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  lüll Waldenstrom s macroglobulinemia Gertz MA; Fonseca R; Rajkumar SVOncologist  2000[]; 5 (1): 63-7Waldenstrom's macroglobulinemia is a low-grade lymphoplasmacytic lymphoma. It has  an overall incidence of 2.5/million/year. The median age at diagnosis is 63  years. The clinical manifestations are hepatomegaly (20%), splenomegaly (15%),  and lymphadenopathy (15%). The most common symptom is fatigue related to a  normochromic, normocytic anemia, and the median hemoglobin value at diagnosis is  10 gm/dl. All patients with Waldenstrom's macroglobulinemia have a circulating  tumor marker, the monoclonal IgM protein. Occasionally high levels of the IgM  monoclonal protein can produce a hyperviscosity syndrome manifested by oronasal  bleeding. Occasionally retinal hemorrhage or serious neurologic complications,  such as somnolence or coma, may occur. The most important prognostic factors are  hemoglobin, age, weight loss, and a cryoglobulin. Therapy has included alkylating  agents, particularly chlorambucil, purine nucleoside analogs such as fludarabine  or cladribine, and most recently the use of rituximab. The median survival of  symptomatic patients is 65 months. Patients without symptoms should not be  treated.|*Waldenstrom Macroglobulinemia/diagnosis/drug therapy/pathology[MESH]|Age of Onset[MESH]|Aged[MESH]|Antineoplastic Agents/*therapeutic use[MESH]|Diagnosis, Differential[MESH]|Humans[MESH]|Immunoglobulin M/*analysis[MESH]|Middle Aged[MESH]|Prognosis[MESH] |