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A review of Waldenstrom's macroglobulinemia
1United Hospital, St. Paul, MN, USA.
Abstract:
Waldenstrom's macroglobulinemia (WM) is an uncommon B cell malignancy that resembles other B cell malignancies, such as multiple myeloma and chronic lymphocytic leukemia. WM's clinical course varies widely, with survival ranging from 1-16 years. WM is diagnosed when a bone marrow biopsy reveals malignant B-lymphocytes arrested at the plasmacytoid lymphocytic stage of the maturation process and when high levels of IgM are found in the serum blood. Common clinical features include anemia, abnormal bleeding, and hyperviscosity, and 20%-40% of patients present with lymphadenopathy or splenomegaly. Alkylating agents have been the most common chemotherapy agents used to treat WM. However, nucleoside analogues are being used more frequently with promising results. Nursing care includes educating the patient about the disease trajectory, providing symptom management, and monitoring the patient's response to treatment.