What’s new in Waldenstrom macroglobulinemia research and treatment?
As noted in the section “Do we know what causes Waldenstrom macroglobulinemia?” scientists are making great progress in understanding how changes in DNA can cause normal lymphocytes to develop into lymphoma cells.
Greater understanding of the chromosome translocations and other gene changes that often occur in WM is providing insight into why these cells grow too quickly, live too long, and do not develop into mature cells that take part in normal immune reactions. Once these changes are better understood, drugs may be developed that block these processes.
Chemotherapy and targeted therapies
Clinical trials are studying new drugs to treat WM, as well as ways to use drugs already known to be effective by combining them in new ways, using different doses, or different sequences of drugs, one after another.
Some of the newer types of drugs that have shown promise against WM include:
- mTOR inhibitors, such as everolimus (Afinitor) and temsirolimus (Torisel)
- Proteasome inhibitors, such as bortezomib (Velcade), carfilzomib (Kyprolis), and oprozomib
- Histone deacetylase (HDAC) inhibitors, such as panobinostat
- Bruton tyrosine kinase inhibitors, such as ibrutinib
Other types of drugs might also be helpful. Doctors have observed that an anti-cholesterol medication (simvastatin) seems to help lower IgM levels in the lab. A study to see if this drug can help patients with WM is going on now.
Another new approach to WM treatment is the use of biological response modifiers that stimulate the patient’s own immune system to attack and destroy the lymphoma cells.
For example, it has recently been found that the bone marrow support tissues (stromal cells) produce a substance called interleukin 6 (IL-6). IL-6 is a strong growth factor for multiple myeloma cells. IL-6 also helps cause the bone destruction seen in myeloma. Some current research efforts are focused on trying to develop ways to block these functions of IL-6, which may lead to new treatments for WM.
Bone marrow and peripheral blood stem cell transplant
Researchers are continually improving bone marrow and peripheral blood stem cell transplant methods, as well as trying to determine how helpful this type of treatment can be for people with WM.
Doctors know it is possible for people with cancer to develop immune responses to their cancer. In rare instances, people’s immune systems have rejected their cancers, and they have been cured. Scientists are now studying ways of boosting this immune reaction by the use of vaccines.
Unlike vaccines used to prevent infections, the purpose of these vaccines is to create an immune reaction against the lymphoma cells in patients who have very early disease or whose disease is in remission but could come back or relapse. This is a major area of research in lymphoma treatment, but it is still being tested in clinical trials. You may want to consider enrolling in one of these studies.
Last Medical Review: 06/19/2013
Last Revised: 06/19/2013