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:
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.
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 (
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
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