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15 - Waldenstrom’s macroglobulinemia/lymphoplasmacytic lymphoma

from Section 3 - Myeloma: clinical entities

Published online by Cambridge University Press:  18 December 2013

By
Steven P. Treon  and
Giampaolo Merlini
Edited by
Stephen A. Schey ,
Kwee L. Yong ,
Robert Marcus  and
Kenneth C. Anderson
Stephen A. Schey
Affiliation:
Department of Haematology, King’s College Hospital, London
Kwee L. Yong
Affiliation:
Department of Haematology, University College Hospital, London
Robert Marcus
Affiliation:
Department of Haematology, King’s College Hospital, London
Kenneth C. Anderson
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

Introduction

Waldenstrom’s macroglobulinemia (WM) is a distinct clinicopathological entity resulting from the accumulation, predominantly in the bone marrow, of clonally related lymphocytes, lymphoplasmacytic cells and plasma cells which secrete a monoclonal IgM protein (Figure 15.1)[1]. This condition is considered to correspond to the lymphoplasmacytic lymphoma (LPL) as defined by the World Health Organization classification system[2]. Most cases of LPL are WM, with less than 5% of cases made up of IgA, IgG and non-secreting LPL.

Epidemiology and etiology

WM is an uncommon disease, with a reported age-adjusted incidence rate of 3.4 per million among males and 1.7 per million among females in the USA, and a geometrical increase with age[3]. The incidence rate for WM is higher among Caucasians, with African descendants representing only 5% of all patients. Genetic factors appear to be important to the pathogenesis of WM. A common predisposition for WM with other malignancies has been raised[4,5], and there have been numerous reports of familiar predisposition, including clustering of family members with WM and other B cell lymphoproliferative diseases[6–10]. In a recent study, 28% of 924 serial WM patients presenting to a tertiary referral had a first or second degree relative with either WM or another B - cell disorder[5]. Frequent familiar association with other immunological disorders in healthy relatives, including hypogammaglobulinemia and hypergammaglobulinemia (particularly polyclonal IgM), autoantibody (particularly to thyroid) production, and manifestation of hyper-responsive B cells have also been reported[10,11].

Type
Chapter
Information
Myeloma
Pathology, Diagnosis, and Treatment
 , pp. 190 - 215
Publisher: Cambridge University Press
Print publication year: 2013

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