Corrigendum: Waldenström's macroglobulinaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (Annals of Oncology (2018) 29 (v41–iv50) (DOI: 10.1093/annonc/mdy146)

Abstract

For patients who relapse > 2-3 years after receiving a rituximab-based regimen, an alternative rituximab-based combination may be considered. If rituximab with cyclophosphamide was used (i.e. DRC), rituximab with either bendamustine (i.e. BR) or bortezomib either with or without dexamethasone (i.e. BDR or VR) may be used [IV, B] [40]. Rituximab with nucleoside analogues (FR, FCR) is an active but also toxic combination and therefore should be used cautiously [III, C]. For patients who achieve a prolonged remission with their primary therapy (i.e. > 3-4 years), re-instituting the prior regimen may also be considered [IV, B] [40]. Ibrutinib may also be a treatment option for patients with late relapses. Is replaced with: For patients who relapse between 1 and 3 years, ibrutinib is an appropriate treatment choice. An alternative rituximab-based combination might be considered in patients who are not eligible for ibrutinib or who relapse later in this time period. For patients who relapse >3 years after receiving a rituximab-based regimen, an alternative rituximab-based combination may be considered. If rituximab with cyclophosphamide was used (i.e. DRC), rituximab with either bendamustine (i.e. BR) or bortezomib either with or without dexamethasone (i.e. BDR or VR) may be used [IV, B] [40]. Rituximab with nucleoside analogues (FR, FCR) is an active but also toxic combination and therefore should be used cautiously [III, C]. For patients who achieve a prolonged remission with their primary therapy (i.e. > 4 years), re-instituting the prior regimen may also be considered [IV, B] [40]. Ibrutinib may also be a treatment option for patients with late relapses. In “Figure 2. Treatment algorithm for patients with relapsed or refractory WM” The following changes apply as shown in the updated version below. Under “Fit patient” 2–3 years Is replaced with: 1–3 years Clinical trial R-based regimen (repeat or alternate) [IV, B] Ibrutinib [III, A] Is replaced with: Clinical trial Ibrutinib [III, A] Alternate R-based regimen [IV, B] Under “Unfit patient” 2–3 years Is replaced with: 1–3 years Clinical trial Alternate R-based regimen Ibrutinib [III, A] Is replaced with: Clinical trial Ibrutinib [III, A] Alternate R-based regimen [IV, B] (Figure Presented).