Supportive treatments are designed to counteract some of the symptoms of the lymphoma and the side effects of the treatments. In WM, these supportive treatments include antibiotics that are given to prevent infections (which may occur during chemotherapy cycles), blood transfusions and plasmapheresis

Antimicrobial prophylaxis

Patients who are receiving chemotherapy often need to take medications to help prevent infections. This often involves the antibiotic, co-trimoxazole, and the anti-viral medication, acyclovir. Some patients will also need to take anti-fungal treatment.

Blood transfusions

Your blood counts can decrease as a result of the WM itself or because chemotherapy is affecting your bone marrow as a side effect. If the counts fall to levels that cause troublesome symptoms, the medical team will consider giving you red cell or platelet transfusions. Transfusions are given through a cannula (a thin flexible tube) into the vein and this can be done either as a day patient or as an inpatient. White blood cells cannot be given by transfusion. Growth factor injections can be used to boost the white blood count if that is low.

Plasma exchange

If the IgM protein in the blood is causing symptoms such as breathing problems, the blood can be thinned by a procedure called ‘plasmapheresis’. This is alternatively called ‘plasma exchange’ and it takes 1–3 hours. In this procedure a cannula is placed into a vein in each arm. Blood is slowly removed from one arm and the blood is passed through a special machine that separates the liquid part of the blood—the ‘plasma’ which contains the IgM protein—from the blood cells. The blood cells are then passed back, together with an artificial plasma substitute, into the other arm.

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