Waldenstrom macroglobulinemia is a rare type of chronic, lymphoproliferative cancer that originates in the white blood cells. It is usually defined as a type of Non-Hodgkins Lymphoma. In case of Waldenstrom macroglobulinemia, the bone marrow produces a large number of abnormal white blood cells that crowd out the healthy white blood cells. These abnormal WBC’s have characteristics of both white blood cells (lymphocytes) called B cells and more mature cells derived from B cells known as plasma cells. These abnormal cells with both lymphocyte and plasma characteristics are known as lymphoplasmacytic cells and hence this condition is also known as lymphoplasmacytic lymphoma. These abnormal WBC’s primarily produces a macroglobulin called immunoglobulin M (IgM) that gets accumulated in the blood and withholds normal blood circulation causing various complications. Due to the overproduction of this large protein, the condition is thus named (macroglobulinemia).
Although the exact cause of Waldenstrom macroglobulinemia is yet to be discovered, many researches show that it might happen when the bone marrow, the soft spongy tissue found within the bones develops one abnormal white blood cell (cell with errors or mutations in its genetic code). These errors tell the cell to multiply rapidly without dying like normal WBC’s do, thus overwhelming the production and development of healthy WBC’s. With passing time, these abnormal cells crowd out the healthy cells but since they have characteristics of both B-cells and plasma cells, they keep trying to produce antibodies. But being abnormal in nature, these mutated cells produce abnormal proteins called IgM. This macroglobulin then gets accumulated in the blood, inhibiting normal cellular function at all levels.
Certain causative factors that increase thr risk of Waldenstrom macroglobulinemia includes:
Age: Waldenstrom macroglobulinemia is more commonly found in older adults above the age of 50, although it can happen to anyone.
Race: Caucasian individuals are more at risk of getting this type NHL.
Gender: Men are more expected than women to develop Waldenstrom macroglobulinemia.
Heredity: A family history of Waldenstrom macroglobulinemia or any other type of lymphoma increase the risk of this cancerous condition.
Waldenstrom macroglobulinemia is slow growing and latent in nature and might not show characteristic symptoms for several years. The symptoms that do come up later in life include:
- Frequent infection
- Easy bruising
- Bleeding from the nose or the gums
- Numbness in your hands or feet
- Weight loss
- Night Sweat
- Shortness of breath
- Changes in vision
- Swollen belly or lymph nodes
Diagnosis And Treatment
Consult a doctor immediately if you detect any of the above-mentioned signs and symptoms. The specialized doctor first does a thorough physical examination by analysing any swollen lymph nodes, including the neck, underarm and groin, as well as for a swollen spleen or liver. The doctor may also acknowledge the patient’s family history of cancerous conditions. Other diagnostics include:
Blood Test: To reveal the amount of healthy blood cells and detect presence of IgM.
Bone Marrow Test: A sample of bone marrow is taken for bone marrow aspiration and biopsy to know about the presence of abnormal cells.
Imaging techniques like X-ray, CT, MRI and Positron Emission Tomography (PET).
The treatment options usually depend upon the type and stage of cancer and include:
- Plasma exchange: Blood is filtered through a machine that separates the liquid part of the blood, called plasma, from the blood cells, thus removing IgM and in turn swapping in healthy plasma.
- Targeted therapy: Specialized medicines are given that block certain proteins or enzymes within the body that help the cancer cells grow.
- Biological therapy: Medicines are given to support and help the body’s natural immunity to fight off the cancer cells.
- Chemotherapy: Powerful chemicals are used to kill the plasma cells.
- Bone marrow transplant: After killing the abnormal cells with chemotherapy, a bone marrow transplant replaces it with stem cells that eventually grow into healthy bone marrow.
- Clinical Trials: Researchers and scientists try out experimental treatments that have not yet been approved by the FDA.