Prevalence and Disability of Peripheral Neuropathy in Patients With Waldenström's Macroglobulinemia

Peripheral neuropathy (PN) is considered a frequent complication of Waldenström's macroglobulinemia (WM). Establishing a causal relationship between PN and WM is complicated by confounding factors such as age-related axonal loss and diabetes. This scoping review aims to summarize the current evidence on WM-associated PN with a focus on prevalence, phenotype, and disability.

We searched PubMed, Embase, Web of Science, CINAHL, and Cochrane Library and included studies describing either prevalence, phenotype, and/or disability of adults with WM and PN.

Thirty-four studies were eligible for inclusion where most studies were retrospective case series. The most frequently reported phenotype was a sensory axonal PN while demyelinating PN only ranged from 8% to 37.5% in unselected WM cohorts. Eight different disability scales were used, primarily in anti-MAG studies. Prevalence of WM-associated PN ranged from 0% to 52% where small cross-sectional studies reported higher prevalence than larger retrospective studies.

Our findings suggest PN in WM is a frequent complication often presented as a sensory axonal PN. Interpretation of results is confounded by referral bias, lack of PN definition, missing clinical and electrophysiological examination, and limited comparable disability measures across PN subtypes. This review underscores the need for a definition of WM-associated PN.