Waldenstrom’s Macroglobulinemia: The Basics

Author: Allyson Van Horn, MPH
Last Reviewed: September 06, 2024

What is Waldenstrom’s Macroglobulinemia?

Waldenstrom’s Macroglobulinemia (WM) is a rare type of non-hodgkin lymphoma and subtype of lymphoplasmacytic lymphoma. WM starts in certain cells in your body called B cells (also called B lymphocytes). B cells help your body’s immune system fight an infection. When B cells are changed due to WM, your body makes abnormal cells called lymphoplasmacytic cells.

Risks of WM

Some risk factors that are linked to WM are:

  • Monoclonal gammopathy which is when antibodies (proteins that help fight infection) are not made the way they should be in your cells.
  • If you are 50 years of age or older.
  • If you have an autoimmune disease or hepatitis C.
  • Family history of WM.
  • Race: WM is more common in White people than African American people.
  • Sex assigned at birth: WM is more common in men than women.

Screening

There are no specific screening tests for WM. But, if you are having symptoms, your healthcare team may do some of the tests used to diagnose WM.

Signs of WM

Some symptoms of WM are:

  • Feeling weak (which can be from anemia).
  • Fever.
  • Night sweats.
  • Weight loss.
  • Loss of appetite.
  • Neuropathy.

Diagnosis of WM

If your healthcare provider thinks you have WM, they will look at your health history and do a physical exam. Some tests that may be done are:

Scoring

WM is not staged like most other cancers. Instead, a scoring system is used. Your score can help figure out the type of treatment you need, and how well the treatment is working. Your score is based on things like:

  • Being older than 65 years old.
  • Having a blood hemoglobin level at or below 11.5 g/dL.
  • Having a platelet count at or below 100,000 mcL.
  • Having a beta-2 microglobulin level higher than 3 mg/L.
  • Having a monoclonal IgM level higher than 7g/dL.

You are given a score based on how many of these factors you have and your score fits into one of these categories:

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

Your provider will talk with you about your score, category, and the type of treatment they recommend.

Treatment

Treatment of WM depends on your score. You may have some of these treatments:

  • Chemotherapy is the use of medications to treat the cancer.
  • Radiation uses high-energy rays (similar to X-rays) to kill cancer cells in a targeted, small area of the body.
  • Stem cell transplants use a patient’s own, or another person’s bone marrow or stem cells to help the patient recover after high doses of chemotherapy.
  • Immunotherapy/Targeted Therapy uses the body’s own immune system to attack cancer cells, along with medications, to kill cancer cells.
  • Plasmapheresis which is the use of a machine that separates the abnormal part of the cell from the rest of the blood cell. The rest of the normal blood cell is infused (put back) into your body.

This article is a basic guide to WM. Talk to your healthcare provider about your diagnosis, staging, and treatment of WM.

American Cancer Society (2018). What is Waldenstrom Macroglobulinemia?

Grunenberg, A., & Buske, C. (2024). How to manage waldenström's macroglobulinemia in 2024. Cancer treatment reviews, 125, 102715. https://doi.org/10.1016/j.ctrv.2024.102715

International Waldenstrom’s Macroglobulinemia Foundation. What is Waldenstrom’s Macroglobulinemia?

National Institutes of Health: National Human Genome Research Institute (2024). Antibody.

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