№ 16Hematology18 min read
Multiple myeloma, Waldenström’s macroglobulinemia
1. Big picture
Multiple myeloma (MM) and Waldenström’s macroglobulinemia (WM) are both monoclonal B-cell/plasma-cell spectrum diseases, but they behave differently.
The exam shortcut is:
| Disease | Cell of origin | Main monoclonal protein | Classic clinical pattern |
|---|---|---|---|
| Multiple myeloma | Clonal plasma cells | Usually IgG, then IgA, or light chains | CRAB: hyperCalcemia, Renal failure, Anemia, Bone lesions |
| Waldenström’s macroglobulinemia | Lymphoplasmacytic lymphoma cells | IgM | Hyperviscosity, neuropathy, lymphadenopathy, splenomegaly, anemia |
When you see bone pain + anemia + renal failure + high total protein + lytic lesions → think multiple myeloma.
When you see elderly patient + IgM monoclonal protein + hyperviscosity symptoms + lymphoplasmacytic marrow infiltration → think Waldenström’s macroglobulinemia.
PART A — MULTIPLE MYELOMA
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