Aspiration has been suspected as a possible cause of WML. However, we were unable to find any evidence of aspiration in any case. We were unable to find any evidence for vaccination as a cause of WML. However, this may be due to the difficulty in identifying the cause of WML. In a recent study, findings also suggests that WML is not an autoimmune disease. In view of these findings it is likely that the underlying cause of WML is associated with the production, and thus clearance, of circulating WMAL-Ig-MA in patients with WML.
There isn’t a single national surveillance program, national survey or study, that can monitor the incidence of WALM. At present, the only way to track the incidence of WALM nationwide is through individual reports from physician"
Waldenstrom macroglobulinemia is a potentially curable, monoclonal gammopathy characterized by an expanded lymphoplasmacytic-immunoglobulin clone (B cell). The neoplastic proliferating clone does not seem to be in need of immunoglobulin for survival.
In WMA, most patients are treated with cytotoxic drugs including chlorambucil, cyclophosphamide, procarbazine, hydroxydaunorubicin, vincristine, and lenalidomide. Other drugs include methotrexate, thalidomide, and rituximab. In some cases, the therapy may include allogeneic hematopoietic stem-cell transplantation.
Most people with waldenstrom macroglobulinemia do not experience any symptoms or signs. Asymmetrical hair and pigmentation, which are common features of waldenstrom macroglobulinemia, are not necessarily signs of the disease. Rarely, some patients may experience an elevated white blood cell count. The symptoms of waldenstrom macroglobulinemia include anemia, fatigue or low energy, fever, hair loss, swollen lymph nodes, and blood in the urine. In advanced cases, the symptoms can include gastrointestinal bleeding, neurological symptoms, and loss of appetite.
The possibility of complete remission with chemotherapy alone is very low. However, some people with refractory WM with multiple relapses can achieve complete remissions after multiple cycles of chemotherapy alone and be cured. The optimal therapy of WM should be tailored to the individual patient according to the pattern of clinical responses to conventional first-line chemotherapy and/or treatment failure.
There are two ongoing clinical trials that are recruiting patients and enrolling study arms for patients with myeloma. At present, we know that other clinical trials have been conducted involving dasatinib in myeloma. There is currently no indication of dasatinib failing or causing side effects in patients with MM. We hope that the presence of such clinical trials in the past (and currently for myeloma) will help patients and clinicians find the best therapy for each patient and not just the most available therapies available. The current study is a Phase 2 Trial. There is still no indication of dasatinib failing or causing side effects in patients with MM.
The average age of onset for a patient with Waldenstrom macroglobulinemia is 74 years. For patients with Waldenstrom macroglobulinemia, the average age of diagnosis is 71 years. It is uncommon for Waldenstrom macroglobulinemia to be diagnosed before 70 years of age. The average age when complete remission occurs is 83 years. The average survival of Waldenstrom macroglobulinemia is 12.8 and a patient who is disease free, no treatment and reaches 95 years of age.
Currently, the only available therapeutic options for adults with Waldenström macroglobulinemia are cytotoxic or bone marrow transplantation. However, these procedures are not available for all patients because some individuals or their families do not seek care. In particular, one important subset of patients has been undertreated. Based on these observations, dasatinib, a targeted therapy, has the potential to address both the patient and their family needs for an improved outcome.
The familial aggregation of WMC is seen in two distinct populations. One was noted in persons with MGUS. Thus, it is most likely unrelated to the presence of WMC on blood tests. The second population is not related to WMC.
Dasatinib is associated with several common side effects that warrant consideration during treatment. Most commonly, diarrhea and vomiting are the most common side effects resulting from dasatinib use.
The safety of dasatinib in this real-life study is consistent with the reassuring observational studies of dasatinib use in children. The data in this study suggest that dasatinib may have an acceptable safety profile for people with WM in real-life clinical practice.