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Types of Lymphoma > Waldenström’s Macroglobulinemia

Last update: 12/12/2013

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Overview of 
Waldenstrom's 
Macroglobulinemia

B-cell stage: 
mature, plasma cells

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Waldenstrom's macroglobulinemia (WM) is a mouthful.  It is also called lymphoplasmacytic lymphoma, or a lymphoplasmacytic disorder.   It tends to have an indolent (slow growing) clinical course and can be treated effectively with standard and targeted therapy.  Sometimes treatment is deferred until there is a need to treat - when the WM causes symptoms.

WM is a kind of blood cell cancer called lymphoma.  Under normal conditions there is a balance in which new cells replace old, and each cell carries out tasks specific to its kindA lymphoma is caused by mutations or errors in lymphocytes, causing these cells to live too long and accumulate over time.  

See also Lymphoma Simplified

For WM the abnormal blood cells are B lymphocytes - mature plasma cells, cells that make an antibody called IgM.  Over time the overproduction of IgM causes the blood to become too thick (hyperviscosity).

(Science talk - Jargon:  the overproduction of the antibody in WM is called monoclonal macroglobulin (IgM) antibody OR
monoclonal IgM gammopathy).

This blood thickening (hyperviscosity) interferes with blood flow through small blood vessels, which leads to many of the symptoms of the disease.

WM also presents with bone marrow infiltration and often with clinical symptoms such as neuropathy

In the News

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* MNt 2013:
Discovery of CXCR4 mutations in Waldenstrom's Macroglobulinemia helps identify which patients are more likely to benefit from ibrutinib http://bit.ly/18CHVNR
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BIG news!  FDA Expedites Potential New Therapy for Rare Lymphoma (WM) - ibrutinib iwmf.com PDF 
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Leukemia. 2013: How to manage Waldenstrom's macroglobulinemia, Buske, Leblond http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626020/ 

technical, written for oncologists and researches.
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Weill-Cornell Med Ctr: Waldenstrom’s Macroglobulinemia Clinical Database Study
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Acta Hem: Familial (inherited) Aggregation of Waldenström Macroglobulinemia
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Medpage Today: ASH: Fludarabine Works Best in Rare Lymphoma Trial (Waldenstrom's)
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Cancer: Temporal and geographic variations of Waldenstrom's incidence
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Novel Treatment Regimens for Waldenström's Macroglobulinemia

Symptoms may include

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fatigue (from anemia)

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weight loss

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headache

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dizziness, mental status changes

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bruising of the skin, rash, nosebleeds, bleeding gums

Sometimes people have no symptoms and it is found by chance following a blood test.

Diagnosis

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A blood test The blood tests will show the number of abnormal cells present and the amount of the IgM antibody in your blood. 

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Bone marrow biopsy to determine if abnormal cells are present in marrow.

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Ultrasound  Lets the doctor see if your liver or spleen is enlarged.

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CT scan  X-ray images are taken from different angles which are processed by a computer to create detailed pictures of the inside of the body. 

Resources

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IWMF-Talk - Internet Discussion Forum

Support specific to Waldenstrom's macroglobulinemia
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About WM:  NCI | Cancerbacup.org.uk | MedlinePlusWaldenstromsresearch.org | theoncologist.alphamedpress.org | International Waldenström’s Macroglobulinemia Founation - IWMF
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Bing Center for WM Research  wmprogram.com
"Comprehensive recommendations for the diagnosis and therapy of Waldenstrom's Macroglobulinemia including the consensus panel reports from the 2nd International Workshop on Waldenstrom's Macroglobulinemia held in Athens, Greece." - www.wmprogram.com/Diagnosis/Default.asp 
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Defining WM
www.wmprogram.com/Diagnosis/WhatisWaldenstrom's(D&T).pdf 
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Prognostic markers and criteria to initiate therapy in WM  www.wmprogram.com/Diagnosis/ConsensusPanel2Manuscript.pdf 
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Treatment Recommendations in WM  www.wmprogram.com/Diagnosis/ConsensusPanel2Manuscript.pdf 
Consensus Panel Recommendations from the Second International
Workshop on Waldenstrom’s Macroglobulinemia
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Uniform Response Criteria in WM  www.wmprogram.com/Diagnosis/ConsensusPanel2Manuscript.pdf 
Consensus Panel Recommendations from the Second International
Workshop on Waldenstrom’s Macroglobulinemia
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Detailed - Guidelines for diagnosis and therapy - BSH   PDF
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Q&A  nci.nih.gov   pdf 
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Waldenstrom's Glossary  
Treatments
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Treatment Overview
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Treatments

TOPIC SEARCH: SearchMedica

Waldenström's Macroglobulinemia is a slowly progressing, or chronic, condition. You may not need treatment and will be monitored with blood tests instead.  Some people may never require treatment.

Apheresis (also called plasmapheresis or plasma exchange)  medlib.med.utah.edu
"The process of apheresis involves removal of whole blood from a patient or donor. Within an instrument that is essentially designed as a centrifuge, the components of whole blood are separated. One of the separated portions is then withdrawn and the remaining components are retransfused into the patient or donor." PAL

Chemotherapy may include Leukeran, Alkeran, Cytoxan, Fludarabine, Rituxan, or steroids.

Splenectomy is the surgical resection (removal) of an enlarged spleen. Case reports indicate this procedure can be effective in treating WM  Related PubMed abstracts | About splenectomy

Waldenström’s Macroglobulinemia:
Questions and Answers  Cancer.gov

Includes How is Waldenström’s macroglobulinemia treated?

ARTICLES

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NEW Novel Treatment Regimens for Waldenström’s Macroglobulinemia: Other Drugs under Investigation in Waldenström's Macroglobulinemia http://bit.ly/cxzcal
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Bing Center researchers publish two new papers on mast cells and WM  wmprogram.com
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Mast cells in Waldenstrom's macroglobulinemia support lymphoplasmacytic cell growth through CD154/CD40 signaling  wmprogram.com/
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A Phase I/II Study of TACI-Ig To Neutralize APRIL and BLyS in Patients with Refractory or Relapsed Multiple Myeloma or Active Previously-Treated Waldenström's Macroglobulinemia. Session Type: Poster Session 770-II 
ASH 2005
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Predictive Factors for Response and Progression after Treatment with Rituximab in Previously Untreated Patients with Waldenstrom's Macroglobulinemia (WM). Session Type: Poster Session 736-III  ASH 2005
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Phase II Study of Bortezomib [Velcade] in Waldenstrom's Macroglobulinemia: Results of WMCTG Trial 03-248. Session Type: Oral Session  http://clincancerres.aacrjournals.org
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Durable remission after splenectomy for Waldenstrom's macroglobulinemia with massive splenomegaly in leukemic phase.
Leuk Lymphoma. 1997 Jul;26(3-4):387-93. PMID: 9322902 | Related articles
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Use of iodine 131I-tositumomab radioimmunotherapy in a patient with Waldenstrom's macroglobulinemia.
Leuk Lymphoma. 2004 Mar;45(3):591-5. PMID: 15160923
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Treatment of Waldenstrom's macroglobulinemia with rituximab.
J Clin Oncol. 2002 May 1;20(9):2327-33. PMID: 11981004  PubMed
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Fludarabine therapy in Waldenstrom's macroglobulinemia patients treated previously with 2-chlorodeoxyadenosine. Leuk Lymphoma. 2002 Feb;43(2):361-3. PMID: 11999570  PubMed
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Treatment of Waldenstrom's macroglobulinemia with rituximab.
J Clin Oncol. 2002 May 1;20(9):2327-33. PMID: 11981004
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Extended Rituximab Therapy for Previously Untreated Patients with Waldenstrom's Macroglobulinemia. Clin Lymphoma. 2002 Dec;3(3):163-6. PMID: 12521393  PubMed
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Thalidomide Active Against Waldenström's Macroglobulinemia -Journal of Clinical Oncology  2001;19:3593-3594,3596-3601.
Clinical Trials
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Clinical Trials and Research Centers

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ClinicalTrials.gov
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newly diagnosed or untreated | recurrent  

TIP: After clicking the desired Lookup query,
click the
Results on Map tab to find studies near you.
bullet WM Clinical Trials Group (WMCTG)
 
   Dana Farber Cancer Inst, MA
   UCLA Medical Ctr., CA
   Stanford University, CA
   Beth Israel Hospital, MA
   Roswell Park Memorial, NY
   St. Vincent's Hospital, NY
   LI Jewish Memorial, NY
   University of Maryland, MD
   University of Miami, FL
   Cleveland Clinic Foundation, OH
   Northwestern University, IL
   Rush Presbyterian, IL
   Rocky Mountain Cancer Ctr., CO
   Arizona Cancer Ctr., AZ
   McMaster University, Canada
   Cross Cancer Ctr., Canada
   St Bartholomew's, UK
   Karolinska Institut, Sweden
   Hopital Schaffner, France
   University of Salamanca, Spain
   Niguarda Hospital, Italy
   McCallum Cancer Ctr., Australia
Research News
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Research News

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Research links  waldenstromsresearch.org 
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Waldenstrom's macroglobulinemia: a review of therapy.
Leuk Lymphoma. 2002 Aug;43(8):1517-26. PMID: 12400593  PubMed
 
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