Lymphoplasmacytic lymphoma: Difference between revisions

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* SPEP and immunofixation showing IgM-kappa M-protein
 
* SPEP and immunofixation showing IgM-kappa M-protein
   
== Clinical Presentation ==
+
== Clinical Manifestations ==
   
 
* Hyperviscosity, including neurological symptoms
 
* Hyperviscosity, including neurological symptoms

Revision as of 08:35, 19 July 2020

Definition

  • Low-grade B-cell neoplasm frequently causing an IgM gammopathy (at which point it is called Waldenstrom's macroglobulinemia)

Investigations

  • SPEP and immunofixation showing IgM-kappa M-protein

Clinical Manifestations

  • Hyperviscosity, including neurological symptoms
  • Peripheral neuropathy
  • Lymphadenopathy, organomegaly, cytopenia
  • Constitutional symptoms

Management

  • Depends on underlying health and age
  • Treatment only indicated if symptoms progressing
  • From most to least effective (and most to least side effects):
    • RCP: rituximab, cyclophosphamide, prednisone (or dexamethasone for DRC)
    • BR: bendamustine/rituximab
    • Chlorambucil/Obinutuzumab
    • Ibrutinib
  • Before chemotherapy, screen for hepatitis B +/- TB/Strongy