American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common treatment for Waldenström macroglobulinemia?

1. Chemotherapy only

2. Rituximab monotherapy or combination therapy

3. Stem cell transplant

4. High-dose radiation therapy

The correct answer is: Rituximab monotherapy or combination therapy

A common treatment for Waldenström macroglobulinemia is the use of rituximab, either as monotherapy or in combination with other agents. This monoclonal antibody targets CD20 on B-cells, which play a significant role in the pathophysiology of this condition. Patients often benefit from rituximab due to its ability to reduce the levels of monoclonal immunoglobulin (IgM) in the blood, thereby alleviating symptoms associated with the disease, such as hyperviscosity and anemia. Rituximab can be combined with other chemotherapeutic agents to enhance its efficacy and improve patient outcomes. This strategic approach is favored in the management of Waldenström macroglobulinemia, as it addresses the underlying disorder more effectively than monotherapy with chemotherapy alone. The nuanced use of rituximab in various combinations has been shown to lead to better response rates and longer progression-free survival for patients compared to using chemotherapy in isolation. Other potential treatments such as stem cell transplantation and high-dose radiation therapy are generally less common and reserved for specific situations, given the overall prognosis and characteristics of the disease. Therefore, the use of rituximab, whether alone or combined with other therapies,