中華民國血液病學會

1. Which statement is false?

A. Petechiae, hematuria, bruising, rectal bleeding, epistaxis, or intracranial hemorrhage were reported as WM related manifestations.

B. In WM patients, the suspected inhibitory coating of platelets by IgM protein, resulting in reduced platelet adhesion and aggregation.

C. Thrombocytopenia is not a common (<5%) occurrence in WM.

D. Amyloidosis can be associated with potentially life-threatening hemorrhage in WM.

2. Which statement is false?

A. Bleeding symptoms usually resolve after therapeutic intervention.

B. If unexplained clinical bleeding or bruising is present, von Willebrand disease (VWD) testing is recommended, as acquired VWD has been identified in some cases of WM, usually with high serum IgM levels.

C. Major bleeding occurred rates in patients receiving ibrutinib in combination with antiplatelet reagents or anticoagulants would not enhance compared with receiving ibrutinib monotherapy.

D. Less specific BTKi (ex. ibrutinib) can inhibit other tyrosine kinases such as TEC, ITK, TXK, and EGFR to enhance bleeding rates.

3. Which statement is false?

A. Bendamustine/rituximab, zanubrutinib and ibrutinib±rituximab for WM primary therapies are all classified as category 1 in NCCN guidelines.(version)

B. Some studies reported treatment of WM patients with antiplatelet or anticoagulant therapies in combination with ibrutinib is common because of a significantly increased risk of atrial fibrillation with ibrutinib.

█ C. The role of autologous stem cell transplantation (ASCT) is clear and can be considered in young patients with aggressive disease behavior.

D. For clinical bleeding patients, monitoring FBC, routine platelet function analysis (particularly with use of TKIs, DOACs, antiplatelets, or surgical intervention likely), and haemoglobin/haematocrit may considered.

The correct answer is as follows

1.Which statement of is false?

A: (C) Thrombocytopenia is not a common (<5%) occurrence in WM.

2.Which statement of is false?

A: (C) Major bleeding occurred rates in patients receiving ibrutinib in combination with antiplatelet reagents or anticoagulants would not enhance compared with receiving ibrutinib monotherapy.

3.Which statement is false about treatment response criteria in NCCN?

A: (A) Bendamustine/rituximab, zanubrutinib and ibrutinib±rituximab for WM primary therapies are all classified as category 1 in NCCN guidelines.(version)