Waldenstrom Macroglobulinemia Treatment

There is no cure for Waldenstrom macroglobulinemia, but people can live with Waldenstrom’s for many years with treatment because Waldenstrom’s is slow-growing, or indolent.

Watchful Waiting

Active surveillance, or “watchful waiting” requires you to be monitored closely by your physician. This “watch and wait” approach allows you to avoid the side effects from cancer treatment, since your disease is stable and not showing symptoms.


Chemotherapy uses drugs to attack cancer cells, slowing or stopping their ability to grow and multiply.

Chemotherapy is usually given:

  • Orally: taking pills or capsules by mouth
  • Intravenously (IV): injecting medication into a vein
  • Intramuscularly (IM): injecting medication into a muscle
  • Subcutaneously: injecting medication under the skin

Chemotherapy is not a "one-size-fits-all" cancer treatment.

The wide range of cancer-fighting drugs attack different types of cancer cells at varying stages of cell development.

Penn medical oncologists are experts at determining which drug or combination of drugs will be the most effective in treating your Waldenstrom macroglobulinemia.

For a comprehensive list of most commonly used chemotherapy agents, please visit OncoLink.

Complications and Side Effects of Chemotherapy

Chemotherapy kills cells in the body. Standard chemotherapy treatments do not distinguish “good” cells from “bad” cells. Therefore, even healthy cells may be killed.

Because of this, people who undergo standard chemotherapy are at high risk of infection. Your physician team can help you understand your risks, and how to lower your risk of infection.

Other side effects from chemotherapy include:

  • Low blood counts
  • Hair loss
  • Mouth sores
  • Nausea
  • Vomiting

Learn more about managing cancer treatment side effects.


Plasmapheresis is the removal of the blood’s plasma. Blood is taken from the patient, the plasma is removed and the remaining white and red blood cells are returned to the body.

Targeted Molecular Therapy

Targeted molecular therapy at Penn Medicine is a type of personalized medical therapy designed to treat cancer by interrupting unique molecular abnormalities that drive cancer growth.

Targeted therapies are drugs that are designed to interfere with a specific biochemical pathway that is central to the development, growth and spread of that particular cancer.

Because not every cancer develops in the same way in every person, targeted molecular therapy is personalized to you and your type of cancer.

In some cancers the molecular targets are known. But in other cancers these targets are still being identified. In some cases, the same types of cancer have different molecular targets.

Identifying the molecular targets in any given patient's cancer requires working closely with pathologists to carefully analyze the cancer pathology.

Targeted cancer therapies such as targeted molecular therapy give medical oncologists a better way to customize cancer treatment. Advantages of molecularly targeted therapy include:

  • Potentially less harm to normal cells
  • Potentially fewer side effects
  • Improved effectiveness
  • Improved quality of life

Radiation Therapy

Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time. In many cases, radiation therapy is capable of killing all of the cancer cells.

Radiation oncologists at Penn Medicine are recognized for techniques that target radiation precisely to the disease site while sparing nearby tissue.

Stem Cell Transplant

Your doctor may speak with you about a stem cell transplant.

  • An autologous stem cell transplant uses your own stem cells. This is a method to deliver high-dose chemotherapy that may be more effective in eradicating cancer cells.
  • An allogeneic transplant uses donor bone marrow or stem cells to replace the cells destroyed by the cancer treatment. A series of special tests are performed to find a donor who is a match for you.

About Our Bone Marrow and Stem Cell Program

Our bone marrow and stem cell transplant team are the same clinicians responsible for your overall treatment and care.

Other ways our bone marrow and stem cell transplant program are unique:

  • Our program is backed by a premier bone marrow and stem cell transplant research program that continues to make history in the development of new treatments through basic science research and clinical trials.
  • We have nationally recognized experts available to provide information, care and support throughout the transplant process.
  • Our bone marrow and stem cell transplant program is one of the oldest and largest in the country, and has pioneered new therapies to treat blood cancers.
  • We have one of the few hematologic malignancy (leukemia, lymphoma and myeloma) research programs in the country that is approved and funded by the National Cancer Institute.
  • We have a dedicated hospital unit that is completely equipped to support transplant patients. Experienced nurses who understand the medical and personal issues patients face during transplant staff the unit.
  • We serve as medical advisors for area outreach organizations, such as the Multiple Waldenstrom macroglobulinemia Networking Group and the Leukemia and Lymphoma Society.

Learn more about bone marrow and stem cell transplants at the Abramson Cancer Center.

Clinical Trials at Penn Medicine for Waldenstrom Macroglobulinemia

Because clinical trials are updated frequently, it’s important to ask your physician about clinical trials throughout your entire treatment.

Advantages of Clinical Trials

Being in a clinical trial offers you the opportunity to be treated with treatments, medications or agents that are not otherwise available.

It also gives you the opportunity to be treated by, and have your case reviewed by experts who are directly involved with the design of the treatment.

Through clinical trials:

  • Diagnosing cancer has become more precise
  • Radiation and surgical techniques have advanced
  • Medications are more successful
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes
  • Strategies to address the late effects of cancer and its treatment have been developed to improve the quality of life

Learn more about clinical trials, frequently asked questions about clinical trials, and available clinical trials at the Abramson Cancer Center.

Complementary and Integrative Therapies

In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy.

These therapies do not have curative intent, and are designed to complement standard treatments – not take their place.

Integrative Oncology Services

Our integrative oncology services can supplement traditional cancer treatments such as chemotherapy.

While conventional medicine plays a critical role in eradicating cancer, integrative oncology services offer you and your family ways to minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

We are knowledgeable of and support complementary cancer treatments.

Our cancer teams work with patients and families to integrate these supportive programs into the overall care plan, while ensuring the safety and health of patients.

Our integrative supportive services include:

  • Acupuncture
  • Diet and nutrition
  • Mindfulness-based stress reduction therapy
  • Reiki therapy
  • Yoga
  • Exercise and rehabilitation

Read more about Integrative Oncology Services.