Calquence is being developed for the treatment of multiple B-cell blood cancers including CLL, MCL, diffuse large B-cell lymphoma, Waldenstrom
macroglobulinaemia, follicular lymphoma, and multiple myeloma and other haematologic malignancies.
NICE had recently rejected the use of Imbruvica for patients with Waldenstrom's
macroglobulinaemia - a rare type of slow growing non-Hodgkin's lymphoma - due to what the committee determined to be a lack of cost-effective evidence and uncertainty concerning other subsets.
Xu et al., "Transcriptional repression of plasma cell differentiation is orchestrated by aberrant overexpression of the ETS factor SPIB in Waldenstrom
macroglobulinaemia," British Journal of Haematology, vol.
Mechanism Examples Impaired capillary Raynaud's phenomenon, acrocyanosis, blood flow peripheral vascular disease, Eisenmenger syndrome, circulatory shock, hypothermia Increased glycolysis Leukemia, polycythemia vera Hyperviscosity Plasma cell dyscrasias, for example, multiple myeloma, monoclonal gammopathy of unknown significance, Waldenstrom
macroglobulinaemia Medication Ascorbic acid, dopamine, mannitol, acetaminophen Preanalytic factors Delay in separation of plasma from formed blood contents
Hatjiharissi et al., "Recommendations for the diagnosis and initial evaluation of patients with Waldenstrom
macroglobulinaemia: a task force from the 8th International Workshop on Waldenstrom
macroglobulinaemia," British Journal of Haematology, vol.
Agglutination of red cells may be seen in cold haemagglutinin disease and waldenstroms
macroglobulinaemia [14,36].
* FDG PET/CT is not recommended for routine staging of nonFDG-avid nodal lymphomas (lymphoplasmacytic lymphoma/ Waldenstrom's
macroglobulinaemia, chronic lymphocytic leukaemia/small lymphocytic, marginal zone splenic, marginal zone unspecified).