EHA-SWG 2017 | Rare Lymphomas: Treatment of WM

On March 11^th, at the EHA-SWG Rare Lymphomas Scientific Meeting 2017 in Barcelona, Spain, Marie José Kersten chaired a scientific session on ‘Waldenström’s Macroglobulinemia’. The second presentation of this session was originally intended to be presented by Meletios Dimopoulos, but was presented by Marie José Kersten on the topic of ‘Treatment of WM’. Below are the key highlights from this presentation:

• The session began with an overview of WM and when to initiate therapy

• Options for treating WM have expanded greatly in the last decade and now include proteasome inhibitors, rituximab, alkylating agents, monoclonal antibodies, etc.
• Rituximab-based regimens have the best outcome for first-line WM patients
• Dexamethasone, rituximab, cyclophosphamide treatment was shown to have 83% ORR. But with high IgM flare rate (32% pts; 11% pts >25% IgM increase)

• A summary of data for proteasome inhibitors and combination therapy was presented, and it was reported that no pts needed plasmapheresis due to IgM flare:

• Rituximab maintenance was shown to result in significantly higher PFS and OS in patients with WM however, this data was from a retrospective analysis

• Novel drug targets:

• Ibrutinib has been shown to be effective in previously treated WM with a 68.1% EFS (95% CI), 90% OS (95% CI) with a median follow-up of 37 months

• In conclusion, rituximab-based therapy is recommended in first-line patients, but evidence is less clear for relapsed WM patients