Dose of ibrutinib in Waldenstrom macroglobulinaemia: Less can be more

Ibrutinib changed the landscape of treatment in Waldenstrom macroglobulinaemia (WM) with excellent responses; however, there are high rates of dose reduction due to adverse events. The impact of this reduced dosing is unclear with regards to outcomes. Sarosiek and colleagues provide valuable data in a very large retrospective study demonstrating that dose reduction is effective in managing adverse events in the majority, with equivalent, if not better, outcomes than those without dose reductions.