Recommendations for initial therapy of patients with WM, based on the individual patient characteristics
| Clinical situation/individual patient characteristics . | Primary choice(s) . | Alternative (s) . |
|---|---|---|
| Patients with WM-related cytopenias or organomegaly | Rituximab-based combination | Bortezomib/rituximab |
| DRC | ||
| Bendamustine/R | ||
| Patients with symptomatic hyperviscosity, cryoglobulinemia or cold agglutinemia | Bortezomib followed by bortezomib/rituximab | Fludarabine/rituximab ± cyclophosphamide |
| Bendamustine/rituximab | ||
| Patients with paraprotein related neuropathy | Rituximab alone | Fludarabine/R |
| DRC | Bendamustine/rituximab | |
| Elderly patients with poor PS | DRC | Rituximab monotherapy |
| Oral fludarabine | Chlorambucil | |
| Elderly patients not eligible for systemic intravenous therapy | Oral fludarabine | Chlorambucil |
| Young patients eligible for ASCT | DRC | Bendamustine/rituximab |
| Bortezomib/rituximab | R-CHOP |
| Clinical situation/individual patient characteristics . | Primary choice(s) . | Alternative (s) . |
|---|---|---|
| Patients with WM-related cytopenias or organomegaly | Rituximab-based combination | Bortezomib/rituximab |
| DRC | ||
| Bendamustine/R | ||
| Patients with symptomatic hyperviscosity, cryoglobulinemia or cold agglutinemia | Bortezomib followed by bortezomib/rituximab | Fludarabine/rituximab ± cyclophosphamide |
| Bendamustine/rituximab | ||
| Patients with paraprotein related neuropathy | Rituximab alone | Fludarabine/R |
| DRC | Bendamustine/rituximab | |
| Elderly patients with poor PS | DRC | Rituximab monotherapy |
| Oral fludarabine | Chlorambucil | |
| Elderly patients not eligible for systemic intravenous therapy | Oral fludarabine | Chlorambucil |
| Young patients eligible for ASCT | DRC | Bendamustine/rituximab |
| Bortezomib/rituximab | R-CHOP |