What is Waldenstrom macroglobulinemia?
Waldenstrom macroglobulinemia (WM), also called lymphoplasmacytic lymphoma, is a rare, slow-growing blood cancer and a type of lymphoma. Often informally called “Waldenstrom’s” or “Waldenstrom’s disease,” WM starts in B cells (a kind of white blood cell) that grow out of control, mainly in the bone marrow and sometimes in the lymph nodes, liver, or spleen. These cells make too much of a protein called immunoglobulin M (IgM). When IgM builds up, it can thicken the blood (called hyperviscosity), making it harder for blood to flow. WM can also lead to low blood counts and swelling of organs. It is most often diagnosed in older adults and affects fewer than 1,500 people in the United States each year.
At Penn Medicine, patients with Waldenstrom's receive care from specialists experienced in treating rare blood cancers. Our team offers advanced testing to confirm the diagnosis and closely monitor the disease. Because WM tends to progress slowly, we focus on careful management, treating when needed while helping you maintain your quality of life.
Symptoms of Waldenstrom’s disease
Symptoms of Waldenstrom’s may include some or all of the following:
- Decrease in vision
- Weight loss without trying
- Numbness in extremities
- Tiredness
- Bluish skin
- Swollen spleen, glands
- Fatigue and weakness
- Low red blood cell count (anemia), which may cause weakness and dizziness
- Low white blood cells (leukopenia), which may cause frequent infections
- Low platelet count (thrombocytopenia), which may cause frequent bleeding
- Thickened blood (hyperviscosity), which may cause headaches, vision changes, dizziness, or confusion
What causes Waldenstrom macroglobulinemia?
We don’t know what causes WM, but factors that may increase your risk include:
- Age: Most people diagnosed are over the age of 60.
- Sex: WM is more common in people assigned male at birth.
- Race: Waldenstrom’s is more common in Caucasians.
Having a condition called IgM monoclonal gammopathy of undetermined significance (MGUS) may also increase your risk for developing Waldenstrom macroglobulinemia. However, the majority of people with IgM MGUS will not develop symptomatic WM.
How is Waldenstrom macroglobulinemia diagnosed?
WM is typically diagnosed through testing your blood and bone marrow. Blood tests often show elevated immunoglobulin M (IgM) levels and signs of low blood counts, such as anemia. A bone marrow culture or biopsy confirms the diagnosis by identifying abnormal lymphoplasmacytic cells. Additional imaging or genetic testing may used to better understand the extent of the disease and help guide treatment.
Waldestrom macroglobulinemia treatment
Because WM often grows slowly, some people do not need treatment right away and may be monitored closely over time. If symptoms develop from hyperviscosity, a short-term procedure called plasmapheresis may be used to quickly remove excess protein from the blood and provide rapid symptom relief. This is a supportive therapy that does not treat the disease itself. When needed, your care team may recommend therapies that directly address WM.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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