Waldenstrom macroglobulinemia (mak-ro-glob-u-lih-NEE-me-uh), also called WM or lymphoplasmacytic lymphoma, is a type of non-Hodgkin's lymphoma (also called non-Hodgkin lymphoma). WM is a rare, slow-growing cancer that begins in the immune system. Abnormal white blood cells (lymphocytes) in the bone marrow make an abnormal protein called monoclonal immunoglobulin M (IgM) that thickens the blood plasma. This causes the symptoms of WM.
The most common signs and symptoms include fatigue, nosebleeds, dizziness, gum bleeding, weight loss, bruising, headache, and numbness or tingling in your hands or feet. Your doctor may also find enlarged lymph glands in your neck, groin or under your arms.
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Treating Waldenstrom macroglobulinemia at Mayo Clinic in Arizona is an integrated practice that can include specialists in hematology, laboratory medicine and pathology, radiology, nephrology and hypertension, and neurology.
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Treating Waldenstrom macroglobulinemia at Mayo Clinic in Florida is an integrated practice that can include specialists in hematology, laboratory medicine and pathology, radiology, nephrology and hypertension, and neurology.
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Treating Waldenstrom macroglobulinemia at Mayo Clinic in Minnesota is an integrated practice that can include specialists in hematology, laboratory medicine and pathology, radiology, nephrology and hypertension, and neurology.
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Your doctor may use the following exam and tests to determine if you have Waldenstrom macroglobulinemia. In tests that use radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure.
- Physical exam. Your doctor will perform a physical exam to determine any health changes you may have, such as enlarged lymph nodes.
- Laboratory tests. Laboratory tests can show changes in your blood cells, blood chemistry and your urine. Blood tests can also tell your doctor if you have the IgM protein, a sign of Waldenstrom macroglobulinemia.
- Bone marrow biopsy. A bone marrow biopsy can tell your doctor about changes in the lymphocyte cells in your bone marrow.
- X-rays. X-rays can show your doctor any changes in your bones.
- Computerized tomography (CT) scan. A CT scan combines a series of X-ray views to produce images of the bones and soft tissues inside your body so that your doctor can look for changes.
The presence of an IgM protein in the blood is a characteristic feature of Waldenstrom macroglobulinemia (WM). However, not everyone with an IgM protein requires immediate treatment. The presence of an abnormal protein without an underlying illness is called monoclonal gammopathy of undetermined significance (MGUS). Many people who have no symptoms can be monitored for years without needing treatment. Even people with high levels of the IgM protein may not have symptoms and may not need treatment for years or ever.
Mayo Clinic doctors have extensive experience in treating WM and are able to determine the point at which a person crosses the line from simply having an IgM protein to having WM that may need treatment. The development of progressive anemia or enlarged, bothersome lymph nodes often requires treatment. Although WM currently can't be cured, it can be controlled. With good results, your activity levels can return to normal.
Treatment may include:
- Chemotherapy. Chemotherapy is medicine that attacks abnormal cells to reduce their effect on healthy bone marrow and lower the level of abnormal protein. You may receive chemotherapy in pill form or through your veins (intravenously).
- Plasma exchange. If thickening of the blood causes problems, plasma exchange (plasmapheresis) can be used to wash the IgM protein out of your bloodstream and replace it with healthy plasma. This highly effective technique usually requires only one or two treatments to lower blood protein levels. The need for more plasma exchanges may depend on the results of other therapy.
- Biotherapy. Biotherapy (biological therapy) may be used alone or in combination with chemotherapy. Biotherapy may boost your immune system's ability to fight cancer and help decrease side effects from certain types of cancer treatments.
Excellence in research is an important goal in the mission of the Division of Hematology. The division focuses on improving the diagnosis and treatment of hematologic diseases, including Waldenstrom macroglobulinemia.
Research related to Waldenstrom macroglobulinemia at Mayo Clinic includes drug trials, nonchemotherapy treatments and genetic links to the disease. Such research may lead to new treatments.
See a list of publications by Mayo Clinic authors on Waldenstrom macroglobulinemia on PubMed, a service of the National Library of Medicine.
Clinical trials are research studies that test new ways to detect, prevent or treat disease. Mayo Clinic conducts more than 3,000 clinical trials and research studies each year and often coordinates national clinical trials with other medical centers.
Learn more about clinical trials and whether Mayo Clinic may be conducting a clinical trial related to your condition or procedure.
June 27, 2013