title: Treatment recommendations from the Eighth International Workshop on Waldenström's Macroglobulinemia.
abstract: Waldenström macroglobulinemia (WM) is a distinct B-cell lymphoproliferative disorder for which clearly defined criteria for the diagnosis, initiation of therapy, and treatment strategy have been proposed as part of the consensus panels of the International Workshop on Waldenström's Macroglobulinemia (IWWM). At IWWM-8, a task force for treatment recommendations was impanelled to review recently published and ongoing clinical trial data as well as the impact of new mutations (MYD88 and CXCR4) on treatment decisions, indications for B-cell receptor and proteasome inhibitors, and future clinical trial initiatives for WM patients. The panel concluded that therapeutic strategies in WM should be based on individual patient and disease characteristics. Chemoimmunotherapy combinations with rituximab and cyclophosphamide-dexamethasone, bendamustine, or bortezomib-dexamethasone provide durable responses and are still indicated in most patients. Approval of the BTK inhibitor ibrutinib in the United States and Europe represents a novel and effective treatment option for both treatment-naive and relapsing patients. Other B-cell receptor inhibitors, second-generation proteasome inhibitors (eg, carfilzomib), and mammalian target of rapamycin inhibitors are promising and may increase future treatment options. Active enrollment in clinical trials whenever possible was endorsed by the panel for most patients with WM.
authors.affiliation: Assistance Publique-Hôpitaux de Paris Hôpital Pitié Salpêtrière, Groupe de Recherche Clinique Hémopathie, Pierre and Marie Curie University, Paris, France;
authors.forename: Véronique
authors.initials: V
authors.lastname: Leblond
authors.affiliation: Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece;
authors.forename: Efstathios
authors.initials: E
authors.lastname: Kastritis
authors.affiliation: Stanford Cancer Institute, Stanford, CA;
authors.forename: Ranjana
authors.initials: R
authors.lastname: Advani
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN;
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ansell
authors.affiliation: Comprehensive Cancer Center Ulm, Institute of Experimental Cancer Research, University Hospital Ulm, Ulm, Germany;
authors.forename: Christian
authors.initials: C
authors.lastname: Buske
authors.affiliation: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA;
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Castillo
authors.affiliation: Servicio de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain;
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Sanz
authors.affiliation: Mayo Clinic, Rochester, MN;
authors.forename: Morie
authors.initials: M
authors.lastname: Gertz
authors.affiliation: Hematology Center, Department of Medicine, Karolinska Institute, Stockholm, Sweden;
authors.forename: Eva
authors.initials: E
authors.lastname: Kimby
authors.affiliation: University College London Hospital, London, United Kingdom;
authors.forename: Charalampia
authors.initials: C
authors.lastname: Kyriakou
authors.affiliation: Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Department of Molecular Medicine, University of Pavia, Pavia, Italy;
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
authors.affiliation: Department of Hematology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands;
authors.forename: Monique C
authors.initials: MC
authors.lastname: Minnema
authors.affiliation: Service d'Hématologie Clinique, Centre Hospitalier Schaffner, Lens, France;
authors.forename: Pierre
authors.initials: P
authors.lastname: Morel
authors.affiliation: Department of Hematology, Niguarda Ca' Granda Hospital, Milan, Italy;
authors.forename: Enrica
authors.initials: E
authors.lastname: Morra
authors.affiliation: Medizinische Klinik IV, Hospital of the Justus-Liebig-University Giessen, Giessen, Germany; and.
authors.forename: Mathias
authors.initials: M
authors.lastname: Rummel
authors.affiliation: University College London (Royal Free Campus), London, United Kingdom.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Wechalekar
authors.affiliation: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA;
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Patterson
authors.affiliation: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA;
authors.forename: Steven P
authors.initials: SP
authors.lastname: Treon
authors.affiliation: Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece;
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
mesh_terms: D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D008258:Waldenstrom Macroglobulinemia / Q000628:therapy*