What is Waldenström's macroglobulinemia?
Waldenström's macroglobulinemia (Waldenström's) is a rare white blood cell cancer. It is a slow-growing type of non-Hodgkin lymphoma. Waldenström's mostly forms in the bone marrow and can slow the growth of normal blood cells, which can lead to anemia
and a weakened immune system.
- The disease stems from an abnormality in B lymphocytes in the bone marrow, causing them to overproduce an immunoglobulin protein that thickens the blood.
- Although it resembles multiple myeloma and indolent lymphoma, Waldenström's is a form of lymphoplasmacytic lymphoma, a low-grade (or indolent) type of lymphoma.
- Not everyone needs to be treated, and some patients benefit from a "watchful waiting" approach.
- While Waldenström's 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.
Incidence
Waldenström's is rare. About 1,000 to 1,500 people are diagnosed each year in the United States.
Growth and spread
The condition is usually in bone marrow and therefore it is considered a disease of the whole body. But it can affect the liver, lymph nodes, and spleen.
Risk factors
Waldenström's is almost twice as common in men as it is in women, and people of Ashkenazi Jewish descent may be at higher risk. Though there is no known inherited genetic factor, it is also common to see the disease occur within families. The chance of
developing Waldenström's increases with age; the average age at which someone is diagnosed is their mid-60s.
Symptoms and signs
Many patients do not have symptoms when they are diagnosed. The disease is often first suspected after a routine blood test. However, the increased amount of IgM produced by Waldenström's cells can cause excess bleeding, as well as problems with vision.
Other symptoms can include an enlarged liver, spleen, or lymph nodes, headaches, fatigue, weight loss, bruising, and nerve damage.
Waldenström's may start with a very early condition, called a precursor condition.
- Smoldering Waldenström's Macroglobulinemia (SWM): In this precursor condition, high concentrations of abnormal lymphocytes and plasma cells are found in the bone marrow and secrete M proteins of IgM type. SWM is characterized by the
absence of end organ damage; M protein concentrations of 3 g/dL or greater; 10 percent or more abnormal lymphocytes and plasma cells in the bone marrow; or a combination of all of these factors.
- Monoclonal Gammopathy of Undetermined Significance (MGUS): In this type of plasma cell neoplasm, there are abnormal plasma cells in the bone marrow – but there is no cancer. The abnormal plasma cells produce monoclonal (M) proteins.
In most patients, the amount of M protein stays the same and there are no symptoms or problems. In some patients, MGUS may later become a more serious condition or cancer, such as Waldenström's.
Disease-modifying therapies
Our researchers are studying the genomic, genetic, and epigenetic factors that characterize conditions that are often precancerous, such as Smoldering Waldenström's Macroglobulinemia and Monoclonal Gammopathy of Undetermined Significance, at our
Center for Prevention of Progression of Blood Cancers (CPOP).
We created this Center to understand, at the molecular level, why some patients go on to develop disease, while others do not – and to develop non-toxic targeted therapies to prevent progression, or even eliminate the disease before it leads to symptoms.
PRCROWD Study
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 the CPOP research effort during a medical appointment, or if you would like additional information,
please email
precursor@partners.org or call 617-582-8664.
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