There are many different treatment options available for WM patients, and their numbers are increasing as researchers discover more about the biology and genetics of the disease.
Treatment may consist of just one drug (single-agent therapy), or two or more drugs (combination therapy). Most studies seem to indicate that combination therapies are more effective, resulting in better and/or longer-lasting responses.
Treatment can usually be administered in an outpatient setting or at home. It may be oral, by intramuscular or subcutaneous injection, or by intravenous therapy. Some treatments require that certain medications be taken the day before or the day of treatment in order to minimize associated side effects.
Treatment cycles may take several weeks to months, depending on the course of therapy chosen. It is not unusual to have a round of therapy and then wait a week or a month before another round of treatment, although some of the newer oral therapies require daily dosing instead on an on-going/steady state basis. Hematologist-oncologists follow established protocols for treatment but may make adjustments depending on side effects or response to therapy.
Most of the treatments in use today were originally approved for the related cancers of follicular lymphoma, chronic lymphocytic leukemia, and multiple myeloma. Once additional Phase 1 and Phase 2 clinical trials established that these treatments had both an acceptable safety profile and were effective for WM patients as well, they were prescribed for “off label” use in WM.
The standard first-line treatment protocol (i.e., the typical first treatment for a WM patient) in Canada, across all provinces, is currently Bendamustine plus Rituximab. But all WMers are unique and different. Your oncologist may recommend other approaches, based on your individual symptoms and circumstances. Below, we provide:
- an overview of the breadth of treatments available today for WM,
- a few words about the class of drugs known as BTK inhibitors, and their status in Canada, and
- a pointer to information about CAR-T therapies.
More information can be obtained by visiting the various subsections in Education on our website.
Download your own copy of a booklet entitled Essential Information: A Physician’s Guide. In partnership with the IWMF, this booklet is part of a global initiative to educate patients and doctors, worldwide. It is a compilation of current knowledge on the diagnosis, treatment and established protocols for WM, intended as a guide to physicians. Although more medically written, we feel it is critical for all patients to be aware of and understand their own treatment options. Its authors are two WM specialist MDs from the Bing Center for WM, at the Dana-Farber Cancer Institute.