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Waldenstrom macroglobulinemia (WM), or lymphoplasmacytic lymphoma, is a rare B-cell malignancy characterized by immunoglobulin M (IgM) paraproteinemia and, in many cases, hyperviscosity-related complications. Currently, there is no standard initial treatment for WM patients.
To evaluate long-term outcomes of initial WM therapy with the nonalkylator regimen of bortezomib, dexamethasone, and rituximab (BDR), European investigators conducted a multicenter, phase II trial involving 59 newly diagnosed symptomatic patients, of whom 61% were older than 65 years. Owing to the known risk for acute rise in IgM level and associated flare in hyperviscosity when rituximab is used in the initial treatment cycle, patients received bortezomib in cycles 1 th…