Waldenström Macroglobulinemia

Waldenström macroglobulinemia (WM) is a rare type of non-Hodgkin lymphoma (NHL) that produces large amounts of an abnormal protein called a macroglobulin. The abnormal protein can cause some of the symptoms of the disease. The lymphoma cells in WM grow mainly in the bone marrow. Bone marrow is the soft, spongy tissue inside your bone. Your bone marrow makes the cells found in your blood. In Waldenström macroglobulinemia, cancer cells multiply rapidly and can invade the bone marrow, spleen, and lymph nodes.

CAUSES

No one knows the exact cause of Waldenström macroglobulinemia. There may be a genetic problem, because it seems to run in some families.

SYMPTOMS

Symptoms can include:

  • Severe tiredness and weakness.

  • Decreased appetite.

  • Bleeding from nose and gums.

  • Unintended weight loss.

  • Night sweats.

  • Swollen belly (abdomen).

  • Easy bruising.

  • Blurred vision, blind spots.

  • Headache.

  • Dizziness.

  • Speech problems.

  • Weakness on one side of the body.

  • A sensation of the room spinning.

  • Kidney problems.

  • Heart problems.

  • Increased risk of infections.

  • Increased size of the spleen, liver and some lymph nodes.

DIAGNOSIS

  • Waldenström macroglobulinemia is usually diagnosed through both blood tests and examination of a bone marrow sample.

  • A biopsy may be performed. This is when the bone marrow is examined under the microscope to see if lymphoma cells are present.

TREATMENT

Some mild cases of Waldenström macroglobulinemia do not cause any symptoms, and will not require treatment for years. When the condition worsens, treatment may include:

  • Chemotherapy. This is a combination of drugs that can kill cancer cells. High dose chemotherapy may be followed by stem cell transplantation. The patient's own stem cells (cells that produce every type of blood cell) are removed and stored, then returned to the patient after chemotherapy. The stem cells go through the bloodstream to the bone marrow, where they make new blood cells to replace those killed by the chemotherapy.

  • Biological therapy. This type of therapy uses substances that destroy cancer cells or that stimulate the immune system to destroy cancer cells.

  • Plasmapheresis. This is a procedure in which the blood is filtered to remove abnormal proteins produced by the cancer cells.

  • Splenectomy. This is an operation to remove the spleen.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Although some of your treatments might affect your appetite, try to eat regular, healthy meals.

  • If you develop any side effects, such as nausea, diarrhea, rash, white patches in your mouth, sore throat or difficulty swallowing, severe fatigue, tell your caregiver. He or she may have recommendations of things you can do to improve symptoms.

  • Consider learning some ways to cope with the stress of having a chronic illness, such as yoga, meditation, or participating in a support group.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever.

  • You develop chest pains.

  • You feel short of breath.

  • You feel very lightheaded or pass out.

  • You notice pain, swelling or redness anywhere in your legs.

  • You have uncontrollable bleeding, such as a nosebleed that will not stop.

  • You are unable to stop throwing up (vomiting).

  • You cannot keep liquids down.

  • You feel depressed.