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Waldenstrom macroglobulinemia does not use numbered stages. Many cancers use stages 1 through 4 to show how far the cancer has spread. Waldenstrom macroglobulinemia does not use the amount of disease in the body to assign numbered stages. Instead, healthcare professionals use risk groups to estimate outlook. Treatment decisions are based mainly on symptoms, complications and test results.

Risk groups

For people with symptomatic Waldenstrom macroglobulinemia, healthcare professionals may use the Modified Staging System for Waldenstrom Macroglobulinemia (MSS-WM). These risk groups estimate outlook, but outlook also depends on age, overall health, complications and response to treatment.

The risk groups include:

• Low risk.
• Low-intermediate risk.
• Intermediate risk.
• High risk.

To decide on the risk group, healthcare professionals use:

• Age. Being older than 65 raises risk. Being older than 75 raises the risk even more.
• LDH level. A lactate dehydrogenase (LDH) level in the blood that is higher than usual raises the risk.
• Amount of albumin. A low level of albumin, a specific protein in the blood, raises the risk.

How Waldenstrom macroglobulinemia can progress

Waldenstrom macroglobulinemia does not use numbered stages, so there is no numbered "final stage." It often worsens slowly. As it progresses, it may cause anemia or other low blood counts, enlarged lymph nodes or spleen, hyperviscosity syndrome, nerve problems, or amyloidosis. In some people, the condition can relapse after treatment or change into a faster growing lymphoma.

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