What`s new in Waldenstrom macroglobulinemia research and treatment?

Genetics

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. Greater understanding of the genes (regions of DNA) involved in certain translocations that often occur in lymphoma is providing insight into why these cells grow too rapidly, live too long, and do not develop into mature cells that take part in normal immune reactions. Scientists are now looking at how these abnormal chromosomes lead to the development of lymphoma. Once this is understood, drugs may be developed that block this process.

Chemotherapy

Clinical trials are studying new chemotherapy drugs. Other trials are studying ways to use drugs already known to be effective in treating lymphoma by combining them in new ways, using different doses, or different sequences of drugs, one after another.

Everolimus (Afinitor®), a drug more commonly used to treat kidney cancer, has been shown to be useful in treating WM. It is not a traditional chemo drug — it belongs to a class of drugs known as mTOR inhibitors. Common side effects with this drug include fatigue (tiredness), mouth pain, diarrhea, and infections.

Doctors 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.

Biological therapy

Another new approach to non-Hodgkin lymphoma treatment is the use of biological response modifiers that stimulate the patient's own immune system to attack and destroy the lymphoma cells. Some of the substances currently being tested include interferons and interleukins.

It has recently been discovered 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 of the myeloma cells. Some current research efforts are focused on trying to develop ways to block these functions of IL-6.

Bone marrow and peripheral blood stem cell transplantation

Researchers are continually improving bone marrow and peripheral blood stem cell transplantation methods.

Vaccines

Doctors have always known that it was possible for people with cancer to develop antibodies to their cancer. In rare instances these people's immune systems have rejected their cancers and they have been cured. Now, scientists have developed ways of encouraging this immune reaction by the use of vaccines. The difference from the usual use of vaccines in children is that in children's vaccinations, the object is to prevent an infectious disease from ever taking hold. With cancer vaccines, the goal is to create an immune reaction in patients who have very early disease or in patients whose disease is in remission. So far, there have been a few successes with this approach. It is a major area of research in lymphoma treatment.