Waldenström Macroglobulinemia
Waldenström macroglobulinemia happens when B cells (immune cells) in the bone marrow, where blood cells are made, turn into cancer cells. Bone marrow is the soft, fatty tissue inside bone cavities that produces red blood cells, white blood cells, and platelets.
Overview
Waldenström macroglobulinemia (WM), also called lymphoplasmacytic lymphoma, is a rare, slow-growing type of non-Hodgkin lymphoma. It develops when abnormal B lymphocytes grow in the bone marrow and produce excessive amounts of an antibody called immunoglobulin M (IgM).
Too much IgM can thicken the blood, making it harder to flow through small blood vessels and causing symptoms such as fatigue, vision changes and bleeding problems. Although there is currently no cure, several treatments can effectively control the disease and relieve symptoms for many years.
Risk Factors
Factors We Cannot Control
Older Age
Most people diagnosed with Waldenström macroglobulinemia are 65 years or older.
Family History
Having close biological relatives with Waldenström macroglobulinemia or other lymphomas may increase the risk.
Certain Medical Conditions
Conditions such as hepatitis C, HIV/AIDS and Sjögren's syndrome have been associated with a higher risk.
Lifestyle & Health Factors
Acquired Gene Mutations
Mutations involving the MYD88 and CXCR4 genes commonly occur during life and contribute to disease development.
Symptoms
1. Fatigue and Weakness
Anemia caused by abnormal bone marrow function commonly leads to tiredness and weakness.
2. Night Sweats and Fever
Some people experience unexplained fever, night sweats and weight loss.
3. Blurred Vision and Headaches
High IgM levels can thicken the blood and cause headaches, dizziness and blurred vision.
4. Bleeding Problems
Frequent nosebleeds or bleeding gums may occur because thickened blood affects circulation.
5. Peripheral Neuropathy
Numbness or tingling in the hands and feet can develop due to nerve involvement.
Diagnosis
1. Blood and Urine Tests
These tests check blood cell counts and measure abnormal IgM protein levels.
2. Bone Marrow Biopsy
A bone marrow sample is examined to identify abnormal lymphoplasmacytic cells.
3. CT or PET-CT Scan
Imaging helps detect enlarged lymph nodes, spleen or other affected organs.
4. Eye Examination
An eye exam can detect bleeding or changes caused by thickened blood.
Treatments
1. Plasmapheresis
This procedure removes excess IgM protein from the blood to quickly relieve symptoms caused by thickened blood.
2. Immunotherapy
Medicines such as rituximab help the immune system destroy abnormal B cells.
3. Chemotherapy
Chemotherapy drugs may be used alone or combined with immunotherapy to control the disease.
4. Targeted Therapy
Targeted medicines such as BTK inhibitors block proteins that help cancer cells survive and grow.
5. Stem Cell Transplant
Stem cell transplantation may be considered for selected people with relapsed or difficult-to-treat disease.
