From the Research
Patients with Waldenstrom's macroglobulinemia should consult their hematologist before taking aspirin, as it may not be appropriate for all patients due to the potential increased bleeding risk. Aspirin can increase bleeding risk, which is particularly concerning for Waldenstrom's patients who may already have bleeding tendencies due to hyperviscosity syndrome or low platelet counts associated with their condition or treatments 1. If a patient needs pain relief or anti-inflammatory medication, acetaminophen (Tylenol) is often a safer alternative that doesn't affect platelet function. For those who require aspirin for cardiovascular protection, the hematologist might approve a low dose (typically 81 mg daily) after evaluating the patient's complete blood count, IgM levels, and viscosity studies, as seen in a study where patients with Waldenstrom's macroglobulinemia were given enteric-coated aspirin 81 mg orally daily 1. The decision involves weighing cardiovascular benefits against bleeding risks, especially for patients on certain treatments like BTK inhibitors (ibrutinib, zanubrutinib) which can increase bleeding risks when combined with aspirin 2. Some key points to consider include:
- Aspirin may not be suitable for all patients with Waldenstrom's macroglobulinemia due to bleeding risks.
- Alternative pain relief medications like acetaminophen may be safer.
- Hematologist evaluation is necessary before starting aspirin for cardiovascular protection.
- Low-dose aspirin (81 mg daily) may be considered after thorough evaluation.
- Regular monitoring of blood counts and symptoms is crucial for patients taking aspirin. Given the most recent evidence from 2025, the management of Waldenstrom's macroglobulinemia involves careful consideration of treatment options and their potential side effects, including bleeding risks associated with aspirin use 3.