Focus on rarer cancers – Waldenström’s macroglobulinemia - #worldcancerday2018 

Waldenström’s macroglobulinemia (also known as lymphoplasmacytic lymphoma) is a rare form of bone marrow cancer, where defective B cells (a type of white blood cell) are produced in a person's bone marrow and affect their immune system. Named after the Swedish doctor who first described the condition, symptoms may include night sweats, anaemia, weight loss, tiredness and symptoms of immune system damage causing infections such as pneumonia and shingles.

Around 400 people in the UK are diagnosed with Waldenström’s each year and because the condition is so rare, University College Hospitals NHS Foundation Trust has set up a specialist clinic to address the needs of this group of patients. Dr Shirley D'Sa is a consultant haematologist and one of the UK's leading experts in Waldenström’s.

Dr D'Sa said: " Waldenström’s macroglobulinemia often develops over a long period of time and many people have no symptoms at all making it difficult to diagnose. However, unlike many other cancers it is a slow disease to progress which means that once diagnosed some patients may be put under surveillance, or watch and wait, so we can analyse how the condition is developing and then decide if treatment is needed.”

If treatment is necessary, options may include chemotherapy or monoclonal antibodies which are drugs that attach themselves to certain proteins on the surface of cancer cells to help fight the disease. Some patients may be suitable for a stem cell transplant where stem cells are obtained usually from their own blood, or rarely from a matched donor, and they are infused (dripped slowly through a cannula into the patient’s vein) after a course of high-dose chemotherapy to reduce the WM disease to a low level.

Dr D’Sa added: “In general Waldenström’s macroglobulinemia is an obedient disease – it responds to treatment and this can restore well-being. Even if the disease behaves out of character or affects unusual areas, strategies exist to overcome these challenges.”

Dr D’Sa has been recognised recently for her work to improve the treatment options for patients with Waldenström’s macroglobulinemia through the Rory Morrison clinical award, named after the BBC journalist, which recognises clinicians that go above and beyond for their patients. Dr D’Sa was particularly praised for her part in obtaining funding for the cancer drug ibrutinib for relapsed WM patients from the NHS cancer drugs fund. Ibrutinib is a cell blocker drug that can help keep WM under control avoiding intensive chemotherapy.

Dr D’Sa commented: “Although Waldenström’s macroglobulinemia is difficult to cure completely, many patients live for a long time with their diagnosis through a combination of ‘watch and wait’ and the treatment options available. It’s a truly multi-faceted disease and biological developments are bringing a greater understanding of it all the time. I genuinely feel that the future for treating WM is brighter than ever which is good news for patients.”

Click here to read our webchat with Dr Shirley D’Sa.