Abstract
Waldenström macroglobulinemia (WM) is a chronic B-cell lymphoproliferative disorder characterized by lymphoplasmacytic cell overgrowth in the bone marrow and increased secretion of IgM immunoglobulins into the serum. Patients with WM have a variety of clinical outcomes, including long-term survival but inevitable recurrence. Recent advances in disease knowledge, including molecular and genetic principles with the discovery of MYD88 and CXCR4 mutations, have rapidly increased patient-tolerable treatment options. WM patients may benefit from chemotherapy regimens that include rituximab-based regimens, alkylating drugs, proteasome inhibitors, monoclonal antibodies, and drugs targeting Bruton tyrosine kinase inhibitors. In light of these advancements, patients can now receive treatment customized to their specific clinical characteristics, focusing on enhancing the depth and durability of their response while limiting the adverse effects. Despite the rapidly developing therapeutic armament against WM, a lack of high-quality evidence from extensive phase 3 trials remains a significant challenge in the research. We believe clinical outcomes will keep improving when new medicines are introduced while preserving efficacy and minimizing toxicity.
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Bushra Ghafoor: Conceptualization, Methodology, Writing – original draft.
Shameera Shaik Masthan: Methodology, Writing – original draft.
Maha Hameed: Methodology, Writing – original draft.
Hafiza Huda Akhtar: Methodology, Writing – original draft.
Azeem Khalid: Methodology, Writing – original draft.
Sana Ghafoor: Methodology, Writing – original draft.
Hassan min Allah: Methodology, Writing – original draft.
Mohammad Mohsin Arshad: Methodology, Writing – original draft.
Iman Iqbal: Writing – review, and editing.
Ahmad Ifitkhar: Conceptualization, Methodology, Writing – review, and editing.
Muhammad Husnain: Conceptualization, Writing – review and editing.
Faiz Anwer: Conceptualization, Writing – review and editing.
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Faiz Anwer Reports personalities from Bristol Myers Squibb as a speaker and feeds from Janssen pharmaceutical as an advisory board member; these fevers are unrelated to the submitted work. Without receiving direct funding, served as the local principal investigator for Allogene Therapeutics, Celgene, GlaxoSmithKline, and Bristol Myers Squibb; has a consulting on an advisory role for Seattle genetics, Incyte Corporation speakers Bureau, Company: Insight Corporation; receives travel and accommodations expenses from Seattle genetics, insight; receives on the radio from insight, complaining: Seattle genetics; and received research funding from Seattle Genetics, company: Calgene, Acetylon pharmaceuticals, Millennium, Astellas Pharma and AbbVie; and reports no other potential conflicts of interest for this work. The other authors declare no competing interests.
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Ghafoor, B., Masthan, S.S., Hameed, M. et al. Waldenström macroglobulinemia: a review of pathogenesis, current treatment, and future prospects. Ann Hematol 103, 1859–1876 (2024). https://doi.org/10.1007/s00277-023-05345-9
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DOI: https://doi.org/10.1007/s00277-023-05345-9