IgM protein levels are predictive of outcomes in WM, entering into the staging system when the IgM level exceeds 7000 mg/dL. Age, hemoglobin level, platelet count, beta-2 microglobulin, and monoclonal IgM concentrations are also important prognostically.
Lactate dehydrogenase is not considered in the International Prognostic Scoring System for WM.
While the immunoglobulin free light chain assay has proven its clinical utility in myeloma, its value is not well established in WM.
CXCR4 mutations are found in approximately 30% of patients with WM, but genetic testing for this mutation is not used in staging; it is only recommended when considering treatment with the Bruton tyrosine kinase (BTK) inhibitors, such as ibrutinib.
Learn more about staging and risk assessment in WM.
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Cite this: Emmanuel C. Besa. Fast Five Quiz: Waldenström Macroglobulinemia Workup - Medscape - Feb 01, 2021.