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NCCN Guidelines for Patients



Waldenström’s Macroglobulinemia, Version 1.2017


Waldenström’s macroglobulinemia Waldenström’s macroglobulinemia

Cancer can also start in the plasma cells, which is

a type of white blood cell. Examples of common

blood cancers are multiple myeloma, leukemia, and


Multiple myeloma starts in the plasma cells that

make antibodies. Leukemia starts in the white blood

cells in the bone marrow or blood. Lymphomas are

cancers that start in lymphocytes. Lymphocytes

are a type of white blood cell. Lymphomas can be

slow growing (indolent) or grow and spread quickly


There are two main types of lymphomas:



Hodgkin lymphoma

is defined by finding a

type of cell called the Reed-Sternberg cell.



Non-Hodgkin’s lymphoma (NHL)


many other types of cancers that start in the

lymphocytes of the immune system.

Most NHLs—90 out of every 100—are B-cell

lymphomas. About 10 out of 100 are T-cell

lymphomas. There are many types of B-cells and

thus, many B-cell cancers. B-cells differ from one

another based on the cell’s stage of development. As

B-cells “mature” they change in their ability to make


Antibodies are Y-shaped proteins that are made in

response to the presence of antigens. Antigens are

substances that are capable of starting an immune

response. Some antigens enter your body from

outside. Such antigens include viruses, bacteria,

chemicals, and pollen. Some antigens are formed

inside your body like those found in tissue cells.

Antibodies attach to antigens, which triggers a

response from your immune system.


macroglobulinemia (WM)

How this cancer starts

WM is a rare cancer of B-cells. It is type of NHL.

WM cells share similarities with both plasma

cells (multiple myeloma) and lymphocytes

(lymphoma). Therefore, the cells are referred to

as lymphoplasmacytic cells. WM cells can invade

the bone marrow and take up too much space.

This causes problems for the other blood cells your

body needs to carry oxygen (red blood cells), fight

infection (white blood cells), or form blood clots

(platelets) to stop bleeding.

For reasons that are not clear, most Waldenström

tumor cells make a type of antibody or

immunoglobulin called IgM (






). This

antibody is “monoclonal,” in that the tumor cells make

identical IgM antibodies. The IgM can then collect

in blood or urine. These excess antibodies can be

measured as a total number. A tumor-specific part

of the IgM can also be measured as a monoclonal

protein amount or M spike. For a diagnosis of WM,

your doctor will also need to check your bone marrow

or another tissue for lymphoplasmacytic cells to

confirm WM.

Lymphoplasmacytic lymphoma






ymphoma (LPL) is a

type of NHL. LPL is also a slow-growing

lymphoma. It usually is found in the lymph nodes.

Lymphoplasmacytic cells are found at diagnosis, but

other types of immunoglobulin other than IgM (such

as IgA, IgG, or light chains alone) may be present. If

IgM is found, it is usually referred to as WM. WM is

considered to be a type of LPL because it involves

lymphoplasmacytic cells.