Treatment of patients with Waldenström macroglobulinaemia: clinical practice update from the Myeloma Foundation of Australia Medical and Scientific Advisory Group

Waldenström macroglobulinaemia (WM) is an indolent B‐cell malignancy characterised by the presence of IgM paraprotein, bone marrow infiltration by clonal small B lymphocytes with plasmacytic differentiation and the MYD88 L265P mutation in >90% of cases. Traditionally, WM has been treated with che...

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Bibliographic Details
Published in:Internal medicine journal 2023-04, Vol.53 (4), p.599-609
Main Authors: Talaulikar, Dipti, Joshua, Douglas, Ho, Phoebe Joy, Gibson, John, Quach, Hang, Gibbs, Simon, Ling, Silvia, Ward, Christopher, Augustson, Bradley M., Trotman, Judith, Harrison, Simon J., Tam, Constantine S.
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Australia - epidemiology
Bone Marrow - pathology
Bruton tyrosine kinase inhibitor
Clinical trials
Drug development
Humans
Immunoglobulin M
Lymphocytes B
Lymphoma
Malignancy
Multiple Myeloma - drug therapy
Mutation
MyD88 protein
Myeloid Differentiation Factor 88 - genetics
Myeloma
Protein-tyrosine kinase
treatment
Waldenstrom Macroglobulinemia - diagnosis
Waldenstrom Macroglobulinemia - drug therapy
Waldenstrom Macroglobulinemia - genetics
Waldenström macroglobulinaemia
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Summary:Waldenström macroglobulinaemia (WM) is an indolent B‐cell malignancy characterised by the presence of IgM paraprotein, bone marrow infiltration by clonal small B lymphocytes with plasmacytic differentiation and the MYD88 L265P mutation in >90% of cases. Traditionally, WM has been treated with chemoimmunotherapy. Recent trials have demonstrated the efficacy and safety of Bruton tyrosine kinase inhibitors in WM, both as monotherapy and in combination with other drugs. There is emerging evidence on the use of other agents including B‐cell lymphoma 2 inhibitors and on the treatment of rare presentations of WM. In this update, the Medical and Scientific Advisory Group of Myeloma Australia reviews the available evidence on the treatment of WM since the last publication in 2017 and provides specific recommendations to assist Australian clinicians in the management of this disease.
ISSN:1444-0903
1445-5994
DOI:10.1111/imj.15980