Waldenstrom macroglobulinaemia treated with sequential hemibody irradiation

Area of Science:

• Hematology
• Oncology

Background:

• Waldenstrom macroglobulinaemia is a rare lymphoproliferative disorder characterized by an IgM monoclonal gammopathy.
• Patients often present with symptoms of anemia, hyperviscosity, and lymphadenopathy.

Observation:

• A 40-year-old male presented with anemia and blurred vision, indicative of Waldenstrom macroglobulinaemia.
• Immediate symptom reversal was achieved with isovolaemic continuous-flow plasmapheresis and red cell transfusion.

Findings:

• Sequential hemibody irradiation was administered as specific therapy.
• At two-year follow-up, the patient exhibited excellent health with improved bone marrow hematopoietic reserve.
• Intermittent plasmapheresis was required to manage symptoms of rising blood viscosity.

Implications:

• Systemic irradiation is a well-tolerated palliative treatment for active macroglobulinaemia, reducing tumor burden.
• Irradiation offers an alternative to chemotherapy and may reduce, but not eliminate, the need for ongoing plasmapheresis.