NCCN Guidelines for Patients
Waldenström’s Macroglobulinemia, Version 1.2017
Guide 1. Risk factors for WM
• Age- 50 years old or older
• Gender- being male
• Race and ethnicity- more common in white
people, and seen in those of Ashkenazi decent
• Family history- family members have WM or other
• History of disease-
◦◦ MGUS (Monoclonal gammopathy of
undetermined significance) is when IgM is
found in the blood at above normal levels. The
level does not go too high or cause symptoms.
Other risk factors for WM are not known at this
WM is a slow-growing type of B-cell NHL. About
1500-2000 people are diagnosed with WM per
year. It is considered to be a rare type of cancer.
Certain risk factors can be seen with WM. Anything
that increases your chances of WM is called a risk
factor. Risk factors can be activities that people do,
things in the environment, or traits passed down from
parents to children through genes. Genes are coded
instructions for your cells.
See Guide 1.
Guide 2. Symptoms of WM
• Hyperviscosity and its effects
• Low number of red blood cells
• Enlarged lymph nodes (adenopathy)
• Enlarged organs (organomegaly)
• Nerve problem that causes pain, tingling, and
• IgM buildup in organs like the heart or kidney
(amyloidosis) causing problems
• IgM buildup in places exposed to the cold
◦◦ For example, your nose, ears, fingers, or toes
turn blue or black and can hurt
• IgM breaks down the red blood cells at low
temperatures (cold agglutinin disease)
◦◦ This is a form of hemolytic anemia (red blood
cells break down quickly)
A main characteristic of WM is having IgM in the
blood. It can be at high levels and this can cause
symptoms. The blood becomes thick from IgM.
The IgM is a big molecule and can’t leave the
bloodstream. This is called hyperviscosity. When the
blood is too thick, it can’t flow right. Hyperviscosity
can happen and cause symptoms like weakness,
changes with eye sight, headache, stroke-like
symptoms, and unexplained bleeding.
See Guide 2.