Waldenstrom’s macroglobulinaemia diagnosis

How is Waldenstrom’s macroglobulinaemia diagnosed?

Waldenstrom’s macroglobulinaemia is diagnosed by examining samples of your blood and bone marrow in a variety of tests.

Full blood count

The first step in the diagnosis is a simple blood test called a full blood count (FBC) or complete blood count (CBC). This involves a sample of blood from a vein in your arm being sent to the laboratory for investigation. Most people with WM will show an increased number of small lymphocytes. Immunoglobulins are also measured to see if any are too high or low. A WM diagnosis needs to be confirmed by examining your cells in your bone marrow.

Bone marrow examination

If the results of your blood tests suggest that you might have WM, a bone marrow biopsy may be required to help confirm the diagnosis. A bone marrow biopsy involves taking a sample of bone marrow, usually from the back of the hip bone and sending it to the laboratory for examination under the microscope. The bone marrow biopsy may be done in the haematologist’s rooms, clinic or day procedure centre and is usually performed under local anaesthesia with sedation given either by tablet or through a small drip in your arm. The sample of bone marrow is examined in the laboratory to determine the number and type of cells present and the amount of haemopoiesis (blood-forming) activity taking place there.

Further testing

Further blood tests may be conducted to examine the amount and presence of the abnormal protein. This protein level will be monitored throughout your treatment to monitor the progress of your disease and response to treatment. Other tests may be conducted to provide information on your general health and how your vital organs are functioning. These include a combination of further blood tests and imaging tests (x-rays, scans and ECG). These results will provide a baseline of your disease and general health, which will be compared with later results to assess how well you are progressing and responding to treatment.