NCCN Guidelines for Patients
Waldenström’s Macroglobulinemia, Version 1.2017
Testing for WM
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.
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.
test for antibodies that can affect your
measures the electrical way
your muscles work.
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.
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.
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 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.