Does chemotherapy treat waldenstrom macroglobulinaemia?

Waldenstrom macroglobulinaemia is a blood cancer involving abnormal lymphoplasmacytic cells and an excess of an antibody called IgM. Some people are monitored without immediate treatment when they have no troublesome symptoms. Treatment is considered when the disease causes problems such as anaemia, bleeding, enlarged lymph nodes, nerve symptoms or thickened blood flow.

Chemotherapy medicines may be combined with targeted medicines or an antibody treatment. The most suitable approach depends on symptoms, IgM level and its effects, blood counts, organ function, previous treatment and whether rapid reduction is needed. A procedure called plasma exchange may be used urgently for symptoms caused by thick blood, but it does not replace cancer treatment.

Ask whether treatment is needed now and what problem it is intended to improve. Review infection history, vaccinations, medicines and nerve symptoms before starting. Ask how blood counts, IgM and organ function will be monitored, how quickly improvement is expected, and whether a treatment change would be considered if the response is limited.

Seek urgent medical advice for new confusion, severe headache, vision changes, unusual bleeding, chest discomfort, breathlessness or sudden weakness. During chemotherapy, promptly report fever, chills, persistent vomiting, severe diarrhoea or any infection symptoms.

What is causing my symptoms, and how will treatment address it? Is chemotherapy being used alone or with another medicine? What warning signs could indicate thickened blood or an infection?