Waldenstrom’s Macroglobulinemia (WM) is a rare indolent white blood cell cancer classified as a lymphoplasmacytic lymphoma; a type of B-lymphocyte (B-cell) non-Hodgkin’s lymphoma. It is often compared with other white blood cell cancers such as chronic lymphocytic leukemia and multiple myeloma with some familiar features. A defining characteristic of the disease is the presence of an elevated Immunoglobulin called IgM. WM is rare, with an incidence rate of about 5 cases per million people per year in Canada and the US.
Jan Gosta Waldenström (1906 – 1996)
In 1944 the Swedish physician Jan Gosta Waldenström (1906 – 1996) identified a rare condition in which patients experienced a thickening of the serum (the liquid portion) of the blood. He described two patients who had bleeding in the area of the mouth and nose as well as in the retina of the eye, low red cell and platelet counts, high sedimentation rate, and lymph node involvement. Bone marrow biopsy showed excess lymphoid cells, yet there was no bone pain, excluding a diagnosis of multiple myeloma. Both patients had a large amount of a single unknown globulin with an extremely high molecular weight. We now know this globulin as IgM. His patients, as Dr. Waldenström himself described in 1961, had a “monoclonal gammopathy.”
Diagnosis of WM generally depends on blood and urine test with a bone marrow biopsy to confirm. Bone marrow biopsies reveal excess lymphoid cells yet no bone pain excluding a diagnosis of Multiple Myeloma. Dr. Waldenstrom first described it as a malignant monoclonal gammopathy in 1961.
Patients with Waldenstrom’s Macrglobulinemia may experience a reduced capacity to produce one or more of the different types of blood cells in the bone marrow because the lymphoplasmacytic cell of WM infiltrates the bone marrow interfering with normal hematopoiesis.
The cause of WM is still unknown. There are studies showing a degree of familial clustering of WM or a related disease in about 20% of the cases examined.
Although WM is incurable; in most cases it can be effectively treated to provide a good quality of life for many years. The support of WM members worldwide has encouraged WM research around the globe and to better treatment options. Today the disease-specific survival has improved from 3-5 years to 11.2 years. Many people have lived 15-25 years. There is much hope for the future.
Visit the WMFC (www.wmfc.ca) and the IWMF (www.iwmf.com) for more comprehensive information and how you can join to receive all the current updates on research and treatment options for WM. Watch for our educational forums both in Canada and the US.