Waldenstrom macroglobulinemia

What is Waldenstrom macroglobulinemia?

Waldenstrom macroglobulinemia (WM) is a rare blood cancer that thickens blood to four times more than normal, making it hard to flow through small vessels.

WM is also known as lymphoplasmacytic lymphoma, which describes the condition where certain white blood cells—usually the B lymphocytes—begin rapidly dividing. This process produces too much of an antibody known as IgM, and it’s this excess IgM that causes the blood to thicken.

WM cancer cells have both the features of plasma cells, similar to multiple myeloma cancer cells, and lymphocytes, similar to non-Hodgkin lymphoma cells.

The causes of WM are unknown

Those affected by this very rare disease are usually over 65, though WM can occur at younger ages. WM tends to spread slowly and can be well-controlled when diagnosed early.

Doctors don’t know the specific cause of WM and point to a combination of factors, such as environment, genetics, and viruses, as possible causes. At some point after birth, a person’s DNA inside normal lymphocytes changes the cells to cancerous lymphoma- or multiple myeloma-like cells.

Symptoms reflect low numbers of healthy blood cells

Patients may experience symptoms that include:

• Fatigue
• Bleeding of the gums and nose bleeds
• Blurred or decreased vision
• Dizziness, headache, confusion
• Easy bruising of the skin
• Numbness, tingling, or burning pain in the hands or feet
• Unintentional weight loss
• Swollen glands

In some cases, WM patients may not yet be experiencing symptoms.

Detecting WM

Findings during physical exams may show a swollen spleen, liver, or lymph nodes. An eye exam may show enlarged veins in the retina or even broken retinal veins.

Based on a patient’s symptoms, doctors may order blood tests to determine the levels of IgM protein in the blood. Higher than normal IgM levels are an indication WM may be developing. A test called serum protein electrophoresis also can detect IgM levels.

Usually doctors confirm a WM diagnosis with a careful study of bone marrow or lymph node tissue to determine if abnormal lymphocytes are present.

Treatments for WM will vary

Your doctor will determine the best course of treatment based on a number of factors, including how quickly the WM is developing. For patients without serious or bothersome symptoms, the initial option may be to watch the disease closely and hold treatment until needed.

When treatment is needed, several options are possible, including:

• Chemotherapy – use of medicines to target and destroy affected cancerous cells
• Immunotherapy – use of the patient’s immune system to create antibodies to destroy cancerous cells
• Plasma exchange (Plasmapheresis) – use of blood plasma to lower the thickness of the blood
• Stem cell transplantation with high-dose chemotherapy – use of replacement stem cells to reset the body’s immune system
• Radiation therapy – use of targeted doses of radiation to shrink affected lymph nodes or an enlarged spleen

Success of treatment

With early diagnosis and delivery of appropriate therapy, survival rates have increased over the years. WM cases nationally show an average survival rate of up to 20 years or more. Patients’ outcomes will vary, based on their particular case. It’s important for patients to discuss their individual prognosis with their doctor.