A practical guide to laboratory investigations at diagnosis and follow up in Waldenström macroglobulinaemia: recommendations from the Medical and Scientific Advisory Group, Myeloma Australia, the Pathology Sub-committee of the Lymphoma and Related Diseases Registry and the Australasian Association of Clinical Biochemists Monoclonal Gammopathy Working Group

M. Gohar Maqbool, Constantine S. Tam, Ian M. Morison, David Simpson, Peter Mollee, Hans Schneider, Henry Chan, Surender Juneja, Yasmin Harvey, Lakshmi Nath, Pravin Hissaria, H. Miles Prince, Helen Wordsworth, Stephen Opat, Dipti Talaulikar

Research output: Contribution to journalReview ArticleOtherpeer-review

2 Citations (Scopus)

Abstract

Waldenström macroglobulinaemia (WM) is an indolent non-Hodgkin lymphoma which usually presents with symptoms related to infiltration of bone marrow or other tissues like lymph nodes, liver or spleen and has certain unusual clinical manifestations, e.g., renal and central nervous system (CNS) involvement. It also has an array of laboratory features including hypersecretion of IgM, cryoglobulinaemia, increased plasma viscosity and identification of mutated MYD88L265P in more than 90% of cases. In this review, we aim to provide a guide to the laboratory investigations recommended for WM at initial diagnosis and at follow-up. A discussion on the nuances of diagnosis and differential diagnoses is followed by bone marrow (BM) assessment, measurement of paraprotein and other ancillary investigations. Recommendations are provided on laboratory work-up at diagnosis, in the asymptomatic follow-up phase, and during and post-treatment. Finally, we briefly discuss the implications of laboratory diagnosis in regard to recruitment and monitoring on clinical trials.

Original languageEnglish
Pages (from-to)167-178
Number of pages12
JournalPathology
Volume52
Issue number2
DOIs
Publication statusPublished - Feb 2020

Keywords

  • CXCR4
  • IgM MGUS
  • IgM paraprotein
  • laboratory investigations for Waldenström macroglobulinaemia
  • lymphoplasmacytic lymphoma
  • MYD88
  • Practical guide for Waldenström macroglobulinaemia
  • transformed Waldenström macroglobulinaemia
  • work-up at diagnosis for Waldenström macroglobulinaemia
  • work-up for Waldenström macroglobulinaemia during and post treatment

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