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Waldenström’s Macroglobulinemia pp 335–343Cite as

Immunomodulatory Agents and Proteasome Inhibitors in Waldenstrom’s Macroglobulinemia

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Abstract

The success of immunomodulatory drugs (IMIDs) and proteasome inhibitors in multiple myeloma prompted in great part their investigation in Waldenstrom’s Macroglobulinemia (WM). The IMIDS (Thalidomide, lenalidomide, and pomalidomide) have been investigated as either single agents or in combination with rituximab and other agents. Thalidomide is associated with pronounced peripheral neuropathy in WM, while lenalidomide produces exaggerated anemia. The use of IMIDs with rituximab is associated with more pronounced rituximab-related IgM flare, particularly with lenalidomide and pomalidomide, and can result in symptomatic hyperviscosity. Proteasome inhibitors are a mainstay of therapy in WM and are associated with rapid reductions in serum IgM and less rituximab-related IgM flaring. Peripheral neuropathy is an important concern with bortezomib, and exploration of alternative schedules and routes of administration for this agent, as well as development of next generation neuropathy sparing proteasome inhibitors is being prioritized to advance their safe and effective use.

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Author information

Authors and Affiliations

  1. Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Steven P. Treon MD, PhD & Jorge J. Castillo MD

  2. National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Efstathios Kastritis MD & Meletios A. Dimopoulos MD

Authors
  1. Steven P. Treon MD, PhD
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  2. Jorge J. Castillo MD
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  3. Efstathios Kastritis MD
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  4. Meletios A. Dimopoulos MD
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Corresponding author

Correspondence to Steven P. Treon MD, PhD .

Editor information

Editors and Affiliations

  1. Haematology, Hôpital Pitié-Salpêtriêre, Paris, France

    Véronique Leblond

  2. Dana Farber Cancer Institute, Boston, Massachusetts, USA

    Steve Treon

  3. School of Medicine, University of Athens, Athens, Greece

    Meletios Dimoploulos

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© 2017 Springer International Publishing Switzerland

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Treon, S.P., Castillo, J.J., Kastritis, E., Dimopoulos, M.A. (2017). Immunomodulatory Agents and Proteasome Inhibitors in Waldenstrom’s Macroglobulinemia. In: Leblond, V., Treon, S., Dimoploulos, M. (eds) Waldenström’s Macroglobulinemia. Springer, Cham. https://doi.org/10.1007/978-3-319-22584-5_23

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  • DOI: https://doi.org/10.1007/978-3-319-22584-5_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22583-8

  • Online ISBN: 978-3-319-22584-5

  • eBook Packages: MedicineMedicine (R0)

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