zapalenie wątroby typu C przeciwciało IgG Pneumocystis jirovecii makroglobulinemia Waldenströma lek przeciwwirusowy parametr immunologiczny onkolog odpowiedź immunologiczna