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Waldenstrom’s macroglobulinaemia (WM)

What is Waldenstrom’s macroglobulinaemia?

Waldenstrom’s macroglobulinaemia (WM) is an uncommon type of blood cancer. WM (lymphoplasmacytic lymphoma) is a disorder that has features in common with indolent non-Hodgkin lymphoma and with myeloma. WM more closely resembles indolent lymphoma in its progression as a disease.

In WM, abnormal lymphoma and plasma cells produce excess amounts of a particular antibody (or immunoglobulin) called IgM. The “M” in IgM stands for macroglobulin and is where the naming macroglobinaemia is derived from. Over time IgM builds up in the bone marrow, spleen and blood, causing it to become thicker and blood flow to various body organs may be impaired. This complication occurs in approximately 10-30% of people with this disease. Symptoms may include changes in vision, headaches, hearing loss, abnormal bleeding and confusion. People can also experience lethargy and fatigue, and are at increased risk of infection.

Because WM affects the plasma cells it is sometimes confused with myeloma, though it does not cause the bone damage seen in myeloma patients and is usually treated in a different way. Most patients are diagnosed with WM after they are affected by the symptoms resulting from the build-up of the antibody in their blood.

Waldenstrom’s macroglobulinaemia: the basics

How common is Waldenstrom’s macroglobulinaemia?

The condition is rare – approximately 2% of all blood cancers diagnosed are WM.

Who gets Waldenstrom’s macroglobulinaemia?

WM is more common in men than women and is most often diagnosed in people in their sixties and older.

What causes Waldenstrom’s macroglobulinaemia?

While the exact cause is not known, WM is not due to infection and cannot be passed from one person to another.

What are the symptoms of Waldenstrom’s macroglobulinaemia?

People may go to see their general practitioner (GP) because they have some troubling symptoms of their disease. Symptoms develop slowly with complaints of tiredness, weakness and possibly weight loss. The symptoms that a person with WM will experience can result from either the presence of the abnormal lymphocytes in the bone marrow or spleen or the result of increased antibody (IgM) in the person’s blood.

As the numbers of abnormal lymphocytes increase, the spleen and lymph nodes “glands” will enlarge. The common lymph nodes affected are in the neck, armpits or in the groin. As the disease progresses further symptoms result from problems with blood cell production. Possible symptoms may include:

  • anaemia, due to a lack of red cells, causing persistent tiredness, dizziness, paleness, or shortness of breath when physically active
  • frequent or repeated infections and slow healing, due to a lack of normal white blood cells
  • pain or discomfort under the ribs on the left side, due to an enlarged spleen
  • painless swelling of the lymph nodes (glands) in your neck, under your arms or in your groin. This is usually a result of lymphocytes accumulating in these tissues
  • excess antibody production leads to thickening of a person’s blood or hyperviscosity. This reduced blood circulation can lead to symptoms of headache, confusion, sleepiness and altered vision. Occasionally the antibody can damage a nerve, causing weakness. Increased antibodies can cause damage to a person’s kidneys.

Some of the symptoms described above may also be seen in other illnesses, including viral infections. So, most people with these symptoms don’t have WM. However, it is important to see your doctor if you have any unusual symptoms, or symptoms that persist much longer than expected so that you can be examined properly.

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