Summary
Waldenström macroglobulinaemia (WM) is an indolent non-Hodgkin lymphoma which usually
presents with symptoms related to infiltration of bone marrow or other tissues like
lymph nodes, liver or spleen and has certain unusual clinical manifestations, e.g.,
renal and central nervous system (CNS) involvement. It also has an array of laboratory
features including hypersecretion of IgM, cryoglobulinaemia, increased plasma viscosity
and identification of mutated MYD88L265P in more than 90% of cases. In this review, we aim to provide a guide to the laboratory
investigations recommended for WM at initial diagnosis and at follow-up. A discussion
on the nuances of diagnosis and differential diagnoses is followed by bone marrow
(BM) assessment, measurement of paraprotein and other ancillary investigations. Recommendations
are provided on laboratory work-up at diagnosis, in the asymptomatic follow-up phase,
and during and post-treatment. Finally, we briefly discuss the implications of laboratory
diagnosis in regard to recruitment and monitoring on clinical trials.
Key words
- Practical guide for Waldenström macroglobulinaemia
- lymphoplasmacytic lymphoma
- laboratory investigations for Waldenström macroglobulinaemia
- transformed Waldenström macroglobulinaemia
- IgM paraprotein
- IgM MGUS
- MYD88
- CXCR4
- work-up at diagnosis for Waldenström macroglobulinaemia
- work-up for Waldenström macroglobulinaemia during and post treatment
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Article info
Publication history
Published online: January 02, 2020
Accepted:
November 10,
2019
Received in revised form:
November 7,
2019
Received:
August 26,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier B.V. on behalf of Royal College of Pathologists of Australasia. All rights reserved.
