CanCer-666: Waldenstrom's macroglobulinemia

Treatment Option for Waldenström’s Macroglobulinemia

ancorez Waldenstrom's macroglobulinemia 12:32 AM

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgCFMgUlnRLjFtAhpVpjrMS-wmHSLvupc37Io4L0k7gJJr1vzv6WkgzGfE1thNEofgd6qt2c7cbCfzH6z9__prW88s3NLXUSJsuQ7xPnPXl2fa1Eg23Siq3dZUn6Og82ypQi4qzNytC0A8/s1600/Treatment+Option+for+Waldenstrom%E2%80%99s+Macroglobulinemia.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="177" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgCFMgUlnRLjFtAhpVpjrMS-wmHSLvupc37Io4L0k7gJJr1vzv6WkgzGfE1thNEofgd6qt2c7cbCfzH6z9__prW88s3NLXUSJsuQ7xPnPXl2fa1Eg23Siq3dZUn6Og82ypQi4qzNytC0A8/s320/Treatment+Option+for+Waldenstrom%E2%80%99s+Macroglobulinemia.jpg" width="320" /></a></div>
Once waldenstrom macroglobulinemia (WM) has been diagnosed, your cancer care team will discuss your treatment options with you. Your options may be affected by factors such as your age and general health and the type of symptoms you are having. Not everyone with waldenstrom macroglobulinemia needs to be treated right away. People who do not have serious or bothersome symptoms can often be watched closely, with treatment starting at a later time if it is needed. If treatment is needed, there are several types that can be used for waldenstrom macroglobulinemia: 
 
Chemotherapy. Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Chemotherapy is given by a medical oncologist or hematologist, doctors who specialize in treating this type of cancer with medication. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time. 
 
The commonly used drugs for people with Waldenström’s macroglobulinemia include chlorambucil (Leukeran), cyclophosphamide (Neosar), fludarabine (Fludara), and cladribine (Leustatin). 
 
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished. 
 
Getting Care for Symptoms and Side Effects. Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs. Palliative care can help a person at any stage of illness. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment. 
 
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, and radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan. Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and supportive care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. 
 
Plasma Exchange. Plasma exchange (also called plasmapheresis) is used to reduce the thickness of the blood. It is done to help relieve the symptoms of hyperviscosity in people with Waldenström’s macroglobulinemia. During this procedure, blood is taken from a vein, and plasma (the liquid part of the blood) is removed from the body after it is separated from the red and white blood cells. The blood cells are then mixed with a plasma substitute, usually an albumin solution, and returned to the patient. This procedure is usually done using a blood cell separator. 
 
Recurrent Waldenström’s Macroglobulinemia. A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence). 
 
When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether your prognosis has changed. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above (such as chemotherapy, targeted therapy, and bone marrow/stem cell transplantation) but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. 
 
Refractory Waldenström’s Macroglobulinemia. If treatment does not stop or eliminate the disease, this is called refractory Waldenström’s macroglobulinemia. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. 
 
Your health care team may recommend a treatment plan that includes a combination of different chemotherapy drugs. Supportive care will also be important to help relieve symptoms and side effects. For most patients, this diagnosis is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group. 
 
Stem Cell Transplantation/Bone Marrow Transplantation. Stem cell transplantation is a medical procedure in which bone marrow that contains cancer is replaced by highly specialized cells, called hematopoietic stem cells, that develop into healthy bone marrow. Hematopoietic stem cells are found both in the bloodstream and in the bone marrow. Today, this procedure is more commonly called a stem cell transplant, rather than bone marrow transplant, because it is the stem cells in the blood that are typically being transplanted, not the actual bone marrow tissue. 
 
However, transplantation is not used often for people with Waldenström’s macroglobulinemia because most patients are older, the treatment does not work equally well for each patient, and there are serious risks with this treatment. 
 
Targeted Therapy. Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. As a result, doctors can better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. 
 
A monoclonal antibody is a type of targeted therapy. It is directed against a specific protein in the cancer cells and it does not affect cells that do not have that protein. Rituximab (Rituxan) is a monoclonal antibody used to treat many different types of B-cell lymphoma. Rituximab works by targeting a cell-surface molecule called CD20. When the antibody attaches to this antigen, some lymphoma cells die and others appear to become more susceptible to chemotherapy. Rituximab can be used either alone or in combination with chemotherapy for people with Waldenström’s macroglobulinemia. 
 
Although it is quite effective by itself, there is increasing evidence that, for people with most types of B-cell non-Hodgkin lymphoma, rituximab works better when combined with chemotherapy. Talk with your doctor about possible side effects for rituximab and how they can be managed. 
 
Watchful Waiting. Some patients with Waldenström’s macroglobulinemia may not need immediate treatment if they are otherwise healthy and the disease is not causing any symptoms or problems. In these situations, patients are closely monitored, and active treatment begins if symptoms develop or the IgM level increases. This is called watchful waiting, watch-and-wait, or active surveillance. There is very good evidence that, in some patients with low-grade lymphoma, watchful waiting does not affect the chances of survival as long as the patient receives regular and careful follow-up. 
 
 
If Treatment Fails 
 
Recovery from cancer is not always possible. If treatment is not successful, the disease may be called advanced or terminal cancer. This <a href="http://cancer-666.blogspot.com/2013/11/how-is-waldenstrom-macroglobulinemia-diagnosed.html">diagnosis</a> is stressful, and this is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important. 
 
Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families.</div>
</div>

Treatment Option for Waldenström’s Macroglobulinemia

Once waldenstrom macroglobulinemia (WM) has been diagnosed, your cancer care team will discuss your treatment options with you. Your opt...

How is Waldenstrom Macroglobulinemia Diagnosed?

ancorez Waldenstrom's macroglobulinemia 11:54 PM

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhKJNzCdGhd86x8pa_NTorWhP2sen20KHFCr5M1nAZh4W-3P9jizVZAP-juIlBHUwKwItpP7oiK-lIYE-wUDGbYdjul3J03UNTtWa6_eZH5eyczTdlZD5V0jYOGdsShqT0BmkAwMAnw6g/s1600/How+is+Waldenstrom+Macroglobulinemia+Diagnosed.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhKJNzCdGhd86x8pa_NTorWhP2sen20KHFCr5M1nAZh4W-3P9jizVZAP-juIlBHUwKwItpP7oiK-lIYE-wUDGbYdjul3J03UNTtWa6_eZH5eyczTdlZD5V0jYOGdsShqT0BmkAwMAnw6g/s200/How+is+Waldenstrom+Macroglobulinemia+Diagnosed.jpg" width="200" /></a></div>
Doctors use many tests to diagnose cancer and find out if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread. This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test: 
 
 
1. Biopsies 
 
<a href="http://cancer-666.blogspot.com/2013/11/signs-and-symptoms-of-waldenstrom-macroglobulinemia.html">The symptoms of waldenstrom macroglobulinemia (WM)</a> and non-Hodgkin lymphoma (NHL) are not distinctive enough for a doctor to know for certain if person has one of them, based on symptoms alone. Most symptoms can also be caused by non-cancerous problems like infections or by other kinds of cancers. Blood tests can help point to the correct diagnosis, but a biopsy (removing samples of affected tissue to look at under a microscope) is the only way to be sure. There are several types of biopsies. 
 
Bone Marrow Aspiration and Biopsy. This is the most important type of biopsy for waldenstrom macroglobulinemia (WM), and is needed to confirm the diagnosis. It can be done at the doctor’s office or at the hospital. The bone marrow aspiration and biopsy are usually done at the same time. The samples are taken from the back of the pelvic (hip) bone, although in some cases they may be taken from the sternum (breast bone) or other bones. 
 
In bone marrow aspiration, you lie on a table (either on your side or on your belly). After cleaning the skin over the hip, the doctor numbs the area and the surface of the bone by injecting a local anesthetic, which may cause a brief stinging or burning sensation. A thin, hollow needle is then inserted into the bone and a syringe is used to suck out a small amount of liquid bone marrow. Even with the anesthetic, most patients still have some brief pain when the marrow is removed. 
 
A bone marrow biopsy is usually done just after the aspiration. A small piece of bone and marrow is removed with a slightly larger needle that is twisted as it is pushed down into the bone. The biopsy may also cause some brief pain. Once the biopsy is done, pressure will be applied to the site to help stop any bleeding. There will be some soreness in the biopsy area when the numbing medicine wears off. Most patients can go home right after the procedure. 
 
The bone marrow samples are then sent to a lab, where a doctor called a pathologist will look at them under the microscope and do other tests (discussed below) to see if they contain lymphoma cells. To diagnose waldenstrom macroglobulinemia, at least 10% of the cells in the bone marrow must be lymphoplasmacytoid lymphoma cells. 
 
Excisional or Incisional Biopsy. For these types of biopsies, a surgeon cuts through the skin to remove an entire lymph node or tumor (excisional biopsy) or a just a small part of a large tumor or lymph node (incisional biopsy). These biopsies are rarely needed in people with waldenstrom macroglobulinemia because the diagnosis is usually made with a bone marrow biopsy. They are used more often for other types of lymphoma. If the area to be biopsied is near the skin surface, this can be done using local anesthesia (numbing medicine). If the area is inside the chest or abdomen, general anesthesia or deep sedation is used (where the patient is asleep). These types of biopsies almost always provide enough tissue to diagnose the exact type of lymphoma. 
 
Fat Pad Fine Needle Aspiration. This type of biopsy may be used in some people with waldenstrom macroglobulinemia to check for amyloid. In this procedure, a needle with a syringe attached is inserted into an area of fat (usually under the skin of the abdomen/belly). A small amount of fat is removed and sent to the lab for testing. 
 
Fine Needle Aspiration (FNA) Biopsy. An FNA biopsy uses a very thin, hollow needle with a syringe to withdraw a small amount of tissue from a tumor or lymph node. This type of biopsy is useful for sampling lymph nodes to see if they are enlarged because of cancer or another cause such as infection. FNA can help diagnose some lymphomas, but waldenstrom macroglobulinemia is usually diagnosed with a bone marrow biopsy instead.For an FNA on an enlarged node near the surface of the body, the doctor can aim the needle while feeling the node. If the enlarged node (or tumor) is deep inside the body, the needle can be guided while it is viewed by a computed tomography ( CT) scan or ultrasound (see the descriptions of imaging tests later in this section). 
 
The main advantage of FNA is that it does not require surgery and can often be done in a doctor’s office. The main drawback is that in some cases it might not get enough tissue to make a definite diagnosis of lymphoma. However, advances in lab tests (discussed later in this section) and the growing experience of many doctors with FNA have improved the accuracy of this procedure. 
 
 
2. Imaging tests 
 
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive particles to produce pictures of the inside of the body. These tests are not needed to diagnose waldenstrom macroglobulinemia, but one or more of them might be done to help determine the extent of the disease (such as looking for an enlarged spleen or lymph nodes). 
 
Computed Tomography (CT). The CT scan is an x-ray test that produces detailed cross-sectional images of your body. Unlike a regular x-ray, CT scans can show the detail in soft tissues (such as internal organs). This scan can help tell if any lymph nodes or organs in your body are enlarged. CT scans are useful for looking for signs of lymphoma in the chest, abdomen, and pelvis. 
 
Before the test, you may be asked to drink a contrast solution and/or get an intravenous (IV) injection of a contrast dye to better outline abnormal areas in the body. You might need an IV line through which the contrast dye is injected. The injection can cause some flushing (a feeling of warmth, especially in the face). Some people are allergic to the dye and get hives or a flushed feeling or, rarely, have more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have any allergies or have ever had a reaction to any contrast material used for x-rays. Medication can be given to help prevent and treat allergic reactions. 
 
A CT scanner has been described as a large donut, with a narrow table in the middle opening. You will need to lie still on the table while the scan is being done. CT scans take longer than regular x-rays, and you might feel a bit confined by the ring while the pictures are being taken. Instead of taking one picture like an x-ray, a CT scanner takes many pictures as it rotates around your body. A computer combines these pictures into detailed images of the part of the body that is being studied. 
 
In some cases, a CT can be used to guide a biopsy needle precisely into a suspicious area. For this procedure, called a CT-guided needle biopsy, you remain on the CT scanning table while a radiologist moves a biopsy needle through the skin and toward the location of the mass. CT scans are repeated until the needle is within the mass. A biopsy sample is then removed and looked at under a microscope. 
 
Magnetic Resonance Imaging (MRI). This test is rarely used in waldenstrom macroglobulinemia, but if your doctor is concerned about the brain or spinal cord, MRI is very useful for looking at these areas. MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. 
 
Sometimes a contrast material is injected into a vein to make some structures clearer. This contrast is not the same as the contrast used for CT scans, but allergic reactions can still occur. Again, medicine can be given to prevent and treat allergic reactions. MRI scans take longer than CT scans – often up to an hour. You may have to lie inside a tube, which is confining and can upset people with a fear of enclosed spaces. Newer, more open MRI machines might be another option. The machine makes loud buzzing and clicking noises that some people find disturbing. Some places provide headphones with music to block this noise out. 
 
Positron Emission Tomography (PET). For a PET scan, a form of radioactive sugar (known as fluorodeoxyglucose or FDG) is injected into the blood. Because cancer cells in the body grow rapidly, they absorb large amounts of the radioactive sugar. After about an hour, you will be moved onto a table in the PET scanner. You lie on the table for about 30 minutes while a special camera creates a picture of areas of radioactivity in the body. The picture is not finely detailed like a CT or MRI scan, but it can provide helpful information about your whole body. 
 
PET scans can help tell if an enlarged lymph node contains lymphoma or is benign. It can also help spot small areas that might be lymphoma, even if the area looks normal on a CT scan. These tests can be used to tell if a lymphoma is responding to treatment. They can also be used after treatment to help decide whether an enlarged lymph node still contains lymphoma or is merely scar tissue. Many medical centers now use a machine that combines the PET scan with a CT scan (PET/CT scan). This lets the doctor compare areas of higher radioactivity on the PET scan with the detailed appearance of that area on the CT. 
 
Ultrasound. Ultrasound uses sound waves and their echoes to produce a picture of internal organs or masses. Ultrasound can be used to look at lymph nodes near the surface of the body or to look inside your abdomen for enlarged lymph nodes or organs such as the liver, spleen, and kidneys. (It can’t be used to look at organs or lymph nodes in the chest because the ribs block the sound waves.) 
 
For this test, a small, microphone-like instrument called a transducer is placed on the skin (which is first lubricated with a gel). It gives off sound waves and picks up the echoes as they bounce off the organs. The echoes are converted by a computer into a black and white image that is displayed on a computer screen. This is an easy test to have done, and it uses no radiation. For most ultrasounds, you simply lie on a table, and a technician moves the transducer over the part of your body being looked at. 
 
Chest X-ray. Plain x-rays of the chest might be done to look for enlarged lymph nodes in the chest. 
 
 
3. Lab Tests 
 
The diagnosis of waldenstrom macroglobulinemia may be suspected if your doctor finds you have low blood cell counts or unusual protein levels on blood tests. If so, your doctor may order a blood test called serum protein electrophoresis to determine what the abnormal proteins are. It is usually only after these tests are done that a biopsy of either the bone marrow or a lymph node is considered. 
 
Beta-2 Microglobulin. This test measures another protein made by the cancer cells in waldenstrom macroglobulinemia. This protein itself doesn’t cause any problems, but it is a useful indicator of a patient’s prognosis (outlook). High levels are linked with a worse outlook. 
 
Blood Cell Counts. The complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in the blood. If the lymphoma cells occupy too much of the bone marrow, these levels will be low. 
 
Cold Agglutinins. Cold agglutinins are antibodies that attack and kill red blood cells, especially at cooler temperatures. These dead cells can then build up and block blood vessels. A blood test can be used to detect these antibodies. 
 
Cryocrit. This test measures the amount of cryoglobulin (a protein that clumps together and blocks blood vessels in cool temperatures) in the blood. 
 
Electrophoresis. The immunoglobulin produced in waldenstrom macroglobulinemia is an abnormal IgM antibody. This antibody is monoclonal, meaning that it is many copies of the exact same antibody. Serum protein electrophoresis (SPEP) is a test that measures the total amount of immunoglobulins in the blood and finds any monoclonal immunoglobulin. Another test, such as immunofixation or immunoelectrophoresis, is then used to determine the type of antibody that is abnormal (IgM or some other type). Finding a monoclonal IgM antibody in the blood is needed to diagnose waldenstrom macroglobulinemia. The abnormal protein in waldenstrom macroglobulinemia is known by several different names, including monoclonal immunoglobulin M, IgM protein, IgM spike, IgM paraprotein, M protein, and M-spike. Other types of monoclonal immunoglobulins, like IgA or IgG, are seen in different disorders (like multiple myeloma and some lymphomas). 
 
Quantitative Immunoglobulins. This test measures the levels of the different antibodies (immunoglobulins) in the blood – IgA, IgE, IgG, and IgM – to see if any are abnormally high or low. In awldenstrom macroglobulinemia the level of IgM is high but the IgG level is often low. 
 
Viscosity. Viscosity is a measure of how thick the blood is. If the IgM level is too high, it will cause the blood to become thick (viscous) so that it can’t flow freely (think about pouring honey compared to pouring water). 
 
 
4. Lab Tests on Biopsy Specimens 
 
All biopsy specimens are looked at under a microscope by a pathologist – a doctor with special training in using lab tests to diagnose diseases. In some cases, a hematopathologist, a doctor with additional training in diagnosis blood and lymph node diseases, might also look at the biopsy. The doctors look at the size and shape of the cells and how the cells are arranged in the lymph node or bone marrow. Sometimes this exam does not provide a definite answer and other lab tests are needed. 
 
Cytogenetics. This technique allows doctors to evaluate the chromosomes (long strands of DNA) in the lymphoma cells. Cells (usually from the bone marrow) are cultured in the lab to get them to divide so that the chromosomes can be seen. Then the chromosomes are stained and looked at under a microscope. Because it takes time for the cells to start dividing, this test can take weeks. 
 
Normal human cells each contain 46 chromosomes. In some lymphomas, the cells may have too many chromosomes, too few chromosomes, missing parts of chromosomes (called a deletion), or other abnormalities. These changes can help identify the type of lymphoma. In waldenstrom macroglobulinemia, deletions are the most common type of chromosome change. 
 
Flow Cytometry. In this test, cells are treated with special man-made antibodies and passed in front of a laser beam. Each antibody sticks only to certain types of cells. If the cells now have antibodies attached to them, the laser will cause them to give off light, which is measured and analyzed by a computer. 
 
This is the most common test for immunophenotyping – classifying lymphoma cells according to the substances (antigens) on their surfaces. Different types of lymphocytes have different antigens on their surface. These antigens may also change as each cell matures. This test can help determine whether lymph node swelling is because of lymphoma, some other cancer, or a non-cancerous disease. It has become very important in helping doctors determine the exact type of lymphoma so they can select the best treatment. 
 
Immunohistochemistry. In this test, a part of the biopsy sample is treated with special man-made antibodies that attach only to specific molecules on the surface of the cells. These antibodies cause color changes, which can be seen under a microscope. This test may help distinguish different types of lymphoma from one another and from other diseases. 
 
Molecular Genetic Tests. Molecular tests such as fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR) are not usually needed to diagnose waldenstrom macroglobulinemia, but they are sometimes used to diagnose other types of non-Hodgkin lymphoma (NHL). These tests look at the cells’ DNA without having to grow the cells in the lab first. The tests can give results in less time than cytogenetics and can be done on cells from different sources (like lymph nodes, blood, and bone marrow). They are generally used to look for specific chromosome or gene changes, not just any change. 
 
 
5. Medical History and Physical Exam 
 
If you have signs or symptoms that suggest you might have waldenstrom macroglobulinemia, your doctor will want to get a thorough medical history, including information about your symptoms, possible risk factors, family history, and other medical conditions. Next, the doctor will do a physical exam, paying special attention to the lymph nodes and other areas of the body that might be involved, including the eyes, nerves, spleen, and liver. The doctor might also look for signs of infection, which can cause many of the same symptoms. If the doctor suspects that waldenstrom macroglobulinemia (or another type of lymphoma) might be causing your symptoms, he or she will likely order blood tests as the next step.</div>
</div>

How is Waldenstrom Macroglobulinemia Diagnosed?

Doctors use many tests to diagnose cancer and find out if it has metastasized (spread). Some tests may also determine which treatments m...

Signs and Symptoms of Waldenstrom's Macroglobulinemia

ancorez Waldenstrom's macroglobulinemia 8:25 AM

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCqXEweNCx2ah-xfCNsnw1HxVFl4vq6Z72n-xNThn-bkSPMB3oDJ6uqU2k-y0YA8R1ms2dgQdnOrAP-A7EfDbyBa3RJCFELDHCyg6aI9Yayoaqmy3gPuAXXyemXBkyAuyZLbcFLddwF5Y/s1600/Signs+and+Symptoms+of+Waldenstrom's+Macroglobulinemia.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCqXEweNCx2ah-xfCNsnw1HxVFl4vq6Z72n-xNThn-bkSPMB3oDJ6uqU2k-y0YA8R1ms2dgQdnOrAP-A7EfDbyBa3RJCFELDHCyg6aI9Yayoaqmy3gPuAXXyemXBkyAuyZLbcFLddwF5Y/s200/Signs+and+Symptoms+of+Waldenstrom's+Macroglobulinemia.jpg" width="200" /></a></div>
People with waldenstrom’s macroglobulinemia (WM) may experience the following symptoms or signs. Sometimes, people with waldenström’s macroglobulinemia do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. Some of the signs and symptoms of people with waldenstrom’s macroglobulinemia are similar to those of people with other types of non-Hodgkin lymphoma (NHL). For example, weight loss, fever, night sweats, and swollen lymph nodes can be seen in many types of non-Hodgkin lymphoma. Other waldenstrom macroglobulinemia symptoms are caused by the abnormal IgM antibody (M protein) made by the cancer cells: 
<ul>
<li>A condition called amyloidosis occurs when a part of the IgM antibody (called the light chain) builds up in organs like the heart and kidneys. This buildup can lead to heart and kidney problems.</li>
<li>If the abnormal protein only causes the blood to become thick in cooler parts of the body (like in the tip of the nose, ears, fingers, and toes), it is called a cryoglobulin. Cryoglobulins can cause pain or other problems in these areas if a person is exposed to cooler temperatures.</li>
<li>In hyperviscosity syndrome, too much of this protein in the blood can cause it to become too “thick.” (This is not the kind of thickness that can be treated with drugs known as “blood thinners.”) When the blood gets too thick, it has trouble traveling through blood vessels. This causes problems such as poor circulation to the brain, which can lead to symptoms similar to a stroke.</li>
</ul>
But, not all patients with WM develop amyloidosis, cryoglobulins, or hyperviscosity. 
 
 
Common Symptoms of Waldenstrom Macroglobulinemia 
 
Fever, Sweats, and Weight Loss. Lymphoma can cause fevers (without an infection), drenching night sweats, and weight loss (without trying). Together, these are called B symptoms. 
 
Loss of Appetite. Some people with waldenstrom's macroglobulinemia lose their appetite. 
 
Neuropathy. The abnormal antibody in some people with waldenstrom's macroglobulinemia can attack and damage nerves outside the brain. This can lead to problems with numbness or a painful “pins and needles” sensation in the feet and legs, which is called neuropathy. 
 
Weakness. The most common symptom of waldenstrom macroglobulinemia is weakness. It can be caused by anemia (too few red blood cells), which can happen when the waldenstrom's macroglobulinemia cells crowd out normal cells in the bone marrow. Some people also feel weak when the blood becomes thick from the buildup of the abnormal protein. 
 
Symptoms of Hyperviscosity (Thick Blood) 
 
IgM proteins are large molecules, and when they accumulate in the blood in high levels, the blood can become viscous or thick. This slows down the flow of blood to different parts of the body. Symptoms of hyperviscosity include: 
<ul>
<li>Confusion</li>
<li>Dizziness</li>
<li>Fatigue</li>
<li>Headaches</li>
<li>Loss of coordination</li>
<li>Nosebleeds and bleeding gums</li>
<li>Vision problems</li>
</ul>
 
Other Problems of Waldenstrom's Macroglobulinemia 
 
Abnormal Bleeding. High levels of abnormal antibody can damage blood vessels. Nosebleeds and bleeding gums are common symptoms of people with waldenstrom's macroglobulinemia. 
 
Digestive Symptoms. In some people with waldenstrom's macroglobulinemia, the buildup of IgM in the intestines can lead to problems such as diarrhea, poor absorption of vitamins, or gastrointestinal bleeding (seen as blood in the stools or dark stools). 
 
Enlarged Lymph Nodes. These usually appear as lumps under the skin around the neck, in the groin, or in the armpits. Enlarged lymph nodes are usually about 1 or 2 inches across. They are seen less often in WM than in most other lymphomas. 
 
Heart Problems. High levels of abnormal IgM protein can directly damage heart tissue. Also, in amyloidosis, abnormal protein builds up in the heart muscle. This makes the heart weaker, affecting its ability to pump blood. In addition, because the blood of people with waldenstrom's macroglobulinemia is thicker than normal, their hearts have to work harder to pump blood throughout the body. This strain can cause the heart muscle to wear down, leading to a condition called congestive heart failure. Symptoms can include heart palpitations, fatigue, weakness, cough, shortness of breath, rapid weight gain, and swelling in the feet and legs. 
 
Infections. The high levels of abnormal antibody in waldenstrom's macroglobulinemia “turn-off” normal antibody production. This makes it harder for the body to resist infections. 
 
Kidney Problems. Waldenstrom's macroglobulinemia can damage the kidneys. The abnormal IgM protein can damage the kidneys directly or through the development of amyloidosis. When the kidneys aren’t working well, excess salt, fluid, and body waste products stay in the blood. The resulting symptoms include weakness, trouble breathing, and fluid buildup in body tissues. 
 
Nervous System Symptoms. In hyperviscosity syndrome, the thickened blood causes poor brain circulation, leading to problems like headache, confusion, and dizziness. It can also cause symptoms like those seen with a stroke, including slurred speech and weakness on one side of the body. Patients with these symptoms should contact their doctor right away. 
 
Sensitivity to Cold. In people with cryoglobulins, exposure to cold temperatures can lead to pain, itching, or sores on the tip of the nose, ears, fingers, or toes due to reduced blood flow to these areas. 
 
Swollen Abdomen. Lymphoma can cause the spleen or liver to enlarge, making the belly look swollen. In the upper part of the abdomen, the liver is on the right and the spleen on the left. When the spleen gets larger, it can press on the stomach, which makes people feel full when they eat only a small amount. 
 
Vision Problems. Bleeding around the small blood vessels inside the eyes or poor circulation in these vessels caused by thickened blood might lead to blurred vision or blind spots. 
 </div>
</div>

Signs and Symptoms of Waldenstrom's Macroglobulinemia

People with waldenstrom’s macroglobulinemia (WM) may experience the following symptoms or signs. Sometimes, people with waldenström’s ma...

The Risk Factors for Waldenstrom Macroglobulinemia

ancorez Waldenstrom's macroglobulinemia 7:43 AM

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGY6xRu_XW3deHcGet9z50Rc8FTIsmEDOQddOFW8SF2VKRbegQYH_3WoDCqAVERQKb78NFrcMLmgO0_UVrFlRXeKZ46tHrp0j5wDIHKhfaqy118QhYCyFmqSkGxx6d3pCtHAdLLAFlic8/s1600/The+Risk+Factors+for+Waldenstrom+Macroglobulinemia.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGY6xRu_XW3deHcGet9z50Rc8FTIsmEDOQddOFW8SF2VKRbegQYH_3WoDCqAVERQKb78NFrcMLmgO0_UVrFlRXeKZ46tHrp0j5wDIHKhfaqy118QhYCyFmqSkGxx6d3pCtHAdLLAFlic8/s200/The+Risk+Factors+for+Waldenstrom+Macroglobulinemia.jpg" width="189" /></a></div>
A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices. 
 
Researchers have found a few risk factors that make a person more likely to develop Waldenstrom macroglobulinemia (WM). But most people with these risk factors never develop the disease. Even if a patient with WM does have one or more risk factors, it is impossible to know for sure how much that risk factor contributed to causing the cancer. The following factors may raise a person’s risk of developing Waldenstrom’s macroglobulinemia: 
 
Age. The risk of Waldenstrom’s macroglobulinemia increases with age. It occurs most commonly in people older than 60. 
 
Certain Autoimmune Diseases. Some research has suggested that people with certain types of autoimmune disease, such as Sjogren syndrome, might be at higher risk for waldenstrom macroglobulinemia. 
 
Hepatitis C. Some studies have found that people with chronic hepatitis C infection might be more likely to develop waldenstrom's macroglobulinemia than people without the virus. But not all studies have found such a link. 
 
Heredity. Genetic factors may play a role. About 20% of patients with waldenstrom's macroglobulinemia have a close relative with waldenstrom macroglobulinemia or with a related B-cell disease, such as MGUS or certain types of lymphoma or leukemia. 
 
Monoclonal Gammopathy of Undetermined Significance (MGUS). Monoclonal gammopathy of undetermined significance (MGUS) is an abnormality of antibody-making cells that is related to multiple myeloma and waldenstrom's macroglobulinemia. In MGUS, like waldenstrom macroglobulinemia and multiple myeloma, abnormal cells in the bone marrow make large amounts of one particular antibody. This antibody is called a monoclonal (or M) protein, and the condition is called a monoclonal gammopathy. As long as the patient has no problems from the abnormal cells or the M protein they make, it is called MGUS. 
 
Generally, the abnormal cells in MGUS make up less than 10% of the bone marrow and the amount of abnormal M protein in the blood is not very high (less than 3 g/dl). MGUS itself does not cause health problems, but each year about 1% to 2% of people with MGUS go on to develop a related cancer (like multiple myeloma, waldenstrom's macroglobulinemia, or lymphoma) or another serious health problem (like amyloidosis). 
 
Race. White people are more likely to develop Waldenstrom’s macroglobulinemia than black people. 
 
Sex. Men are more likely to develop Waldenström’s macroglobulinemia than women. The reason for this is not known. 
 </div>
</div>

The Risk Factors for Waldenstrom Macroglobulinemia

A risk factor is anything that increases a person’s chance of developing cancer . Although risk factors often influence the development ...

Waldenstrom's Macroglobulinemia

ancorez Waldenstrom's macroglobulinemia 7:22 AM

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
What is Waldenstrom Macroglobulinemia? 
 
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizLrM8DFhj530EVxRQuU1E_I3bL5NY3CdteFHD061jvtrLxc5dFXsoncuioT2SIX9RAMx9UCZrPn-QGizqClzM8Q-d7mcLN_HGpkTTysLLasvTCsLCudc-y-YdLGcc9pFwNpJl934NFzE/s1600/Waldenstrom's+macroglobulinemia.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizLrM8DFhj530EVxRQuU1E_I3bL5NY3CdteFHD061jvtrLxc5dFXsoncuioT2SIX9RAMx9UCZrPn-QGizqClzM8Q-d7mcLN_HGpkTTysLLasvTCsLCudc-y-YdLGcc9pFwNpJl934NFzE/s200/Waldenstrom's+macroglobulinemia.JPG" width="200" /></a></div>
Waldenstrom's macroglobulinemia (also known as lymphoplasmacytic lymphoma or immunocytoma) is a rare, indolent (slow-growing) B-cell lymphoma that occurs in less than two percent of patients with NHL. There are about 1,500 new cases of Waldenström's each year. The disease usually affects older adults and is primarily found in the bone marrow, although lymph nodes and the spleen may be involved. 
 
Waldenstrom macroglobulinemia (WM) is a type of non-Hodgkin lymphoma (NHL) in which the cancer cells make large amounts of an abnormal protein (called a macroglobulin). Another name for waldenstroms macroglobulinemia is lymphoplasmacytic lymphoma. This condition used to be called Waldenstrom’s macroglobulinemia, so some people refer to it as Waldenstrom’s. To understand Waldenstrom macroglobulinemia, it helps to know about lymphoid tissue in the body. 
 
About Lymphoma and the Lymph System 
 
Non-Hodgkin lymphoma (NHL) is a term that refers to many types of cancer of the lymphatic system, which can have different symptoms and signs, physical findings, and treatment options. The lymphatic system is made up of thin tubes that branch out to all parts of the body and helps fight infection. The lymphatic system carries lymph, a colorless fluid containing lymphocytes. Lymphocytes fight germs in the body. B-lymphocytes (also called B-cells) make antibodies, and T-lymphocytes (also called T-cells) destroy viruses and foreign cells and regulate the B-cells to make antibodies. 
 
Groups of bean-shaped organs called lymph nodes are located throughout the body at different sites in the lymphatic system. Lymph nodes are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other parts of the lymphatic system include the spleen, which makes lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, located in the throat. 
 
About Waldenstrom’s Macroglobulinemia 
 
Waldenstrom's macroglobulinemia is a cancer that starts in B cells. The cancer cells in people with waldenstrom's macroglobulinemia are similar to those of 2 other types of cancer: multiple myeloma and non-Hodgkin lymphoma. Multiple myeloma is considered a cancer of plasma cells and non-Hodgkin lymphoma is a cancer of lymphocytes. Waldenstroms macroglobulinemia cells have features of both plasma cells and lymphocytes and are called lymphoplasmacytoid. 
 
Waldenstrom's macroglobulinemia cells make large amounts of a certain type of antibody (immunoglobulin M, or IgM), which is known as a macroglobulin. Each protein made by the WM cells is the same, so it is called a monoclonal protein, or just an M protein. The buildup of this M protein in the body can lead to many of the symptoms of WM, including excess bleeding, problems with vision, and nervous system problems. 
 
The <a href="http://cancer-666.blogspot.com/2013/11/waldenstroms-macroglobulinemia.html">waldenstroms macroglobulinemia</a> cells grow mainly in the bone marrow, where they can crowd out the normal cells that make the different types of blood cells. This can lead to low levels of red blood cells (called anemia), which can make people feel tired and weak. It can also cause low numbers of white blood cells, which makes it hard for the body to fight infection. The numbers of platelets in the blood can also drop, leading to increased bleeding and bruising. Lymphoma cells can also grow in organs like the liver and spleen, causing these organs to swell and leading to abdominal pain.</div>
</div>

Waldenstrom's Macroglobulinemia

What is Waldenstrom Macroglobulinemia? Waldenstrom's macroglobulinemia (also known as lymphoplasmacytic lymphoma or immunocytoma)...

Definition and Description of the Waldenstrom's Disease

Gaptek_ancorez Waldenstrom's macroglobulinemia 12:05 PM

<div dir="ltr" style="text-align: left;" trbidi="on"> 
<div style="text-align: justify;"><h1>Definition of Waldenstrom's Disease</h1></div><div style="text-align: justify;">Waldenstrom's macroglobulinemia are a rarefied, confirmed <a href="http://cancer-666.blogspot.com/">cancer</a> of the resistant arrangement that's characterised along hyperviscosity, or deepening, of the blood.</div><div style="text-align: justify;"> 
</div><div style="text-align: justify;"><h2>Description of Waldenstrom's Disease</h2></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3Nq3VIW9291jZEg7x6LdL1J45ksg7moFl_WiOTcLb3C9TM8OXiGKLcp9caP1uGKw_bF7MH1wtBiTrvpxLAlWnE4ZxX8eusjV_FJj5uKF5pbY5HuFBSch13kE27YYoADSS1OLg_KmVUSMl/s1600/Definition+and+Description+of+the+Waldenstrom%27s+Disease.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3Nq3VIW9291jZEg7x6LdL1J45ksg7moFl_WiOTcLb3C9TM8OXiGKLcp9caP1uGKw_bF7MH1wtBiTrvpxLAlWnE4ZxX8eusjV_FJj5uKF5pbY5HuFBSch13kE27YYoADSS1OLg_KmVUSMl/s320/Definition+and+Description+of+the+Waldenstrom%27s+Disease.jpg" width="194" /></a></div><div style="text-align: justify;">Waldenstrom's macroglobulinemia (WM) are a lymphoma, or cancer the Crab of the systema lymphatic. They comprised 1st described in 1944, along the Swedish doctor January Gosta Waldenstrom, inmates who accepted a deepening of the blood serum, or liquidity function, of the ancestry. Their serum arrested a good deal of an identical big atom known as a globulin. Thus, the disarrays are named macroglobulinemia.</div><div style="text-align: justify;"> 
</div><div style="text-align: justify;">Lymphomas are cancers who arise in weaves of the systema lymphatic. Totally, lymphomas other Hodgkin's disease, admitting WM, is cognized conjointly since non-Hodgkin's lymphomas. At that place are 13 major cases of non-Hodgkin's lymphomas, et al that is identical rarefied. Additional calls that are some of the times applied as WM admitted: lymphoplasmacytic lymphoma, lymphoplasmacytic leukemia, macroglobulinemia of Waldenstrom, basal macroglobulinemia, Waldenstrom's syndrome, Waldenstrom's peliosis, or hyperglobulinemic peliosis. Peliosis adverts to embellished blobs along the abrade, consequent upon the patronize bloody and contusing that careful comprise a symptom of WM.</div><div style="text-align: justify;"> 
</div><div style="text-align: justify;">WM is assorted because an inferior or fainéant anatomy of lymphoma since they are a slow-growing cancer who acquires fewer symptoms than additional cases of lymphomas. WM almost a great deal bears on males across the age of 65. Often, these diseases brings about no more symptoms and doesn't ask discourse. It's not comprised analysed because extensively since additional cases of lymphoma.</div></div>

Definition and Description of the Waldenstrom's Disease

Definition of Waldenstrom's Disease Waldenstrom's macroglobulinemia are a rarefied, confirmed cancer of the resistant arrangement...

CanCer-666

Treatment Option for Waldenström’s Macroglobulinemia

How is Waldenstrom Macroglobulinemia Diagnosed?

Signs and Symptoms of Waldenstrom's Macroglobulinemia

The Risk Factors for Waldenstrom Macroglobulinemia

Waldenstrom's Macroglobulinemia

Definition and Description of the Waldenstrom's Disease

Health Products

Hot News

Random