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Targeted treatments


The cells that cause Waldenstrom's macroglobulinaemia have certain proteins in them. These proteins act as messengers, which help the cells to survive and grow.

What are targeted treatments?


Targeted treatments are medicines that have been specially designed to seek out parts of a Waldenstrom's macroglobulinaemia cell. Most targeted treatments find the proteins and attack them. This stops them sending messages, killing the cancer cells in the process. Because of this targeted approach, fewer healthy cells are damaged than with chemotherapy, which can mean fewer side effects.

Some of these medicines are very new, and therefore many are still being tested and aren’t available outside of clinical trials.

Close up of unrecognizable senior man lying on bed and being handed medication to take

Antibody therapy is also a type of targeted treatment. This drug targets a protein on the surface of the WM cell. The most common you’ll hear about is rituximab. 

BTK Inhibitor
  • Why not start treatment straightaway?
    When you’re first diagnosed with WM, being told you don’t need immediate treatment may surprise, or even worry, you. You might think that it must be better to kill the cancer cells before they can increase more. However active monitoring is a safe and recommended way to care for people with slow-growing cancers like WM. There isn’t any evidence to show that being treated earlier has any benefits. Treatment itself can have some harsh side effects, which can be long lasting. By putting you on active monitoring, your doctor is saving treatment for when it can have the maximum impact. If your doctor sees signs that your WM is worsening, they will discuss treatment options with you immediately. However, many people stay on active monitoring for years, meaning they can lead full lives without the side effects of needless treatment.
  • What happens on active monitoring?
    You’ll have regular check-ups with your healthcare team, where you’ll have blood tests and a chance to talk about how you’re feeling and any symptoms or concerns you have. Normally these are face-to-face at the hospital, but since the COVID-19 pandemic, many check-ups have moved to video call or telephone. This doesn’t affect how you are monitored, just the way you speak to your healthcare team. Your blood tests and symptoms will help your doctor understand how your WM is behaving, and whether it’s time to start treatment or not. The check-ups also mean your doctor can pick up on any other conditions, for example anaemia, and ensure you get the right treatment for this. It’s important to raise concerns or mention any symptoms, however minor, at your check-up as your healthcare team might want to investigate these further. When you’re first diagnosed, these check-ups may be more frequent – for example, every 3 months – but as time goes by and if your WM remains stable, the check-ups may become less frequent. Some people who have been on active monitoring for years might have one check-up a year.
  • Is active monitoring safe?
    Yes. It is the recommended way to care for people with WM that isn’t growing and who either don’t have symptoms or whose symptoms are mild.
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