Waldenström's macroglobulinemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]

Laboratory Findings

Complete blood count

• Normocytic normochromic anemia - presents in 80% of patients
• Leukopenia
• Thrombocytopenia - presents in 50% of patients with bleeding diathesis

Peripheral smear

• Plasmacytoid lymphocytes
• Normocytic normochromic red blood cells
• Rouleaux formation

Chemistry lab tests

• Lactate dehydrogenase - is elevated indicating the extent of tissue involvement.
• Creatinine is elevated.
• Electrolyte abnormalities can be present with hypercalcemia in 4% of patients with Waldenström's macroglobulinemia.
• Erythrocyte Sedimentation Rate and uric acid may be elevated.
• Renal and hepatic function
• Total protein levels
• Albumin-to-globulin ratio
• Rheumatoid factor, cryoglobulins, direct antiglobulin test and cold agglutinin titre results can be positive.
• Beta-2-microglobulin is elevated in proportion to tumor mass.
• Coaglulation studies can be abnormal with elevated prothrombin time, activated partial thromboplastin time, and thrombin time.

Nerve conduction study

• Patients with Waldenström's macroglobulinemia should have nerve conduction study and antimyelin associated glycoprotein serology should be done.

Plasma viscosity

• Plasma viscosity should be measured in patients presenting with hyperviscosity syndrome.

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