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Published on: June 23, 2019
Waldenström's macroglobulinemia in young African-American adults
S Ahmed1, M S Shurafa, C R Bishop
1Department of Internal Medicine, Barbara Ann Karmanos Cancer Institute and Wayne State University, Detroit, Michigan, USA.
Abstract:
We have identified five African-American patients with Waldenström's macroglobulinemia (WM) diagnosed at a young age (ages 35, 38, 38, 40, 51; 4 males, 1 female). All had a history of intravenous heroin abuse and four also used cocaine. Their manner of presentation and clinical course were typical. Three of three patients tested for the hepatitis C virus (HCV) were positive and three of three patients tested were HIV negative. The potential relationship between intravenous drug abuse and/or HCV to development of WM in this group of young patients is provocative, especially since a polyclonal increase in serum IgM is commonly seen in chronic intravenous heroin addicts. More recently, the contribution of HCV is being evaluated in lymphoproliferative disorders. Although WM is typically a disease of older people, it should also be considered in the differential in a young patient with a suggestive clinical picture.
Insights
This study identifies young African-American patients with Waldenström's macroglobulinemia (WM), a rare cancer. Intravenous drug use and Hepatitis C virus (HCV) infection may be linked to early-onset WM.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Waldenström's macroglobulinemia (WM) is typically diagnosed in older individuals.
- Young-onset WM is rare, prompting investigation into potential contributing factors.
- Intravenous drug abuse (IVDA) and Hepatitis C virus (HCV) infection are associated with lymphoproliferative disorders.
Purpose of the Study:
- To report on a cohort of young African-American patients diagnosed with WM.
- To explore potential associations between IVDA, HCV infection, and early-onset WM.
- To highlight the importance of considering WM in young patients with suggestive symptoms.
Main Methods:
- Retrospective case series analysis of five young African-American patients with WM.
- Review of patient histories, clinical presentations, and laboratory findings.
- Testing for Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV).
Main Results:
- Five African-American patients (ages 35-51) were diagnosed with WM.
- All patients reported a history of intravenous heroin abuse; four also used cocaine.
- Three of three patients tested positive for HCV; three of three tested negative for HIV.
- Clinical presentation and course were typical for WM despite young age.
Conclusions:
- Early-onset WM in young African-American patients may be associated with a history of IVDA and HCV infection.
- HCV is being increasingly evaluated for its role in lymphoproliferative disorders.
- WM should be considered in the differential diagnosis of young patients presenting with suggestive clinical features, particularly those with a history of IVDA or HCV infection.
