The following are links to treatment guidelines for front-line and salvage therapy developed by several centers of excellence in the management of WM. Because there is no established standard of treatment, these guidelines may vary somewhat from one center to another.
There are many different treatment options available for WM patients, and they 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 of 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.
A relapse or recurrence after treatment occurs when laboratory values and physical signs and symptoms begin to trend in a deteriorating direction. These signs and symptoms may be quite similar to those that led to initial treatment. At this point, patients and their hematologist-oncologists are confronted with choosing the next appropriate course of action, be it continued periodic monitoring or re-treatment, which is sometimes referred to as salvage therapy.
The period after treatment when a WM patient has experienced either stabilization of disease, an improvement in disease status, or even, unfortunately, disease progression is called a “response”. While an improvement in disease status is sometimes commonly referred to as a “remission”, the preferred scientific terminology is “response”.
Complementary and Integrative Medicine consist of wellness-promoting treatments that complement conventional Western medical care and are used as adjuncts to mainstream cancer care. These are used primarily for symptom control and to enhance physical and emotional strength during and after mainstream cancer treatment. These treatments should be chosen based on consultation with a physician trained in integrative medicine who can help you decide on the care you need based on what’s right for you, considering the type of conventional cancer treatment you are receiving.
A side effect is any unfavorable or unintended sign, symptom, or disease associated with the use of a therapy. Most treatments for WM come with side effects, which may include one or more of the following: nausea or vomiting, constipation, diarrhea, low blood counts, hair loss, fatigue, infusion reactions, increased risk of infections, and neuropathy.
Watch and wait is not really a treatment but rather a philosophy to avoid treatment after diagnosis until it becomes necessary. The watch and wait approach to WM is based on the fact that it is an indolent cancer, and many patients experience slow disease progression with few symptoms over a period of months or even years. The advantage to this strategy is that a patient avoids for as long as possible the use of treatments which can have adverse side effects.
Patients should be treated when they have symptoms and not on the basis of blood test results alone. This applies not only to consideration of initial treatment but also to treatment following relapse, which is sometimes called salvage therapy. Many therapies have toxic side effects, and treating patients who don’t yet have symptoms may potentially have an adverse effect on quality of life and health that is worse than the disease itself at that point.