Waldenström's Macroglobulinemia Diagnosis

Early and accurate diagnosis of Waldenström's macroglobulinemia helps you have the highest chance for successful treatment. However, the disease can be challenging to diagnose. It is important for a pathologist experienced in Waldenström's to read your test results.

Since our experts focus on lymphoma and see more patients than most cancer centers, they are among the most experienced in the country at recognizing Waldenström's macroglobulinemia. These specialists use the most advanced technology and techniques to pinpoint Waldenström's.

Waldenström's Macroglobulinemia Diagnostic Tests

If you have symptoms that may signal Waldenström's, your doctor will examine you and ask you questions about your health and your family medical history.

One or more of the following tests may be used to find out if you have Waldenström's and if it has spread. These tests also may be used to find out if treatment is working.

Lymph node biopsy: A small piece of tissue is removed from a lymph node and looked at with a microscope. Sometimes the entire node is removed.

Imaging tests, which may include:

• X-rays
• CT or CAT (computed axial tomography) scans
• PET (positron emission tomography) scans
• MRI (magnetic resonance imaging) scans

Blood and urine tests: Blood and urine tests are used to determine and follow levels of abnormal proteins produced by Waldenström's macroglobulinemia. In the blood, these proteins are called monoclonal proteins (M proteins) or paraproteins. They are measured by a test called serum protein electrophoresis (SPEP). In the urine, these proteins are known as Bence Jones proteins. They are measured by a urine protein electrophoresis (UPEP) on a 24-hour sample of urine. An additional test, called an immunofixation (IFE) may help find small traces of abnormal proteins in either the blood or urine.

Bone marrow aspiration and biopsy

Waldenström's Macroglobulinemia Staging

Staging is a system of classifying specific cancers by how much disease is in the body and where it has spread when it is diagnosed. Such a system does not exist for Waldenström's macroglobulinemia.

However, using the International Prognostic Scoring System for Waldenström's, experts look at certain factors that may help predict outcomes. Some situations may mean a patient does not do as well. These include:

• Age more than 65
• Hemoglobin level less than 11.5
• Platelet count 100 or less
• Beta-2-microglobulin more than 3 mg/L
• Monoclonal IgM level more than 7 g/dL

In scoring Waldenström's macroglobulinemia, doctors give each of the above factors a single point. Then they assign a patient to a certain group:

• Low risk: Younger than 65 with no more than one point
• Intermediate risk: 65 or older and/or have two points
• High risk: At least three points

Getting a Second Opinion at MD Anderson

The pathologists at MD Anderson are highly specialized in diagnosing and staging Waldenström's macroglobulinemia. We welcome the opportunity to provide second opinions for Waldenström's.