Onkológia 4/2017

Ibrutinib in treatment of Waldenström´s makroglobulinemia – case report

Objective: The main aim of our case report is to present the case of Waldenström´s macroglobulinemia and the experiences with the use of the Bruton kinase inhibitor in the second line of treatment. Case report: In the report we describe the course of Waldenström´s macroglobulinemia at 55 years old women patient. We achieved partial remission with the use of conventional chemotherapy and high – volume plasmapheresis in first – line therapy, but without improvement in clinical features and we also confirmed the progression of disease infiltration in bone marrow. Therefore, we used ibrutinib – Bruton´s kinase inhibitor in second – line therapy, which, despite not having curative potential, achieved stabilization of paraprotein´s level and significant improvement in clinical symptoms of disease. Conclusion: Waldenström´s macroglobulinemia is disease of the elderly often connected with polymorbidity in this age cathegory, which limits the use of conventional chemotherapeutic regimens. The use of Ibrutinib together with another mechanism of action with a relatively favorable toxicity profile allows the treatment of patients that are refractory or unsuitable for chemotherapy.

Keywords: Waldenström´s macroglobulinemia, lymphoplasmacytic lymphoma, neuropathy, ibrutinib, plasmapheresis