Waldenstrom’s Macroglobulinemia (WM) symptoms, complications and treatment options uptodate.
Waldenstrom’s Macroglobulinemia (WM) is one of the harmful monoclonal gammopathies. It is a chronic, slothful, lympho-proliferative disorder. Waldenstrom’s Macroglobulinemia is also called Waldenstrom’s syndrome , Waldenstrom’s disease, Waldenstrom’s cancer and Lymphoplasmacytic Lymphoma.
Waldenstrom’s syndrome is caused by cancer cells making large amounts macroglobulin (an abnormal protein) in B-cells. It is a type of of non-Hodgkin lymphoma (NHL) cancer. The tumor cells in individuals with WM are like those of 2 different sorts of disease:
- Multiple myeloma
- Non-Hodgkin lymphoma
Multiple Myeloma is viewed as a cancer of plasma cells and non-Hodgkin lymphoma, which is a malignancy of lymphocytes. Waldenstrom macroglobulinemia cells have components of both plasma cells and lymphocytes and are called lymphoplasmacytoid.
The clinical appearances of Waldenstrom macroglobulinemia result from the presence of the IgM paraprotein and malignant lymphoplasmacytic cell invasion of the bone marrow and other sites of tissue. The clinical presentation is like that of multiple myeloma aside from that:
- Organomegaly is regular in Waldenstrom macroglobulinemia and is uncommon in multiple myeloma.
- Lytic disease of bones and renal ailment are uncommon in Waldenstrom macroglobulinemia however are common in multiple myeloma.
Waldenstrom’s Macroglobulinemia Symptoms and Treatments
Waldenstrom’s Macroglobulinemia symptoms involve presence of abnormally high levels of a macroglobulin (immunoglobulin M [IgM]), raised serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. Let’s have a look at some common Waldenstrom’s Macroglobulinemia symptoms, diagnoses, treatment and complications:
Waldenstrom’s Macroglobulinemia Symptoms
Since Waldenstrom’s macroglobulinemia is indolent (moderate developing), there may be no signs or indications of infection for quite a long time before and even after diagnosis. However, WM patients may encounter these common Waldenstrom’s Macroglobulinemia symptoms:
Fever, Sweats and Weight Loss
Lymphoma can cause fevers (without an infection) drenching night sweats and weight loss (without trying). Together these all can be sign and symptoms for Waldenstrom’s macroglobulinemia.
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.
Further, even if Waldenstrom’s macroglobulinemia signs and symptoms are observed, there may be no connection between the level of monoclonal IgM and/or the measure of bone marrow infiltration with the level of severity of symptoms. A few patients don’t have signs or symptoms of WM. In these cases, Waldenstrom’s macroglobulinemia may be identified amid a routine blood test. Below is a complete list of possible Waldenstrom’s macroglobulinemia symptoms:
- Fatigue, weakness and serious exhaustion
- Loss of appetite or weight
- Recurrent fever
- Bleeding from the nose and gums
- Easily wounding and bruising of the skin
- Night sweats
- Swollen lymph nodes in the neck, groin or armpits
- Enlargement spleen and liver (felt as a swollen belly)
- Numbness burning, prickling or tingling sensations in the hands, feet, legs, ears, or nose
- Vision related problems
- Migraines, dizziness, or confusions
- Carpel tunnel syndrome
- Masses on spine, breast or eye sockets
- Swelling in extremities
- Swollen or enlarged tongue
- Shortness of breaths
- Pinpoint red flat blotches known as petechiae
- Recurrent infections in sinuses and upper respiratory tract
- Rash or hives
- Palpitations of heart
- Anemia (decreased production of red blood cells)
These indications don’t generally mean to have Waldenstrom’s macroglobulinemia. Be that as it may, it is critical to talk about any symptoms with an oncology specialist, since they might likewise flag other health issues.
Waldenstrom’s Macroglobulinemia Complications
Waldenstrom’s macroglobulinemia complications includes the following:
- Hyperviscosity syndromes
- Visual aggravations secondary to hyperviscosity disorder
- Loose bowels and malabsorption secondary to gastrointestinal (GI) inclusion
- Less common renal diseases
- Amyloidosis of the heart, kidney, liver, lungs, and joints
- Bleeding manifestations secondary to platelet dysfunctions and coagulation elements and fibrinogen anomalies because of interactions with plasma IgM
- Raynaud syndrome secondary to cryoglobulinemia
- Increased inclination to infections because of B-cell dysfunctions (disease related) or T-cell dysfunctions (treatment related, especially after nucleoside analogues)
- Heart failure
- Increased rate of lymphomas, myelodysplasia, and leukemias
Waldenstrom’s Macroglobulinemia Treatment Options Uptodate
Once Waldenstrom’s macroglobulinemia diagnosis is established for a patient, physician will talk about the best choices to treat it. This relies upon a few components, including the degree of the ailment and your general health condition.
Waldenstrom’s macroglobulinemia treatment will be modified to the specific patient needs. One or multiple of the following treatments may be prescribed to treat the cancer or relieve symptomatic manifestations.
Chemotherapy treatment
This frequently is the best treatment, and a blend of chemo medications is utilized more usually. Ibrutinib (Imbruvica) is an FDA approved anti-cancer chemotherapy drug targeting B-cell malignancies. It provides ongoing control of Waldenstrom’s macroglobulinemia (WM).
Radiology treatment
New radiology treatment procedures and striking expertise permit specialists to focus on Waldenstrom’s macroglobulinemia tumors all the more unequivocally, conveying the most extreme measure of radiation with minimal harm to healthy cells.
Immunotherapy
On the cutting edge of new medications, immunotherapies to treat Waldenstrom’s may include:
- Monoclonal antibodies, including Rituxan® (rituximab)
- Biological therapies that create antibodies that devastate tumor cells
- Proteasome inhibitors, for example, Velcade® (bortezomib)
- Immune modulators, for example, thalidomide and lenalidomide, that adjust the environment of the cancerous cell and permit it to die
- Targeted therapies that assault cancerous cells by utilizing small particles to block pathways cells use to survive and increase in number
Stem Cell Transplantation
If Waldenstrom’s macroglobulinemia does not react to chemotherapy or on the off chance that it return backs or recur, a stem cell transplant may be suggested.
Plasma Transfusion
If indications of too thick blood or hyperviscosity are present, plasma can be uprooted and supplanted with normal plasma from a healthy donor. This rapidly alleviates and relieves the symptoms until chemotherapy or immunotherapy can obliterate the Waldenstrom’s cells that are bringing about the buildup of anomalous protein.
Iron Therapy
New research suggests that intravenous iron therapy may help to improve iron levels in patients with Waldenström macroglobulinemia who exhibit severely depressed transferrin saturation (TSAT) levels.