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Laboratory features

Authoring team

The hallmark of Waldenstrom's macroglobulinaemia is the presence of a monoclonal IgM spike on serum protein electrophoresis in the beta or gamma globulin region.

Other features:

  • increased serum viscosity
  • anaemia - usually normochromic, normocytic; occasionally haemolytic
  • raised ESR
  • marked rouleaux formation; +ve Coomb's test
  • bone marrow sections - hypercellular; infiltrated by the plasmacytic lymphocytes which are also present on peripheral blood
  • Bence Jones proteinuria in at least 10% of cases
  • x-rays should be normal; renal failure is unusual
  • IgM may cause cryoglobulinaemia

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