Macroglobulinemia of Waldenstrom
Macroglobulinemia of Waldenstrom is a cancer of the B lymphocytes (a type of white blood cell). It is associated with the overproduction of proteins called IgM antibodies.
Waldenstrom macroglobulinemia; Macroglobulinemia - primary; Lymphoplasmacytic lymphoma
Waldenstrom macroglobulinemia is a result of a condition called lymphoplasmacytic lymphoma. What causes too much production of the IgM antibody is unknown. Overproduction of IgM causes the blood to become too thick. This is called hyperviscosity. It can make it harder for blood to flow through small blood vessels.
Waldenstrom macroglobulinemia is very rare. Most people with this condition are over age 65, but it may occur in younger people.
Symptoms may include any of the following:
- Bleeding of the gums
- Blurred or decreased vision
- Bluish skin
- Easy bruising of the skin
- Flank pain
- Mental status changes
- Numbness, tingling, or burning pain in the hands, feet, fingers, toes, ears, or nose
- Swollen glands
- Unintentional weight loss
- Vision loss in one eye
Exams and Tests
A physical examination may reveal a swollen spleen, liver, and lymph nodes. An eye exam may show enlarged veins in the retina or retinal bleeding (hemorrhages).
A CBC shows a low number of red blood cells and platelets. A blood chemistry shows evidence of kidney disease. A serum viscosity test can tell if the blood has become thick. Symptoms usually occur when the blood is four times thicker than normal.
A test called serum protein electrophoresis shows an increased level of the IgM antibody. Levels are often higher than 3 grams per deciliter (g/dL).
Bone lesions are very rare. If they are present, a bone marrow examination will show cells that resemble both lymphocytes and plasma cells.
Additional tests that may be done:
- 24-hour urine protein
- Total protein
- Serum globulin electrophoresis
- Immunofixation in urine
- T (thymus derived) lymphocyte count
Plasmapheresis removes unwanted substances from the blood. In macroglobulinemia, it removes or reduces the high level of IgM, and is used to quickly control the symptoms caused by blood thickening.
Drug therapy may include corticosteroids or combinations of chemotherapy drugs.
Patients who have a low number of red or white blood cells or platelets may need transfusions or antibiotics.
The average survival is about 6.5 years. Some people live more than 10 years.
In some persons, the disorder may produce few symptoms and progress slowly.
- Changes in mental function, possibly leading to coma
- Congestive heart failure
- Gastrointestinal bleeding
- Vision problems
When to Contact a Medical Professional
Call your health care provider if symptoms of this disorder develop.
National Cancer Institute: PDQ Adult Non-Hodgkin Lymphoma Treatment. Bethesda, MD. National Cancer Institute. Date last modified 4/11/2014. Available at: www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/HealthProfessional. Accessed June 9, 2014.
Rajkumar SV. Plasma cell disorders. In: Goldman L, Schaer AI, eds. Goldman's Cecil Medicine. 23rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 193.
Reviewed By: Todd Gersten, M.D., Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.