Suggested genomic-driven treatment algorithm in patients with WM. *In patients with hyperviscosity, plasmapheresis should be instituted urgently. Single-agent rituximab can be considered in patients with a low burden of disease. Rituximab can induce a temporary but potentially significant IgM flare. **Maintenance therapy can be considered in patients who have responded to chemoimmunotherapy. MUT, mutated; WT, wild type.