This protocol addresses Waldenstrom macroglobulinemia presenting with symptomatic hyperviscosity that requires immediate disease control. The combination of active disease and urgent symptoms defines the starting point of the treatment sequence.
For patients requiring immediate disease control due to symptomatic hyperviscosity, initial plasmapheresis is recommended to achieve rapid symptom reduction before systemic therapy is introduced.
Following plasmapheresis, systemic treatment should be initiated as soon as possible. The protocol defines a set of preferred first-line regimens along with additional recommended options — the complete regimen details and selection algorithm are available in the full protocol.
The primary aims are reduction in the serum IgM protein and symptom relief, along with reducing the risk of organ damage.
DOI: 10.6004/jnccn.2024.0001
According to the NCCN Panel, for patients requiring immediate disease control, such as those with symptomatic hyperviscosity, initial plasmapheresis is recommended.
After plasmapheresis, systemic treatment should be initiated as soon as possible.
Response to therapy in WM is defined by reduction in the IgM protein.
The goal of treatment is symptom relief and reducing the risk of organ damage.
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