Common treatment regimes
For people with Waldenstrom's macroglobulinaemia, the most common first-line treatments are combinations of drugs. These combinations are known as ‘regimens’.
Regimens are usually split into cycles. You’ll have the drugs at one point in the cycle, before having a period of not taking them. Because treatment can have side effects or be harsh on your body, cycles give your body time to recover. Cycles vary in length depending on what drugs you are taking, but usually last around 2-6 weeks. You’ll normally have multiple cycles as part of your treatment.
Treatment regimens used for WM
There are two regimens most commonly used to treat Waldenstrom's macroglobulinaemia: BR and DRC. Both these regimens have shown to effectively reduce the amount of cells that cause WM, helping people living with WM to go into remission and feel better. They’re also safe regimens to have had if you are offered a stem cell transplant later on.
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Both these regimens are recommended as first-line treatment for WM patients.
Is one regimen better than the other?
The type of treatment you’re offered will be down to your individual circumstances, including your general health and symptoms.
There aren’t any trials that have directly compared BR and DRC. Researchers have looked at other data about the regimens and found evidence to suggest that BR may be more effective in the long term, meaning that your Waldenstrom's macroglobulinaemia could take longer to come back. In the study, people who receive BR and DRC had similar responses, meaning both regimens were effective in killing the cells responsible for WM.
BR is a more toxic treatment, meaning that can be harsh on the body and isn’t suitable for everyone. Sometimes the dose might need to be reduced or you may not have as many cycles as your doctor planned because of the treatment’s toxicity.
DRC is less toxic, and studies have shown that fewer people get serious side effects that affect their treatment and quality of life.