Bortezomib (BDR regimen)

Proteasome inhibitor (with dexamethasone + rituximab)

Response rate
~80-85% (frontline BDR)
Onset
Weeks-months
Route
SC 1.3mg/m2 (weekly) + dexamethasone + rituximab
Line
1st
IgM effect
Significant reduction

Evidence summary

Proteasome inhibitor active against plasma cell component of WM. Used in BDR (bortezomib-dexamethasone-rituximab) combination. Effective in both frontline and relapsed settings. Risk of peripheral neuropathy limits use, especially in patients with pre-existing IgM neuropathy. Subcutaneous route reduces neuropathy risk.

Sources (3)

DetailsGertz MA (2023) WM: 2023 update on diagnosis, risk stratification, and management · Am J HematolDOI
DetailsGertz MA (2025) WM: 2025 update on diagnosis, risk stratification, and management · Am J HematolDOI
DetailsTreon SP (2015) How I treat Waldenström macroglobulinemia · BloodDOI