Fast Five Quiz: Waldenström Macroglobulinemia Workup

Emmanuel C. Besa, MD


February 01, 2021

MYD88 L265P is not found in IgM multiple myeloma. Instead, it is specifically associated with WM and IgM MGUS. However, it cannot be used to differentiate between WM and IgM MGUS. MYD88 mutations were observed in five of nine patients with IgM MGUS as well as five of six patients with monoclonal protein levels exceeding 0.5 g/dL.

The mutations are also associated with splenic marginal zone lymphoma (4%), IgM amyloidosis (71%), and mucosa-associated lymphatic tissue lymphoma (7%). Distinguishing between WM and marginal zone lymphoma continues to be a clinical challenge.

Learn more about differential diagnosis in WM.


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