Novel treatment regimens for Waldenstrom's macroglobulinemia

Waldenstrom's macroglobulinemia (WM) is a B-cell lymphoproliferative disorder defined by bone marrow infiltration by lymphoplasmacytic cells as defined by the current classification systems. According to its transition situation between mutated chronic lymphocytic leukemia and multiple myeloma, several new therapeutic alternatives have been proposed for this entity based on the experience with these two well-known conditions together with the highly singular data provided by preclinical models. Thus, in WM two main therapeutic attitudes are possible: the use of conventional therapies based on the administration of single drugs or combinations with alkylating agents, purine analogues and anti-CD20 monoclonal antibodies; or the use of very new combinations that, without rejecting the previously mentioned drugs, include new agents, such as proteasome inhibitors, immunomodulatory agents or even histone deacetylase inhibitors and PI3K/AKT inhibitors, among others. Here we review the most recent results reported for the use of new combinations and new drugs in patients with WM at different stages of the disease.