Waldenströms

Waldenström's macroglobulinemia, often shortened to Waldenström's, is a rare, slow-growing non-Hodgkin lymphoma. It is characterized by an overproduction of abnormal B-lymphocytes, a type of white blood cell, which produce large amounts of a specific protein called IgM (immunoglobulin M). This excess IgM is known as a monoclonal protein or M-protein and is responsible for many of the symptoms of the disease.

The abnormal B-cells infiltrate the bone marrow, lymph nodes, and spleen. In the bone marrow, they crowd out normal blood-forming cells, leading to anemia (low red blood cell count), thrombocytopenia (low platelet count), and neutropenia (low white blood cell count). The IgM protein can also thicken the blood, a condition called hyperviscosity syndrome, which can cause symptoms like headaches, dizziness, blurred vision, and nosebleeds.

Waldenström's is named after the Swedish physician Erik Waldemar Waldenström, who first described the condition in 1944. The exact cause is unknown, but it is believed to involve genetic mutations in B-cells. While it can affect people of any age, it is more common in older adults, typically diagnosed in individuals over 60.

Symptoms can be vague and develop gradually, often including fatigue, weakness, weight loss, swollen lymph nodes, and enlarged spleen or liver. Diagnosis involves blood tests to detect the M-protein and abnormal cells, bone marrow biopsy, and imaging scans. Treatment depends on the severity of symptoms and may range from watchful waiting for asymptomatic patients to chemotherapy, targeted therapy, or plasmapheresis for those with more severe disease. Waldenström's macroglobulinemia is generally considered incurable but manageable, with many patients living for years with the condition.