Waldenström macroglobulinemia is a rare, slowgrowing non-Hodgkin lymphoma. WM is also called lymphoplasmacytic lymphoma. It starts in white blood cells called B Lymphocytes or B cells.
B cells are an important of the body’s immune system that form in the lymph nodes, spleen and other lymphiod tissues, including bone marrow. Some B cells transform into plasma cells that create, store and release antibodies that protect the body. Lymphoplasmacytic cells are cells that are in the process of maturing from cells to plasma cells. In WM, abnormal lymphoplasmacytic cells multiply out of control, producing large amounts of a protein called monoclonal immunoglobulin M (IgM or “macroglobulin”) antibody. High levels of IgM in the blood cause hyperviscosity (thickness or gumminess), which leads to many of the symptoms of WM.
Waldenström Macroglobulinemia Symptoms
Some patients do not have symptoms. For those who do have symptoms, the most common ones are weakness, severe fatigue, bleeding from the nose or gums, weight loss, and bruises or other skin lesions. Severely high levels of IgM can lead to hyperviscosity syndrome, in which the blood becomes abnormally thick. Symptoms of this syndrome include visual problems (e.g., blurring or loss of vision) and neurological problems (e.g., headache, dizziness, vertigo). During a physical exam, a doctor may also find swelling of the lymph nodes, spleen and or liver.
Waldenström Macroglobulinemia Diagnosis
Initial diagnosis of WM is based on blood test and bone marrow biopsy results. Blood tests are used to determine the level IgM in the blood and the presence of proteins, or tumor markers, that can indicate WM. For the biopsy, a sample of bone marrow (soft, sponge-like tissue in the center of most bones) is removed, usually from the back of the pelvis bone, through a needle for examination under a microscope. The pathologist (a doctor who identifies diseases by studying cells and tissue under a microscope) looks for certain types of lymphocytes (white blood cells) that indicate WM.1 Flow cytometry (a method of measuring cell properties using a light-sensitive dye and laser or other type of light) is often used to look at markers on the cell surface or inside the lymphocytes.
Waldenström Macroglobulinemia Treatment
- High-dose chemotherapy with autologous stem cell transplantation
- Splenectomy
- Thalidomide and bortezomib
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