Waldenstrom Macroglobulinemia Diagnosis

Few Inital Symptoms

Abnormal results from routine examinations or blood work often provide the first indications of the disease.

Routine Exams and Unusual Results

Waldenstrom’s macroglobulinemia progresses very slowly, with few initial symptoms. As a result, abnormal results from routine examinations or blood work often provide the first indications of the disease. A physical examination may reveal swollen lymph nodes, or an enlarged liver or spleen. Blood work may show abnormal blood counts, especially low levels of red blood cells and platelets.

Blood tests may also reveal hyperviscosity syndrome, or a thickening of the liquid portion of blood (the serum). Hyperviscosity is a common complication of Waldenstrom’s macroglobulinemia, and is caused by excess production if IgM antibodies. More information on hyperviscosity is available on the complications page.

Regular eye examinations may also suggest the presence of WM. Retinal bleeding and enlarged retinal blood vessels can occur as a result of Waldenstrom’s.

IgM Antibodies and Gel Electrophoresis

A high level of monoclonal IgM antibodies is the distinguishing feature of Waldenstrom’s macroglobulinemia. Medical science defines a monoclonal antibody as an antibody that originates from a specific abnormal cell. The characteristic high levels of IgM antibodies associated with WM make it possible to diagnose the condition using a test called gel electrophoresis.

Gel electrophoresis uses a special gel and electrical current to separate the proteins in a blood sample into individual groups. These groups are categorized according to type and amount and are then graphed. Abnormally high levels of specific proteins, or antibodies, will produce a “spike” on the graph. In the case of Waldenstrom’s, gel electrophoresis will reveal a monoclonal spike, or M spike, of IgM antibodies.

Although not as common as blood tests, gel electrophoresis analysis can also separate proteins in urine. Urine testing is sometimes used to diagnose Waldenstrom’s macroglobulinemia.

Bone Marrow Biopsy Tests

Bone marrow biopsies may also be used in the diagnostic process. A small amount of bone marrow is removed (“aspirated”) using a long thin needle. The sample is then examined for high levels of B cells and plasma cells.

Prognosis of Waldenstrom’s Macroglobulinemia

The accepted survival time for people with WM is five to seven years after diagnosis. However, due to the rarity of the disease relatively little research has examined survival rates for Waldenstrom’s macroglobulinemia. Many people live with the disease for years with few symptoms or complications.

WM vs. Multiple Myeloma: What’s the Difference?

Multiple myeloma is a blood cancer similar to WM. Both diseases have characteristic monoclonal spikes on gel electrophoresis. They do have some important differences, however. Multiple myeloma presents with multiple bone lesions, a symptom that is rarely associated with WM. In addition, multiple myeloma causes kidney complications, while damage to the kidneys is less likely to occur in Waldenstrom’s because of the size of the IgM pentamer. Finally, the prognosis for WM is much more positive than it is for multiple myeloma.