Inclusion Criteria:

● Established diagnosis of Waldenström macroglobulinemia (the 2nd Workshop on
Waldenstrom's macroglobulinemia)

Patient must have had 1 (or 2) lines of chemotherapy containing alkylating agent and/or
Fludarabine :and /or monoclonal antibody and must have :

- Life expectancy > 3 months

- Age > 18 years

- ECOG performance status 0-1-2

- ANC > 1 x 109/L

- Creatinine clearance, calculated according to the formula of cockcroft and Gault > 40
ml/min

- Total bilirubin < 2x ULN

- ASAT, ALAT < 2x ULN

- A negative serum pregnancy test one week prior to treatment must be available both
for pre-menopausal women and for women who are < 2 years after the onset of menopause

- Adequate contraceptive methods for males and pre-menopausal females for 6 months
after treatment discontinuation.

- Written informed consent

- Platelets> 100X 109

Exclusion Criteria:

- Active secondary malignancy or chemotherapy/radiotherapy for any neoplastic disease
other than Waldenström macroglobulinemia prior to the study

- Medical condition requiring the long-term (estimated to be more than one month) use
of oral corticosteroids

- Patients with active bacterial, viral or fungal infection

- Known infection with HIV, Hepatitis B (except post vaccinal profile) or C

- Treatment with any, other investigational agent or participating in another trial
within 30 days prior to entering this study

- Lactation/pregnancy

- Concurrent severe diseases which exclude the administration of therapy heart
insufficiency NYHA grade III/IV, LEVF < 50% and or RF < 30%, myocardial infarction
within the past 6 months prior to study

- Severe pulmonary or heart problems (acute diffuse pulmonary and pericardial disease)

- Severe chronic obstructive lung disease with hypoxemia

- Severe diabetes mellitus

- Hypertension difficult to control

- Impaired renal function with creatinine clearance < 40 ml/min according to the
formula of Cockcroft and Gault

- Cerebral dysfunction

- Richter's syndrome

- Neuropathy> grade 1

- Positive Beta HCG

- Severe Hepato cellular alteration