Waldenstrom macroglobulinemia

Treatment

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.