Overview

Waldenstrom macroglobulinemia (mak-roe-glob-u-lih-NEE-me-uh) is a type of cancer that begins in the white blood cells. Waldenstrom macroglobulinemia is considered a type of non-Hodgkin lymphoma. It's sometimes called lymphoplasmacytic lymphoma.

In Waldenstrom macroglobulinemia, some white blood cells undergo changes that turn them into cancer cells. The cancer cells can build up in the spongy material inside the bones where blood cells are made. This material is called bone marrow. The cancer cells crowd healthy blood cells out of the bone marrow. Cancer cells also may build up in other parts of the body, such as the lymph nodes and the spleen.

The cancer cells make a protein called immunoglobulin M (IgM) that can build up in the blood. Too much IgM can reduce blood flow in the body, which can damage the organs and cause other problems.

Waldenstrom macroglobulinemia can't be cured. Treatments aim to ease symptoms and reduce organ damage. Treatment options may include a "watch and wait" approach, plasma exchange, targeted therapy, chemotherapy, immunotherapy and a bone marrow transplant, also known as a bone marrow stem cell transplant.

Symptoms

Waldenstrom macroglobulinemia grows slowly. It might not cause symptoms for years.

When they happen, Waldenstrom macroglobulinemia symptoms may include:

  • Fatigue.
  • Fever.
  • Drenching night sweats.
  • Weight loss that happens without trying.
  • Numbness or weakness in the arms or legs.
  • Swollen lymph nodes, which might feel like a lump under the skin. They happen most often in the neck, armpits and groin.
  • A feeling of pain or fullness under the ribs on your left side, which may be caused by an enlarged spleen.
  • Easy bruising.

Waldenstrom macroglobulinemia sometimes causes thickened blood and slow blood flow, called hyperviscosity syndrome. It can happen if the cancer cells make too much IgM that builds up in the blood. Hyperviscosity syndrome symptoms include:

  • Vision changes such as blurry vision, double vision or vision loss.
  • Headache.
  • Dizziness.
  • Ringing in the ears.
  • Sudden hearing loss.
  • Bleeding nose or gums.
  • Shortness of breath.
  • Confusion.
  • Memory loss.
  • Fainting.

When to see a doctor

Make an appointment with a healthcare professional if you have any symptoms that worry you. If you have symptoms of hyperviscosity syndrome, seek emergency medical attention right away.

Get Mayo Clinic cancer expertise delivered to your inbox.

Subscribe for free and receive an in-depth guide to coping with cancer, plus helpful information on how to get a second opinion. You can unsubscribe at any time. Click here for an email preview.

I would like to learn more about

We use the data you provide to deliver you the content you requested. To provide you with the most relevant and helpful information, we may combine your email and website data with other information we have about you. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. You may opt out of email communications at any time by clicking on the unsubscribe link in the email.

Causes

It's not clear what causes Waldenstrom macroglobulinemia. Cancer happens when cells develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

In Waldenstrom macroglobulinemia, the changes happen in the white blood cells. The changes turn some of the white blood cells into cancer cells. The cancer cells can build up in the spongy material inside the bones where blood cells are made. This material is called bone marrow. The cancer cells crowd healthy blood cells out of the bone marrow. The cancer cells also may build up in the lymph nodes and the spleen.

Waldenstrom macroglobulinemia cells make a protein that the body can't use called IgM. IgM can build up in the blood. This may reduce blood flow in the body and cause other problems.

Risk factors

Factors that can increase the risk of Waldenstrom macroglobulinemia include:

  • Older age. Waldenstrom macroglobulinemia can happen at any age. But it's most common in adults 70 and older.
  • Race and ethnicity. White people are more likely to develop Waldenstrom macroglobulinemia than are people of other races.
  • A family history of lymphoma. Having a blood relative, such as a parent or sibling, with Waldenstrom macroglobulinemia may increase your risk of Waldenstrom macroglobulinemia.
  • A history of autoimmune diseases. People with a history of autoimmune diseases are at a higher risk of Waldenstrom macroglobulinemia.

Complications

Complications of Waldenstrom macroglobulinemia may include:

Hyperviscosity syndrome

Some people with Waldenstrom macroglobulinemia develop hyperviscosity syndrome. Hyperviscosity refers to the thickening of the blood that leads to slower flow through the blood vessels. In Waldenstrom macroglobulinemia, this happens because of the increased proteins in the blood. Hyperviscosity syndrome can cause life-threatening complications.

Bing-Neel syndrome

Bing-Neel syndrome describes when Waldenstrom macroglobulinemia involves the central nervous system. The central nervous system includes the brain and spinal cord. Bing-Neel syndrome can cause headaches, seizures, weakness or numbness in the limbs, and unusual nerve pain or tingling. Bing-Neel syndrome can develop when a person is in remission or, less commonly, when the cancer first starts. The outlook is usually worse when it develops later.

A switch to a more aggressive form of cancer

Some people with Waldenstrom macroglobulinemia can develop a more aggressive form of cancer.

Secondary cancers

People with Waldenstrom macroglobulinemia are at a higher risk of developing other cancers. These may include thyroid cancer, kidney cancer and melanoma.

Dec. 20, 2025

Living with waldenstrom macroglobulinemia?

Connect with others like you for support and answers to your questions in the Blood Cancers & Disorders support group on Mayo Clinic Connect, a patient community.

Blood Cancers & Disorders Discussions

cdurbin
What are most common side effects when starting HU (Hydroxyurea)?

200 Replies Sat, Dec 20, 2025

atir
Polycythemia Vera: Just been diagnosed

450 Replies Sat, Dec 20, 2025

dburkert
T cell large granulocytic leukemia

31 Replies Thu, Dec 18, 2025

See more discussions
  1. Waldenstrom macroglobulinemia/lymphoplasmacytic lymphoma. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1475. Accessed Nov. 3, 2025.
  2. Epidemiology, pathogenesis, clinical manifestations, and diagnosis of Waldenstrom macroglobulinemia. https://www.uptodate.com/contents/search. Accessed Nov. 3, 2025.
  3. Clinical manifestations, pathologic features, and diagnosis of lymphoplasmacytic lymphoma. https://www.uptodate.com/contents/search. Accessed Nov. 3, 2025.
  4. Treatment and prognosis of Waldenstrom macroglobulinemia. https://www.uptodate.com/contents/search. Accessed Nov. 3, 2025.
  5. Elsevier Point of Care. Clinical Overview: Waldenstrom macroglobulinemia. https://www.clinicalkey.com. Accessed Nov. 3, 2025.
  6. Ferri FF. Waldenstrom macroglobulinemia. In: Ferri's Clinical Advisor 2026. Elsevier; 2026. https://www.clinicalkey.com. Accessed Nov. 3, 2025.
  7. Nimmagadda R. EPSi. Mayo Clinic. May 5, 2022.
  8. Elsevier Point of Care. Clinical Overview: Hyperviscosity syndrome. https://www.clinicalkey.com. Accessed Nov. 3, 2025.
  9. Prognosis in Waldenstrom's macroglobulinemia. International Waldenstrom's Macroglobulinemia Foundation. https://iwmf.com/prognosis. Accessed Nov. 13, 2025.