Waldenström's Macroglobulinemia

Expert Care and Treatment for Waldenström's Macroglobulinemia

The Bing Center for Waldenström's Macroglobulinemia includes laboratory-based and clinical investigators who focus on this disease and related Immunoglobulin M (IgM) disorders.

Your care team will collaborate to develop a comprehensive, personalized treatment plan that offers the most advanced therapies and an array of supportive resources. 

Bing Center

What Is Waldenström's Macroglobulinemia?

Waldenström's macroglobulinemia (WM) is an uncommon blood cell cancer that originates from malignant B-cells. It is a slow-growing type of non-Hodgkin lymphoma. Waldenström's mostly forms in the bone marrow and can slow normal blood cell growth, which can lead to anemia and a weakened immune system. 

  • The disease occurs because of an abnormality in B lymphocytes in the bone marrow, causing them to produce too much immunoglobulin protein (IgM) that thickens the blood. 
  • Although WM shares similarities with multiple myeloma and indolent lymphoma, it is a form of lymphoplasmacytic lymphoma, a low-grade (or indolent) type of lymphoma. 
  • Not every patient with WM needs to be treated; some patients benefit from a "watchful waiting" approach. 
  • While WM is incurable and will return despite treatment, many people are able to lead active lives and may experience years of symptom-free remission after treatment. 


Waldenström's is uncommon. About 2,000 to 3,000 people are diagnosed each year in the United States. 

Growth and Spread 

Since WM develops in the bone marrow, it is considered a disease of the whole body. It can also affect the liver, lymph nodes, spleen, and peripheral and central nervous systems. 

Risk Factors 

  • Gender: WM is almost twice as common in men as it is in women, 
  • Age: The chance of developing Waldenström's increases with age; the mid-60's is the average age at which most patients are diagnosed.
  • Ethnic heritage: Up to 20% of WM patients have an Ashkenazi Jewish heritage.
  • Family history: Up to 20% of WM patients have a first- or second-degree relative with WM or another lymphoma, multiple myeloma, or chronic lymphocytic leukemia. This suggests there may be a genetic risk factor. We are leading research studies in collaboration with the National Institutes of Health (NIH) to identify the role genetics plays in WM. 

Symptoms and Signs 

Many patients do not have symptoms when they are diagnosed. For these individuals, WM may be discovered during routine blood or imaging tests. Symptomatic patients may have symptoms due to anemia (tiredness, weakness, dizziness, shortness of breath, headaches) or other deficiencies in blood counts due to the high number of WM cells in the bone marrow, enlarged lymph nodes, or spleen. They may also have symptoms due to the IgM protein made by the WM cells, including neuropathy (numbness, tingling, durning or pain) in the legs and feet or arms and hands; cryoglobulinemia (skin lesions or joint pain); cold agglutinemia (tiredness, weakness, dizziness, sweating, shortness of breath); and rarely, kidney, brain, or spinal cord involvement. 

Waldenström's may start with a very early condition, called a precursor condition. Precursors for WM are:

  • Smoldering Waldenström's Macroglobulinemia (SWM): In this precursor condition, there are high numbers of abnormal lymphocytes and plasma cells in the bone marrow that secrete M proteins of IgM type. Patients with SWM usually do not have symptoms. 
  • Monoclonal Gammopathy of Undetermined Significance (MGUS): Abnormal plasma cells are in the bone marrow – but there is no cancer. The abnormal plasma cells produce monoclonal (M) proteins. In some patients, MGUS may later progress to a more serious condition or cancer, such as Waldenström's or multiple myeloma. 

Early Detection and Interception 

Our colleagues in the Center for Early Detection and Interception of Blood Cancers (formerly the Center for Prevention of Progression), led by Irene Ghobrial, MD, are studying the genetic and epigenetic factors that characterize conditions that are often precancerous to WM, such as smoldering Waldenström's macroglobulinemia and Monoclonal Gammopathy of Undetermined Significance (MGUS). The Center's mission is to understand, at the molecular level, why some patients go on to develop WM disease, while others do not – and to develop targeted therapies to prevent progression, or even eliminate the disease before it leads to symptoms. 


If you are a patient – or the physician of a patient – with a precursor condition and are willing to have samples of blood and cancer cells collected for our research effort during a medical appointment, or if you would like additional information, please email precursor@partners.org or call 617-582-8664

Why Choose Us

The Bing Center for Waldenström’s Macroglobulinemia (WM) is the largest center in the world dedicated to studying and developing new treatments for WM and related Immunoglobulin M(IgM) disorders, including IgM-related neuropathy and Bing Neel syndrome. It is part of the Hematologic Oncology Treatment Center at Dana-Farber Brigham Cancer Center. The Bing Center has contributed to important advances in understanding and treating WM. We are credited with discovering the MYD88 and CXCR4 mutations in WM, the approval of the first-ever drug for WM (ibrutinib), and advancing many new drugs through clinical trials. 

We provide comprehensive services to patients with these cancers, including:  

  • The largest referral center for Waldenström's macroglobulinemia in the world. 
  • A highly specialized center focusing exclusively on Waldenström's diagnostics, treatment, and research. 
  • Personalized, genomic-based treatment plan, using the latest therapies. 
  • Carefully considered approach that does not always include immediate treatment. 
  • Care plans tailored to the needs of each patient, from the first meeting through subsequent treatments in the years to come.
  • Expertise in managing complications of WM, such as IgM neuropathy, amyloidosis, central nervous system involvement by WM (Bing Neel syndrome), transformation to aggressive lymphoma, cryoglobulinemia, and cold agglutinin disease. 
  • Consultations and second opinions for patients and physicians around the world.
  • Pioneering research in genomic sequencing and related treatments, setting the standard of care for this disease worldwide.
  • Physician-scientists who are not only part of the care team, but also work in our labs to develop drugs that target the genetic drivers of Waldenström's, bringing new and more effective treatments to patients quickly. 
  • Our specialists lead the development of international guidelines for WM workup, diagnosis, prognosis, response, and treatment. 
  • A treatment plan developed by a multidisciplinary team that works closely together to ensure that every approach is considered.
  • A full range of support services, including nutrition services; access to psychiatrists, psychologists, and social workers; integrative therapies; support specialists, programs, and services.