Macroglobulinemia of Waldenst... Health Article

Definition

Macroglobulinemia of Waldenstrom is a cancer of the B lymphocytes (a type of white blood cell). It is associated with the overproduction of proteins called IgM antibodies.

Alternative Names

Waldenstrom's macroglobulinemia; Macroglobulinemia - primary; Lymphoplasmacytic lymphoma

Causes, incidence, and risk factors

Waldenstrom's macroglobulinemia is a result of a condition called lymphoplasmacytic lymphoma. The cause of the overproduction of the IgM antibody is unknown, but researchers believe it is made by lymphoma cells.

Overproduction of IgM causes the blood to become too thick. This is called hyperviscosity It occasionally makes it harder for blood to flow through small blood vessels.

About 1,500 people in the United States are diagnosed with Waldenstrom's macroglobulinemia every year. Most people with this condition are over age 65, however, it may occur in younger people.

Symptoms

• Bleeding of the gums
• Blurred or decreased vision
• Dizziness
• Easy bruising of the skin
• Fatigue
• Headache
• Mental status changes
• Nosebleeds
• Numbness, tingling, or burning pain in the hands, feet, fingers, toes, ears, or nose
• Rash
• Unintentional weight loss
• Vision loss in one eye

Additional symptoms that may be associated with this disease:

• Bluish skin discoloration
• Fingers that change color upon pressure
• Flank pain
• Swollen glands

Signs and tests

A physical examination may reveal a swollen spleen, liver, and lymph nodes. An eye exam may show enlarged veins in the retina or retinal bleeding (hemorrhages).

A CBC shows a low number of red bloods and platelets. A blood chemistry shows evidence of kidney disease. A serum viscosity test can tell if the blood has become thick. Symptoms usually occur when the blood is four times thicker than normal.

A test called serum protein electrophoresis shows an increased amount of the IgM antibody. Levels seen in Waldenstrom's macroglobulinemia are generally greater than 3 g/dL.

Bone lesions are very rare. If they are present, a bone marrow examination will show cells that resemble both lymphocytes and plasma cells.

Additional tests that may be done:

• 24-hour urine protein
• Total protein
• Serum globulin electrophoresis
• Immunofixation in urine
• T (thymus derived lymphocyte count