Consensus panel 2 from the 12^th International Workshop on Waldenstrom Macroglobulinemia was tasked with updating the guidelines on the diagnosis and management of patients with Bing-Neel syndrome (BNS).  The report, available here, summarizes the clinical symptoms that may be present with BNS, discusses the criteria required for diagnosis of BNS, makes recommendations for follow-up imaging, and proposes revised guidelines for response assessment in BNS.

Histological transformation (HT) in Waldenström’s macroglobulinemia (WM) is a rare complication and despite growing literature in the last years, no consensus recommendations exist.  This panel was convened to review the current data on transformed WM and make recommendations on its diagnosis and management.  The report can be read here.

Consensus Panel 5 aimed to establish working definitions for intolerance and resistance to covalent BTK inhibitors, as well as provide strategies to identify and manage these issues not infrequently encountered in clinical practice.  The report can be read here.

Approximately 95% of lymphoplasmacytic lymphomas (LPL) are IgM secreting and are characterized as Waldenstrom Macroglobulinemia (WM). Conversely, non-IgM secreting LPL are rare. As part of the 12th International Workshop on WM (IWWM-12), a consensus panel of experts was tasked to develop recommendations for the management and response assessment of non-IgM LPL.  Their report is available here.

The Consensus Panel 3 (CP3) of the 12^th International Workshop on Waldenström macroglobulinemia (IWWM-12) has reviewed and incorporated current data to make recommendations for the management of patients with high-risk WM (HR-WM).  The report can be read here.

Clinical trial NCT05006716 of Beigene’s BGB-16673, a Bruton Tyrosine Kinase Targeted Protein Degrader, is recruiting patients in Calgary, Edmonton, Québec, Vancouver, and Toronto.    Official title of the study: A Phase 1/2, Open-Label, Dose Escalation and Expansion Study of the Bruton Tyrosine Kinases Targeted Protein Degrader BGB-16673 in Patients with B-cell Malignancies.  For more information, see the trial’s description on the NIH website.

Two journal article provide an end-to-end review of WM.  Co-authored by experts from the Dana-Farber Cancer Institute, they are highly recommended to all practitioners.

• Part 1: Epidemiology, Pathogenesis, Clinicopathologic Characteristics, Differential Diagnosis, Risk Stratification, and Clinical Problems is available at https://www.mjhid.org/mjhid/article/view/5732/4535
• Part 2: Focus on Therapy is available at https://www.mjhid.org/mjhid/article/view/5878/4639

NCT05952037 (https://clinicaltrials.gov/study/NCT05952037) is using a new BCL-2 inhibitor, Sonrotoclax, and is strictly for WM patients.  The trial is world-wide, but is recruiting in just one location in Canada, in North Vancouver, at the Lions Gate Hospital Chemotherapy Clinic.  It has several arms running in parallel:  one is for treatment-naive patients; the other three are for Relapsed/Refractory patients with various treatment histories.

This booklet provides a compilation of current knowledge on the diagnosis, treatment, and established protocols for WM.  Complete with references to published papers, throughout, it has been modified with a small number of Canadian-specific footnotes.  Authored by two WM specialist MDs from the Bing Center for WM at the Dana-Farber Cancer Institute, it is presented in partnership with the International Waldenstrom’s Macroglobulinemia Foundation (IWMF).

Quoting from the paper, published in ASCO’s Journal of Clinical Oncology: “Extended follow-up results confirm improved long-term safety and tolerability of zanubrutinib compared with ibrutinib and support deeper, earlier, and more durable responses in patients with WM regardless of previous treatment or CXCR4 and MYD88 mutational statuses.”

A concise summary of the entire 11th International Workshop on WM, entitled What we learned, and how it will impact scientific discovery and patient care, is available here, as published in the journal Seminars in Hematology.

Consensus Panel 4 (CP4) of the 11^th International Workshop on Waldenstrom’s Macroglobulinemia (IWWM-11) was tasked with reviewing the current criteria for diagnosis and response assessment.  Their report is available here.

Consensus Panel 6 (CP6) of the 11th International Workshop on Waldenström’s Macroglobulinemia (IWWM-11) was tasked with reviewing the state of the art for diagnosis, prognosis, and therapy of AL amyloidosis associated with Waldenström macroglobulinemia (WM).  Their report is available here.

Consensus Panel 7 (CP7) of the 11^th International Workshop on WM was convened to examine the current generation of completed and ongoing clinical trials involving novel agents, consider updated data on WM genomics, and make recommendations on the design and prioritization of future clinical trials.  Their report is available here.

Consensus Panel 5 (CP5) of the 11th International Workshop on Waldenstrom’s Macroglobulinemia (IWWM-11; held in October 2022) was tasked with reviewing the current data on the coronavirus disease-2019 (COVID-19) prophylaxis and management in patients with Waldenstrom’s Macroglobulinemia (WM).  Their report is available here.

Consensus Panel 3 (CP3) of the 11^th International Workshop on Waldenström’s Macroglobulinemia (IWWM-11) was tasked with reviewing the current molecular necessities and best way to access the minimum data required for a correct diagnosis and monitoring.  Their report is available here.

The Consensus Panel 2 (CP2) of the 11th International Workshop on Waldenström’s Macroglobulinemia (IWWM-11) has reviewed and incorporated current data to update the recommendations for treatment approaches in patients with relapsed or refractory WM (RRWM).  Their report is available here.

Consensus Panel 1 (CP1) of the 11^th International Workshop on Waldenstrom’s Macroglobulinemia (IWWM-11) was tasked with updating guidelines for the management of symptomatic, treatment-naïve patients with WM.  Their report is available here.

Two clinical trials are available for WM patients at various sites across Canada:

• https://clinicaltrials.gov/ct2/show/NCT04624906: Treatment naive patients; Bendamustine + Rituximab, plus one year of Acalabrutinib
• https://clinicaltrials.gov/ct2/show/NCT04728893: R/R patients; Nemtabrutinib (a non-covalent BTK inhibitor)

A summary of the 11th International Workshop on WM (iwWM) held October, 2022, has been published at https://link.springer.com/article/10.1007/s12254-023-00876-3.  Click on the “Download PDF” box on the right.

Partially funded by the WMFC and presented at ASH in December, 2022, this research identified three subtypes of WM.

The full abstract that Dr. Hunter presented at ASH is available here.

Two other WM-related abstracts using the multiomic analysis from Dr. Hunter’s research were also presented at ASH:

• An in-depth investigation into why epigenomic regulation is so important to MYD88 mutations is available here
• The data also has been applied to investigating why ibrutinib (and by extension other BTK inhibitors) may result in long Progression-Free Survival (PFS); that abstract is available here

Dr. Steve Treon of the Dana-Farber Cancer Institute presents a thorough summary of the latest knowledge of WM and its current and upcoming treatments.  See https://youtu.be/JCrdW4VpNpw.

This journal article by a set of researchers from across Canada provides an overview of treatment options for WM, and their usage in current (2022) Canadian WM treatment.  See https://www.mdpi.com/1718-7729/29/10/560.