Table of Contents Table of Contents
Previous Page  22 / 60 Next Page
Show Menu
Previous Page 22 / 60 Next Page
Page Background


NCCN Guidelines for Patients



Waldenström’s Macroglobulinemia, Version 1.2017


Testing for WM

Test results

Your doctor may order a coagulation test. This would

be done if you have unusual bruising or bleeding.

The results of all your tests will help plan your next

steps of cancer care.

More tests for WM include:


test for how IgM responds to certain

red blood cell antigens at colder temperatures. This

can cause red cell breakdown and anemia. This IgM

gathers in places that get colder on your body (ears,

nose, fingers, or toes) and blocks the blood vessels.

Cold agglutinins-

test for cold agglutinins, which

are antibodies that destroy red blood cells at colder

temperatures. These antibodies can cause the cells

to block the blood vessels just like cryoglobulins.


test of the blood to see how well your

blood is clotting and how long it takes to clot. Blood

clots stop your bleeding. This test can also be done

before surgery. For those with a bleeding disorder

called VWD (






isease), testing is only

done if bleeding or bruising is present.

Hepatitis B or C (disease of the liver)-

test of your

blood for this virus. Rituximab can activate hepatitis

B. Rituximab is a common drug for WM. People with

cryoglobulinemia may have hepatitis C.

Neurology (brain) exam -

visit with a specialist to

check for nerve damage.

Anti-MAG (m







antibody -

test for antibodies that can affect your


Electromyelogram -

measures the electrical way

your muscles work.

Amyloid -

test the bone marrow for this abnormal

protein. It can build up and cause damage to

your nerves (peripheral neuropathy) and organs


Retinal exam -

exam of the back of your eye to check

for any changes or bleeding from hyperviscosity.

Test results

The results from your blood tests, imaging studies,

and biopsy will determine whether you get treatment

or not. The tests can happen while you are being

watched for symptoms or signs of WM. They can

continue during treatment and after treatment is over.

Blood tests may be done often, where imaging tests

will be done at certain time points decided by your

doctors. Doctors can use NCCN treatment guidelines

to make a care plan. This plan is then based on

recommendations from science and the experience

of NCCN experts.

Prognostic factors

A prognostic factor is something that affects or helps

predict the likely outcome of a disease. A doctor

considers your personal traits like age, test results,

and extent of cancer when talking about survival

(your prognosis).

Treatment factors

Your age, overall health, including other medical

conditions, and symptoms play a part in whether

or not you get treatment for WM. Your doctor can

decide when and which kind you get. This is based

on your medical needs and test results. For people

with WM, treatment is given to control disease and

limit harm to your organs. If you are not having

symptoms, you may not be treated right away.

Treatment will not be started for you based on the

level of IgM measured in your blood. IgM can go up

or down for different reasons. Even the treatment

itself can make the level go up or down. As long as

you have no symptoms, you may wait to be treated.

Your doctor will watch you closely to see if the cancer

is growing. This is known as observation. You will

both decide when and if you should start treatment.