Ibrutinib is another agent that has been approved for use in this condition. Combination treatment with Ibrutinib and Rituximab showed significantly  higher disease progression free survival than with just Rituximab treatment.Autologous bone marrow transplantation is a treatment option.Zanubrutinib is indicated for the treatment of adults with Waldenström macroglobulinemia. Salvage therapy
When primary or secondary resistance invariably develops, salvage therapy is considered. Allogeneic stem cell transplantation can induce durable remissions for heavily pre-treated patients. Drug pipeline
As of October 2010, there have been a total of 44 clinical trials on Waldenström macroglobulinemia, excluding transplantation treatments. Of these, 11 were performed on previously untreated patients, 14 in patients with relapsed or refractory Waldenström. A database of clinical trials investigating Waldenström macroglobulinemia is maintained by the National Institutes of Health in the US. Patient stratification
Patients with polymorphic variants (alleles) FCGR3A-48 and -158 were associated with improved categorical responses to rituximab-based treatments. Prognosis
Current medical treatments result in survival of some longer than 10 years; in part this is because better diagnostic testing means early diagnosis and treatments. Older diagnosis and treatments resulted in published reports of median survival of approximately 5 years from time of diagnosis. Currently, median survival is 6.5 years. In rare instances, Waldenström macroglobulinemia progresses to multiple myeloma.The International Prognostic Scoring System for Waldenströms Macroglobulinemia is a predictive model to characterise long-term outcomes.
Such failure is called biochemical failure and is defined as a PSA reading of 2.0 ng/mL above nadir (the lowest reading taken post primary treatment).As of August 2014, a clinical trial administering sipuleucel-T in conjunction with ipilimumab (Yervoy) was tracking subjects but no longer enrolling new subjects; the trial evaluates the clinical safety and anti-cancer effects (quantified in PSA, radiographic and T cell response) of the combination therapy in patients with advanced prostate cancer. References
This article incorporates public domain material from Dictionary of Cancer Terms. U.S. National Cancer Institute. Further reading
Huber ML, Haynes L, Parker C, Iversen P (February 2012). "Interdisciplinary critique of sipuleucel-T as immunotherapy in castration-resistant prostate cancer". Journal of the National Cancer Institute. 104 (4): 273–9. doi:10.1093/jnci/djr514. PMC 3283534. PMID 22232132. "Sipuleucel-T: APC 8015, APC-8015, prostate cancer vaccine--Dendreon". Drugs in R&D. 7 (3): 197–201. 2006. doi:10.2165/00126839-200607030-00006. PMID 16752945. External links
"Sipuleucel-T". Drug Information Portal. U.S. National Library of Medicine.