← Kelly Casteel, MD

Six Decades of Waldenström Macroglobulinemia Therapy

An interactive, clinician-facing chronicle of the trials that reshaped Waldenström macroglobulinemia — from the alkylator and purine‑analog era through rituximab chemoimmunotherapy and proteasome inhibitors to the BTK‑inhibitor revolution of ibrutinib and zanubrutinib, and the emerging non‑covalent BTK and BCL‑2 agents. Click any drug to trace its Phase 1→3→approval lineage; click a trial for arms, endpoints, results, and FDA/EMA milestones.

Data verified against ClinicalTrials.gov & primary literature · last reviewed Jul 2026

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Drug class

Trial phase

Ph 1 Ph 2 Ph 3

Status

Approved Investigational Withdrawn / failed

Activity

Ongoing only

NCCN

In NCCN v2.2026 Category 1 only

Reference

Solid outline = approved Dashed outline = investigational Dashed rose = withdrawn / failed Pulsing dot = ongoing trial ✓badge = FDA / EMA approved NCCN category badge (1 / 2A / biomarker) Ambient curve = rising survival as approvals accrue

Scroll horizontally → · click a drug node to open its trial lineage

NCCN preferred regimens by line of therapy

Derived from NCCN Clinical Practice Guidelines in Oncology — Waldenström Macroglobulinemia / Lymphoplasmacytic Lymphoma, Version 2.2026

Preference tiers (Preferred / Other Recommended / Useful in certain circumstances) and Categories of Evidence (1, 2A) are summarised for reference and attributed to NCCN. This is not a reproduction of the guideline; consult the authoritative, current version at nccn.org. Click a drug chip to jump to that agent’s trial lineage. Evidence categories and tiers are summarised for reference.