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NCCN Guidelines for Patients



Waldenström’s Macroglobulinemia, Version 1.2017

These three techniques check the type of

immunoglobulin and amount in your blood. This

is done by looking at the sample on a gel. Other

immunoglobulins are IgA, IgG, IgD, and IgE. They

can also be found with these tests. For example,

with LPL other immunoglobulins besides IgM may be

seen at diagnosis.

Serum viscosity

Viscosity measures how thick the blood can be. High

levels of IgM in the blood will cause the blood to

be thick and not flow right. This test can be helpful

when WM and hyperviscosity is suspected. Your

doctor will check if the thickness of the blood is high;

cP (




oise) is the unit of measurement related

to thickness of the blood. People with WM may

have symptoms when the level is above 4 cP. If the

levels of IgM are too high, you may need immediate

treatment to relieve symptoms. Many doctors chose

to just follow the IgM level since it takes time to get

serum viscosity levels back. Sometimes, this level

may not be reliable.

Guide 3. Imaging tests

Imaging test

What is your doctor checking?


low-dose radiation to take one picture at a time. • Your lymph nodes and other organs.


high-energy sound waves make pictures. • Your lymph nodes and other organs.

MRI (magnetic resonance imaging) scan-


waves and strong magnets make detailed pictures.

• Your brain and spinal cord.

CT (computed tomography) scan-

x-rays are done

to take pictures from many angles.

• Your chest, abdomen, and pelvis.

◦◦ You can get dye (contrast material) for this type of


PET (positron emission tomography) scan-

a tracer

detects disease and takes 3-D pictures.

• How your body is working. The tracer lights up in

certain areas where cells (can be cancer) are moving


Beta-2 microglobulin

Beta-2 microglobulin is a protein in the blood that

can be measured at diagnosis. This protein doesn’t

cause issues but helps the doctor learn how you

will respond to treatment. When it comes to making

decisions about treatment, more information from

research is needed on beta-2 microglobulin.

Imaging tests

Imaging tests are used to take pictures (images) of

the inside of your body. Your doctor will want to check

the lymph nodes and other organs in your body.

Imaging is done to see if the cancer is in more than

one area. Imaging tests may also be done during or

after treatment to see how the body is responding.


Testing for WM

Imaging tests