Stages By Mayo Clinic Staff 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. Request an appointment Diagnosis & treatmentSurvival rates Oct. 17, 2026 Share on: FacebookTwitter 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 Primary Myelofibrosis with JAK2: Anyone have Ojjaara (momelotinib)? 37 Replies Thu, Oct 15, 2026 chevron-right Anyone diagnosed with Primary Central Nervous System (CNS) Lymphoma? 105 Replies Thu, Oct 15, 2026 chevron-right Anyone have chronic lymphocytic leukemia (CLL)? 406 Replies Wed, Oct 14, 2026 chevron-right See more discussions Show references Pemov A, et al. The landscape of rare genetic variants in familial Waldenström macroglobulinemia. Blood Neoplasia. 2024; doi:10.1016/j.bneo.2024.100013. Gertz MA. Waldenström macroglobulinemia: 2025 update on diagnosis, risk stratification, and management. American Journal of Hematology. 2025; doi:10.1002/ajh.27666. Kapoor P, et al. Current approach to Waldenström macroglobulinemia. Blood Reviews. 2023; doi:10.1016/j.blre.2023.101129. Zanwar S, et al. Diagnosis and risk stratification in Waldenström macroglobulinemia. Journal of the National Comprehensive Cancer Network. 2024; doi:10.6004/jnccn.2024.7024. Sarosiek S, et al. Report of Consensus Panel 2 from the 12th International Workshop on the management of Bing-Neel syndrome in patients with Waldenstrom's macroglobulinemia. Seminars in Hematology. 2025; doi:10.1053/j.seminhematol.2025.04.005. Kumar SK, et al. Waldenström macroglobulinemia/lymphoplasmacytic lymphoma, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2024; doi:10.6004/jnccn.2024.0001. Waldenstrom macroglobulinemia. American Cancer Society. https://www.cancer.org/cancer/types/waldenstrom-macroglobulinemia.html. Accessed Aug. 26, 2026. Ferri FF. Waldenström macroglobulinemia. In: Ferri's Clinical Advisor 2027. Elsevier; 2027. https://www.clinicalkey.com. Accessed Aug. 26, 2026. Zanwar S, et al. Simplified risk stratification model for patients with Waldenström macroglobulinemia. Journal of Clinical Oncology. 2024; doi:10.1200/JCO.23.02066. McMaster ML. The epidemiology of Waldenström macroglobulinemia. Seminars in Hematology. 2023; doi:10.1053/j.seminhematol.2023.03.008. Treon SP, et al. Report of Consensus Panel 4 from the 11th International Workshop on Waldenstrom's macroglobulinemia on diagnostic and response criteria. Seminars in Hematology. 2023; doi:10.1053/j.seminhematol.2023.03.009. Garcia-Sanz R, et al. Report of Consensus Panel 3 from the 11th International Workshop on Waldenström's macroglobulinemia: Recommendations for molecular diagnosis in Waldenström's macroglobulinemia. Seminars in Hematology. 2023; doi:10.1053/j.seminhematol.2023.03.007. Buske C, et al. Report of Consensus Panel 1 from the 11th International Workshop on Waldenstrom's macroglobulinemia on management of symptomatic, treatment-naïve patients. Seminars in Hematology. 2023; doi:10.1053/j.seminhematol.2023.03.005. Medical review (expert opinion). Mayo Clinic. Oct. 5, 2026. Related Associated Procedures Bence-Jones protein test Biological therapy for cancer Bone marrow biopsy Bone marrow transplant Cancer treatment Chemotherapy Complete blood count (CBC) CT scan Lumbar puncture (spinal tap) MRI Positron emission tomography (PET) scan Show more associated procedures Products & Services A Book: Mayo Clinic Family Health Book Newsletter: Mayo Clinic Health Letter — Digital Edition Show more products and services from Mayo Clinic Waldenstrom macroglobulinemiaSymptoms&causesDiagnosis&treatmentStagesSurvivalratesDoctors&departmentsCare atMayoClinic CON-20314000 Diseases & Conditions Waldenstrom macroglobulinemia