Chronic Immune Stimulation and Subsequent Waldenström Macroglobulinemia

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Abstract
Waldenström macroglobulinemia (WM) is a distinct B-cell subtype of non-Hodgkin lymphoma (NHL) characterized by lymphoplasmacytic infiltration of the bone marrow and a monoclonal IgM protein.1,2 Patients often present initially with nonspecific symptoms. The most common symptoms are fatigue and malaise attributable to anemia. Other findings may include hepatomegaly (20% of patients), splenomegaly (15%), lymphadenopathy (15%-20%), hyperviscosity (15%), and peripheral neuropathy (20%).3 Typically, clinical symptoms are attributable to the extent of tumor infiltration and to elevated monoclonal IgM levels.4