Fast Five Quiz: Waldenström Macroglobulinemia Workup

Emmanuel C. Besa, MD


February 01, 2021

A WM diagnosis is confirmed with the presence of IgM monoclonal protein associated with ≥ 10% clonal lymphoplasmacytic cells in bone marrow.

Approximately 90% of patients with WM have the MYD88 mutation L265P; however, the mutation alone is not diagnostic of WM. Its presence may be helpful in distinguishing WM from other types of lymphoma and IgM multiple myeloma. 

Other workup includes the following approaches:

  • Imaging studies are recommended for assessment of lymphadenopathy, extramedullary disease, or organomegaly.

  • In all patients with visual disturbance, hyperviscosity symptoms, and/or an IgM level ≥ 3000 mg/dL, fundoscopic examination is recommended.

  • Patients with findings of peripheral neuropathy should undergo nerve conduction studies and anti-myelin-associated glycoprotein serology.

Learn more about the diagnosis of WM.


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