Multiple Myeloma Treatment Information for Healthcare Professionals

Macroglobulinemia

The guidelines for the treatment of patients with macroglobulinemia are similar to those for multiple myeloma. Because macroglobulins are large proteins, which are confined to the intravascular space, patients must be observed for the occurrence of hyperviscosity syndrome.

There is no staging system in general use. The median survival of patients with macroglobulinemia is longer (that is, approximately 60 months) than for multiple myeloma. Only symptomatic patients should be treated. See the PDQ summary on adult non-Hodgkin's lymphoma for information on the treatment of Waldenstrom's Macroglobulinemia.

Treatment options:

1. Careful monitoring for evidence of disease progression without immediate chemotherapy in asymptomatic patients.
   
2. Standard treatment with any alkylator, such as chlorambucil, administered on a daily or intermittent schedule.¹

Good results have also been reported for patients treated with a combination of melphalan + vincristine + cyclophosphamide + carmustine + prednisone (the M2 protocol).²

References:

1. Kyle RA, Garton JP: The spectrum of IgM monoclonal gammopathy in 430 cases. Mayo Clinic Proceedings 62(8): 719-731, 1987.
2. Case DC, Ervin TJ, Boyd MA, et al.: Waldenstrom's macroglobulinemia: long-term results with the M-2 protocol. Cancer Investigation 9(1): 1-7, 1991.

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