Genomic-based treatment algorithm for patients with symptomatic, previously treated WM. Clinicians should consult local regulatory approvals and guidelines for BTKi status and use in WM. Algorithm represents the recommendations of the authors based on clinical trial data summarized in the text, consensus recommendations (as previously reported⁶⁸), and their practice experiences with patients with WM. Recommendations are intended for educational purposes. See also notations for Figure 2. Nucleoside analogues should be avoided in younger patients, and candidates for autologous stem cell transplantation. Autologous stem cell transplantation may be considered in patients with multiple relapses and chemotherapy-sensitive disease, and those with amyloidosis for consolidation after PI or Benda-R therapy (as discussed elsewhere⁶⁶). ¹Zanubrutinib may also be prioritized for those with TP53 alterations (discussed elsewhere³⁵). Clinical trial options should always be considered.