Chemotherapy for Waldenstrom Macroglobulinemia

Chemotherapy (chemo) is an important part of treatment for Waldenstrom macroglobulinemia. Chemo is the use of anti-cancer drugs. It can be taken by mouth or injected into a vein, a muscle, or under the skin.

How is chemo given for Waldenstrom macroglobulinemia?

Chemo is given in cycles. A period of treatment is followed by a rest period to allow your body time to recover. Each chemo cycle generally lasts for several weeks. Most chemo treatments are given in the doctor’s office, clinic, or hospital outpatient department.

Some of the chemo drugs used to treat Waldenstrom macroglobulinemia include:

• Alkylating drugs (cyclophosphamide and bendamustine)
• Anthracycline drugs (doxorubicin)
• Purine analogs (fludarabine, cladribine)
• Steroids (prednisone, dexamethasone)
• Vincristine

These drugs may be used alone or combined with other drugs, such as targeted drugs or immunotherapy drugs.

Possible side effects of chemo

Chemo drugs affect cells that multiply fast. Cancer cells multiply quickly, but so do other healthy cells in your body, including blood-forming cells, hair cells, and cells that make up the lining of your gut. Damage to these fast-growing healthy cells causes side effects.

The side effects of chemo depend on the type and dose of the drugs and the length of time they are given.

Common side effects

These side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation

Side effects from low blood cell counts

Chemo can damage bone marrow, where new blood cells are made. This can lead to low blood cell counts, which can result in:

• Increased chance of infections from having too few white blood cells (leukopenia)
• Easy bruising or bleeding from low platelets (thrombocytopenia)
• Fatigue from low red blood cells (anemia)

Side effects from specific chemo drugs

Some chemo drugs have other specific side effects. For example:

• Steroids can cause many side effects, including high blood pressure, high blood sugar, changes in mood, changes in appetite, and trouble sleeping.
• Anthracycline drugs like doxorubicin can damage your heart.
• Vincristine can damage nerves, leading to numbness, tingling, or weakness in the hands or feet. This is known as peripheral neuropathy.

For more on this, see After Treatment for Waldenstrom Macroglobulinemia.

Managing chemo side effects

If you have side effects, your cancer care team can suggest steps to ease them. For example, you can take medicines to help prevent and control nausea and vomiting.

Most side effects are temporary and go away after treatment is finished. If you have serious side effects, your cancer care team may give you a reduced dose or stop your chemo, at least temporarily.