Current approach to Waldenström Macroglobulinemia

Ravi, Gayathri; Kapoor, Prashant

doi:10.1016/j.ctarc.2022.100527

Cited by 11 publications

(10 citation statements)

References 113 publications

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“…A phase II study of venetoclax monotherapy (NCT02677324) 71 , 72 enrolled 32 patients with previously treated WM, of whom 16 were previously treated with BTK inhibitors. The data suggested that patients with prior BTK inhibitor exposure had a longer time to respond than patients without prior BTK inhibitor exposure (4.5 vs. 1.4 months; P < .001).…”

Section: Approaches To Address Ibrutinib Intolerancementioning

confidence: 99%

Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies

2023

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Ibrutinib is a first-generation inhibitor of Bruton tyrosine kinase (BTK) that is currently approved to treat patients with B-cell malignancies, including Waldenström macroglobulinemia (WM), relapsed/refractory (R/R) mantle cell lymphoma (MCL), R/R marginal zone lymphoma (MZL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Off-target adverse effects, such as atrial fibrillation, hypertension, and bleeding, have been observed and may limit a patient’s tolerance for treatment. Currently, there is no well-established treatment regimen for patients who cannot tolerate ibrutinib. Approaches to address such patients include managing ibrutinib side effects with supportive care or dose reductions, switching to an alternative covalent BTK inhibitor, or abandoning covalent BTK inhibitors for alternative forms of treatment. Here we review the literature and provide guidance on treating ibrutinib-intolerant patients with B-cell malignancies.

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Section: Approaches To Address Ibrutinib Intolerancementioning

confidence: 99%

Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies

2023

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“…WM is a lymphoproliferative condition often characterised by lymphadenopathy, splenomegaly, hepatomegaly, hyperviscosity syndrome and B symptoms. Flow cytometry is significant for elevated IgM levels, CD5 -/+, CD19 +, CD20 +, CD22 +, CD79a +, CD25 +, CD27 +, FMC7 + and CD103- 6. Literature suggests that the presence of MYD88 mutation is the standard to establish diagnosis 3 6…”

Section: Introductionmentioning

confidence: 99%

“…Flow cytometry is significant for elevated IgM levels, CD5 -/+, CD19 +, CD20 +, CD22 +, CD79a +, CD25 +, CD27 +, FMC7 + and CD103- 6. Literature suggests that the presence of MYD88 mutation is the standard to establish diagnosis 3 6…”

Section: Introductionmentioning

confidence: 99%

Challenging diagnosis of IgM multiple myeloma

Mahmood,

Ahmed,

Thalody

et al. 2024

BMJ Case Rep

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IgM monoclonal gammopathies such as IgM myeloma and Waldenström macroglobulinaemia are distinct haematological conditions; however, differentiating between these entities can often present as a challenge.In this review, we explore the challenging diagnosis and treatment of IgM myeloma in a patient presenting with unexplained macrocytic anaemia, elevated serum protein and IgM levels in the absence of t(11;14) and lytic bone lesions that are classically associated with the diagnosis of IgM myeloma. The diagnosis was established based on 40% monoclonal plasma cell population on a bone marrow biopsy, gain of 1q21 on fluorescence in situ hybridisation, cyclin D1 positivity and absence of MYD88 mutation.

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“…Thus, a considerable number of cases benefit from monitoring without any therapy [ 5 ]. Nevertheless, 75–85% of all cases may require treatment based on the development of symptoms derived from the disease [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, manifestations may vary depending on the involved tissue, including BM or extramedullary infiltration, or those related to the monoclonal component [ 6 ]. Therefore, IgM paraprotein can cause specific complications due to its physical–chemical properties, autoantibody activity, tissue deposition and non-specific interactions with other proteins, such as cryoglobulins, cold agglutinin syndrome (CAS) and amyloidosis [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient

et al. 2023

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Waldenström macroglobulinemia (WM) is a slowly progressive hematologic malignancy that usually responds rapidly to treatment. Being a lymphoplasmacytoid neoplasm, it is associated with a monoclonal IgM component, which may be associated with multiple manifestations and symptoms. We report the case of a 77-year-old woman diagnosed with WM following the development of severe and sudden pancytopenia associated with a cold agglutinin syndrome. In order to treat the WM and the underlying hemolysis, treatment with rituximab, corticosteroids and cyclophosphamide was started. Despite the improvement in hemolysis parameters, pancytopenia persisted, and we started a second line with ibrutinib. During treatment the patient developed an uncommon invasive fungal infection (IFI) with bone marrow granulomatosis and myelofibrosis. This case shows an unusual clinical course with a poor hematopoietic response to treatment and a large number of intercurrent complications.

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Current approach to Waldenström Macroglobulinemia

Cited by 11 publications

References 113 publications

Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies

Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies

Challenging diagnosis of IgM multiple myeloma

Invasive Cutaneous Candidiasis, Autoimmune Hemolytic Anemia and Pancytopenia: A Challenging Scenario for Waldenström Macroglobulinemia in an Elderly Patient

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