Waldenström macroglobulinemia: A review of the entity and its differential diagnosis

Advances in Anatomic Pathology

Volumn 19, Issue 1, 2012, Pages 11-27

  Shaheen, Saad P ^a   Talwalkar, Sameer S ^b   Lin, Pei ^b   Medeiros, L Jeffrey ^b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b UNIVERSITY OF TEXAS   (United States)

Author keywords

diagnostic criteria; differential diagnosis; immunophenotype; Waldenstr m macroglobulinemia

Indexed keywords

CHLORAMBUCIL; CLADRIBINE; CYCLOPHOSPHAMIDE; FLUDARABINE; IMMUNOGLOBULIN A; IMMUNOGLOBULIN M; PARAPROTEIN; RITUXIMAB;

B CELL LYMPHOMA; B LYMPHOCYTE; CLINICAL FEATURE; DIFFERENTIAL DIAGNOSIS; HISTOPATHOLOGY; HUMAN; IMMUNOPHENOTYPING; LIGHT CHAIN; LYMPHOCYTE; PRIORITY JOURNAL; REVIEW; WALDENSTROEM MACROGLOBULINEMIA;

DIAGNOSIS, DIFFERENTIAL; HUMANS; WALDENSTROM MACROGLOBULINEMIA;

EID: 83755164215     PISSN: 10724109     EISSN: 15334031     Source Type: Journal    
DOI: 10.1097/PAP.0b013e31824019d0     Document Type: Review

References (105)

1. Waldenström J. Incipient myelomatosis or essential hyperglobulinemia with fibrinogenopenia: a new syndrome? Acta Med Scand. 1944;117:216-247.
2. Lin P, Hao S, Handy BC, et al. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol. 2005;123:200-205. (Pubitemid 40194080)
3. Lin P, Bueso-Ramos CE, Wilson CS, et al. Waldenstrom's macroglobulinemia involving extramedullary sites: Morphologic and immunophenotypic findings in 44 patients. Am J Surg Pathol. 2003;27:1104-1115.
4. Brunning RD, McKenna RW. Plasma cell dyscrasias and related disorders. In: Rosai J, Sobin LH, eds. Atlas of Tumor Pathology: Tumors of the Bone Marrow Third Series, Fascicle 9. Washington, DC: Armed Forces Institute of Pathology; 1994:323-365.
5. Lin P, Medeiros LJ. Lymphoplasmacytic lymphoma/Waldenstrom's macroglobulinemia: an evolving concept. Adv Anat Pathol. 2005;12:246-255. (Pubitemid 41463805)
6. Harris NL, Jaffe ES, Stein H, et al. A revised European- American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994;84:1361-1392. (Pubitemid 24273002)
7. The Non-Hodgkin's Lymphoma Classification project. A clinical evaluation of the International Lymphoma Study Group Classification of Non-Hodgkin's Lymphoma. Blood. 1997;89:3909-3918.
8. Berger R, Isaacson PG, Piris MA, et al. Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. In: Jaffe ES, Harris NL, Stein H, et al, eds. World Health Organization Classification of Tumours Tumors of Haematopoietic and Lymphoid Tissues. Lyon: IARC Press; 2001:132-134.
9. Owen RG, Treon SP, Al-Katib A, et al. Clinicopathologic definition of Waldenstrom's macroglobulinemia: consensus panel recommendations from the second International Workshop on Waldenstrom's macroglobulinemia. Semin Oncol. 2003;30:110-115. (Pubitemid 36506291)
10. Owen RG, Barrans SL, Richards SJ, et al. Waldenström macroglobulinemia: development of diagnostic criteria and identification of prognostic factors. Am J Clin Pathol. 2001; 116:420-428. (Pubitemid 32851976)
11. Swerdlow SH, Berger F, Pileri SA, et al. Lymphoplasmacytic lymphoma. In: Swerdlow SH, Campo E, Haris NL, et al, eds. orld Health Organization Classification of Tumours Tumors of Haematopoietic and Lymphoid Tissues. Lyon: IARC Press; 2008:194-195.
12. Groves FD, Travis LB, Devesa SS, et al. Waldenstrom's macroglobulinemia: incidence patterns in the United States, 1988-1994. Cancer. 1998;82:1078-1081.
13. Fonseca R, Hayman S. Waldenström macroglobulinemia. Br J Haematol. 2007;138:700-720.
14. Kyle RA, Dispenzieri A, Kumar S, et al. IgM monoclonal gammopathy of undetermined significance (MGUS) and smoldering Waldenstrom's macroglobulinemia (SWM). Clin Lymphoma, Myeloma, & Leukemia. 2011;11:74-76.
15. Linet MS, Humphrey RL, Mehl ES, et al. A case-control and family study of Waldenstrom's macroglobulinemia. Leukemia. 1993;7:1363-1369. (Pubitemid 23291076)
16. McMaster ML, Goldin LR, Bai Y, et al. Genomewide linkage screen for Waldenstrom macroglobulinemia susceptibility loci in high-risk familes. Am J Hum Genet. 2006;79:695-701. (Pubitemid 44452746)
17. Treon SP, Hunter ZR, Aggarwal A, et al. Characterization of familial Waldenstrom's macroglobulinemia. Ann Oncol. 2006;17:488-494.
18. Kristinsson SY, Bjorkholm M, Goldin LR, et al. Risk of lymphoproliferative disorders among first-degree relatives of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia patients: a population-based study in Sweden. Blood. 2008;112:3052-3056.
19. Hanzis C, Ojha RP, Hunter R, et al. Associated malignancies in patients with Waldenstrom's macroglobulnemia and their kin. Clin Lymphoma, Myeloma & Leukemia. 2011;11:88-92.
20. Sigurdur SY, Koshiol J, Goldin LR, et al. Genetic and immune-related factors in the pathogenesis of lymphoplasmacytic lymphoma/Waldenstrom's macroglobulinemia. Clin Lymphoma & Myeloma. 2009;9:23-26.
21. Aoki H, Takishita M, Kosaka M, et al. Frequent somatic mutations in D and/or JH segments of Ig gene in Waldenstrom's macroglobulinemia and chronic lymphocytic leukemia (CLL) with Richter's syndrome but not in common CLL. Blood. 1995;85:1913-1919.
22. Kriangkum J, Taylor BJ, Mant MJ, et al. The malignant clone in Waldenstrom's macroglobulinemia. Sem Oncol. 2003;30:132-135.
23. Agnello V, Chung RT, Kaplan LM. A role for hepatitis C virus infection in type II cryoglobulinemia. N Engl J Med. 1992;327:1490-1495.
24. Pozzato G, Mazzaro C, Crovatto M, et al. Low-grade malignant lymphoma, hepatitis C virus infection, and mixed cryoglobulinemia. Blood. 1994;84:3047-3053. (Pubitemid 24328097)
25. Sansonno D, De Vita S, Cornacchiulo V, et al. Detection and distribution of hepatitis C virus-related proteins in lymph nodes of patients with type II mixed cryoglobulinemia and neoplastic or non-neoplastic lymphoproliferation. Blood. 1996;88:4638-4645. (Pubitemid 26419147)
26. Dimopoulos MA, Panayiotidis P, Moulopoulos LA, et al. Waldenström's macroglobulinemia: clinical features, complications, and management. J Clin Oncol. 2000;18: 214-226.
27. Rajkumar SV, Kyle RA. Plasma cell disorders. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia: W. B. Saunders; 2008:1426-1437.
28. Baehring JM, Hochberg EP, Raje N, et al. Neurological manifestations of Waldenstrom macroglobulinemia. Nat Clin Pract Oncol. 2008;4:547-556.
29. Dispenzieri A, Gertz MA, Witzig TE. Cryoglobulinemia and heavy chain disease. In: Greer JP, Foerster J, Lukens JN, et al, eds. Wintrobe's Clinical Hematology. 12th ed. Philadelphia, PA: Lippincott, Williams andWilkins; 2009:2484-2496.
30. Stone MJ. Pathogenesis and morbidity of autoantibody syndromes in Waldenstrom's macroglobulinemia. Clin Lymphoma Myeloma Leukemia. 2011;11:157-159.
31. Ansell SM, Kyle RA, Reeder CB, et al. Diagnosis and management of Waldenström macroglobulinemia: mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) guidelines. Mayo Clin Proc. 2010;85:824-833.
32. Gertz MA, Kyle RA. Hyperviscosity syndrome. J Intensive Care. 1995;10:128-141.
33. Owen RG, Johnson SA, Morgan GJ. Waldenström's macroglobulinemia: laboratory diagnosis and treatment. Hematol Oncol. 2000;18:41-49.
34. Owen RG, Lubenko A, Savage J, et al. Autoimmune thrombocytopenia in Waldenström's macroglobulinemia. Am J Hematol. 2001;66:116-119.
35. Morel P, Duhamel A, Gobbi P, et al. International prognostic scoring system for Waldenstrom macroglobulinemia. Blood. 2009;113:4163-4170.
36. Hivert B, Tamburini J, Vekhoff A, et al. Prognostic value of the International Scoring System and response in patients with advanced Waldenstrom macroglobulinemia. Haematologica. 2011;96:785-788.
37. Remstein ED, Hanson CA, Kyle RA, et al. Despite apparent morphologic and immunophenotypic heterogeneity, Waldenström's macroglobulinemia is consistently composed of cells along a morphologic continuum of small lymphocytes, plasmacytoid lymphocytes and plasma cells. Semin Oncol. 2003;30:182-186. (Pubitemid 36506306)
38. Bartl R, Frisch B, Mahl G, et al. Bone marrow histology in Waldenström's macroglobulinemia. Clinical relevance of subtype recognition. Scand J Haematol. 1983;31:359-375. (Pubitemid 13005174)
39. Barakat FH, Medeiros LJ, Wei EX, et al. Residual monotypic plasma cells in patients with Waldenstrom macroglobulinemia after therapy. Am J Clin Pathol. 2011;135:365-373.
40. Varghese AM, Rawstron AC, Ashcroft AJ, et al. Assessment of bone marrow response in Waldenström's macroglobulinemia. Clin Lymphoma Myeloma. 2009;9:53-55.
41. Pasricha SR, Juneja SK, Westerman DA, et al. Bone-marrow plasma cell burden correlates with IgM paraprotein concentration in Waldenstrom macroglobulinaemia. J Clin Pathol. 2011;64:520-523.
42. Sargent RL, Cook JR, Aguilera NI, et al. Fluorescence immunophenotypic and interphase cytogenetic characterization of nodal lymphoplasmacytic lymphoma. Am J Surg Pathol. 2008;32:1643-1653.
43. Aozasa K, Uda H. Lymph node involvement in Waldenström's macroglobulinemia. Acta Pathol Jpn. 1980;30: 437-444. (Pubitemid 11248080)
44. Harrison CV. The morphology of the lymph node in the macroglobulinaemia of Waldenström. J Clin Pathol. 1972;25:12-16.
45. Konoplev S, Medeiros LJ, Bueso-Ramos C, et al. Immunophenotypic profile of lymphoplasmacytic lymphoma/ Waldenstrom macroglobulinemia. Am J Clin Pathol. 2005; 124:414-420. (Pubitemid 41232928)
46. San Miguel JF, Vidriales MB, Ocio E, et al. Immunophenotypic analysis of Waldenström's macroglobulinemia. Semin Oncol. 2003;30:187-195.
47. Morice WG, Chen D, Kurtin PJ, et al. Novel immunophenotypic features of marrow lymphoplasmacytic lymphoma and correlation with Waldenström's macroglobulinemia. Mod Pathol. 2009;22:807-816.
48. Al-Quran SZ, Yang L, Magill JM, et al. Assessment of bone marrow plasma cell infiltrates in multiple myeloma: the added value of CD138 immunohistochemistry. Hum Pathol. 2007;38:1779-1787. (Pubitemid 350179926)
49. Hunter ZR, Branagan AR, Manning R, et al. CD5, CD10, and CD23 expression in Waldenström's macroglobulinemia. Clin Lymphoma. 2005;5:246-249. (Pubitemid 40614235)
50. Ho AW, Hatjiharissi E, Ciccarelli BT, et al. CD27-CD70 interactions in the pathogenesis of Waldenstrom macroglobulinemia. Blood. 2008;112:4683-4689.
51. Mansoor A, Medeiros LJ, Weber DM, et al. Cytogenetic findings in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. Chromosomal abnormalities are associated with the polymorphous subtype and an aggressive clinical course. Am J Clin Pathol. 2001;116:543-549. (Pubitemid 34450288)
52. Bang SM, Seo JW, Park KU, et al. Korean Multiple Myeloma Working Party (KMMWP). Molecular cytogenetic analysis of Korean patients with Waldenström macroglobulinemia. Cancer Genet Cytogenet. 2010;197:117-121.
53. Terré C, Nguyen-Khac F, Barin C, et al. Trisomy 4, a new chromosomal abnormality in Waldenström's macroglobulinemia: a study of 39 cases. Leukemia. 2006;20:1634-1636. (Pubitemid 44264115)
54. Schop RFJ, Kuehl WM, Van Wier SA, et al. Waldenström macroglobulinemia neoplastic cells lack immunoglobulin heavy chain locus translocations but have frequent 6q deletions. Blood. 2002;100:2996-3001.
55. Ocio EM, Schop RF, Gonzalez B, et al. 6q deletion in Waldenström macroglobulinemia is associated with features of adverse prognosis. Br J Haematol. 2007;136:80-86. (Pubitemid 44912591)
56. Braggio E, Keats JJ, Leleu X, et al. Identification of copy number abnormalities and inactivating mutations in two negative regulators of nuclear factor-kappaB signaling pathways in Waldenstrom's macroglobulinemia. Cancer Res. 2009;69:3579-3588.
57. Buckley PG, Walsh SH, Laurell A, et al. Genome-wide microarray-based comparative genomic hybridization analysis of lymphoplasmacytic lymphomas reveals heterogeneous aberrations. Leuk Lymphoma. 2009;50:1528-1534.
58. Poulain S, Braggio E, Roumier C, et al. High-throughput genomic analysis in Waldenstrom's macroglobulinemia. Clin Lymphoma, Myeloma & Leukemia. 2011;11:106-108.
59. Offit K, Parsa NZ, Filippa D, et al. t(9;14)(p13;q32) denotes a subset of low-grade non-Hodgkin's lymphoma with plasmacytoid differentiation. Blood. 1992;80:2594-2599.
60. Iida S, Rao PH, Nallasivam P, et al. The t(9;14)(p13;q32) chromosomal translocation associated with lymphoplasmacytoid lymphoma involves the PAX-5 gene. Blood. 1996; 88:4110-4117. (Pubitemid 26399155)
61. Morrison AM, Jager U, Chott A, et al. Deregulated PAX-5 transcription from a translocated IgH promoter in marginal zone lymphoma. Blood. 1998;92:3865-3878. (Pubitemid 28525213)
62. Cook JR, Aguilera NI, Reshmi-Skarja S, et al. Lack of PAX5 rearrangements in lymphoplasmacytic lymphomas: reassessing the reported association with t(9;14). Hum Pathol. 2004;35:447-454. (Pubitemid 38507081)
63. Hirase N, Yufu Y, Abe Y, et al. Primary macroglobulinemia with t(11;18)(q21;q21). Cancer Genet Cytogenet. 2000;117: 113-117.
64. Sahota SS, Forconi F, Ottensmeier CH, et al. Origin of the malignant clone in typical Waldenström's macroglobulinemia. Semin Oncol. 2003;30:136-141. (Pubitemid 36506296)
65. Kriangkum J, Taylor BJ, Treong SP, et al. Clonotypic IgM V/D/J sequence analysis in Waldenström's macroglobulinemia suggests an unusual B-cell origin and an expansion of polyclonal B cells in peripheral blood. Blood. 2004;104:2134-2142. (Pubitemid 39297868)
66. Kriangkum J, Taylor BJ, Reiman T, et al. Origins of Waldenström's macroglobulinemia: does it arise from an unusual B-cell precursor? Clin Lymphoma. 2005;5:217-219. (Pubitemid 40614229)
67. Martín-Jiménez P, García-Sanz R, Balanzategui A, et al. Molecular characterization of heavy chain immunoglobulin gene rearrangements in Waldenström's macroglobulinemia and IgM monoclonal gammopathy of undetermined significance. Haematologica. 2007;92:635-642. (Pubitemid 350144265)
68. Gutierrez NC, Ocio EM, de Las Rivas J, et al. Gene expression profiling of B lymphocytes and plasma cells from Waldenström's macroglobulinemia: comparison with expression patterns of the same cell counterparts from chronic lymphocytic leukemia, multiple myeloma and normal individuals. Leukemia. 2007;21:541-549.
69. Chng WJ, Schop RF, Price-Troska T, et al. Gene-expression profiling of Waldenstrom macroglobulinemia reveals a phenotype more similar to chronic lymphocytic leukemia than multiple myeloma. Blood. 2006;108:2755-2763.
70. Hatjiharissi E, Ngo H, Leontovich AA, et al. Proteomic analysis of Waldenstrom macroglobulinemia. Cancer Res. 2007;67:3777-3784. (Pubitemid 46762164)
71. Leleu X, Jia X, Runnels J, et al. The Akt pathway regulates survival and homing in Waldenstrom macroglobulinemia. Blood. 2007;110:4417-4426. (Pubitemid 351377808)
72. Romashkova JA, Makarov SS. NF-kB is a target of AKT in anti-apoptotic PDFG signaling. Nature. 1999;401:86-90.
73. Ghobrial IM, Roccaro A, Hong F, et al. Clinical and translational studies of a phase II trial of the novel oral Akt inhibitor perifosine in relapsed or relapsed/refractory Waldenstrom's macroglobulinemia. Clin Cancer Res. 2010;16:1033-1041.
74. Roccaro AM, Sacco A, Husu EN, et al. Dual targeting of the PI3K/Akt/mTOR pathway as an antitumor strategy in Waldenstrom macroglobulinemia. Blood. 2010;115:559-569.
75. Leleu X, Eeckhoute J, Jia X, et al. Targeting NF-KB in Waldenstrom macroglobulinemia. Blood. 2008;111: 5068-5077.
76. Chen CI, Kouroukis CT, White D, et al. Bortezomib is active in patients with untreated or relapsed Waldenstroms's macroglobulinemia: a phase 2 study of the National Cancer Institute of Canada clinical trials group. J Clin Oncol. 2007;25:1570-1575. (Pubitemid 46733084)
77. Treon SP, Hunter ZR, Matous J, et al. Multicenter clinical trial of bortezomib in relapsed/refractory Waldenstrom's macroglobulinemia: results of WMCTG trial 03-248. Clin Cancer Res. 2007;13:3320-3325. (Pubitemid 46944918)
78. Hatzimicheal EC, Christou L, Bai M, et al. Serum levels of IL-6 and its soluble receptor (sIL-6R) in Waldenstrom macroglobulinemia. Eu J Haematol. 2001;66:1-6. (Pubitemid 32099402)
79. Levy Y, Fermand JP, Navarro S, et al. Interleukin 6 dependence of spontaneous in-vitro differentiation of B cells from patients with IgM gammopathy. Proc Natl Acad Sci U S A. 1990;87:3309-3313.
80. Roccaro AM, Sacco A, Chen C, et al. microRNA expression in the biology, prognosis, and therapy of Waldenstrom macroglobulinemia. Blood. 2009;113:4391-4402.
81. Costinean S, Zanesi N, Pekansky Y, et al. Pre-B cell proliferation and lymphoblastic leukemia/high-grade lymphoma in E(mu)-miR155 transgenic mice. Proc Natl Acad Sci U S A. 2006;103:7024-7029.
82. Ghobrial IM, Fonseca R, Gertz MA, et al. Prognostic model for disease-specific and overall mortality in newly diagnosed symptomatic patients with Waldenström macroglobulinemia. Br J Haematol. 2006;133:158-164.
83. Kimby E, Treon SP, Anagnostopoulos A, et al. Update on the recommendations for assessing response from the Third International Workshop on Waldenstrom's macroglobulinemia. Clin Lymphoma Myeloma. 2006;6:380-383.
84. Dimopoulos MA, Gertz MA, Kastritis E, et al. Update on treatment recommendations from the fourth international workshop on Waldenstrom's macroglobulinemia. J Clin Oncol. 2009;27:120-126.
85. Lin P, Mansoor A, Bueso-Ramos C, et al. Diffuse large B-cell lymphoma occurring in patients with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. Clinicopathologic features of 12 cases. Am J Clin Pathol. 2003;120:246-253. (Pubitemid 37046359)
86. Leleu X, Soumerai J, Roccaro A, et al. Increased incidence of transformation and myelodysplasia/acute leukemia in patients with Waldenström macroglobulinemia treated with nucleoside analogs. J Clin Oncol. 2009;27:250-255.
87. Ling S, Joshua DE, Gibson J, et al. Transformation and progression of Waldenström's macroglobulinemia following cladribine therapy in two cases: natural evolution or iatrogenic causation? Am J Hematol. 2006;81:110-114. (Pubitemid 43208599)
88. Rosales CM, Lin P, Mansoor A, et al. Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia associated with Hodgkin disease. A report of two cases. Am J Clin Pathol. 2001;116:34-40. (Pubitemid 32601124)
89. Tursz T, Brouet JC, Flandrin G, et al. Clinical and pathologic features of Waldenström's macroglobulinemia in seven patients with serum monoclonal IgG or IgA. Am J Med. 1977;63:499-502. (Pubitemid 8214921)
90. Braggio E, Keats JJ, Leleu X, et al. High-resolution genomic analysis in Waldenström's macroglobulinemia identifies disease- specific and common abnormalities with marginal zone lymphomas. Clin Lymphoma Myeloma. 2009;9:39-42.
91. Valdez R, Finn WG, Ross CW, et al. Waldenström macroglobulinemia caused by extranodal marginal zone B-cell lymphoma: a report of six cases. Am J Clin Pathol. 2001;116: 683-690. (Pubitemid 34453208)
92. Kyrtsonis MC, Levidou G, Korkolopoulou P, et al. CD138 expression helps in distinguishing Waldenstrom's macroglobulinemia (WM) from splenic marginal zone lymphoma (SMZL). Clin Lymphoma, Myeloma Leukemia. 2011;11:99-102.
93. Watkins AJ, Huang Y, Ye H, et al. Splenic marginal zone lymphoma: characterization of 7q deletion and its value in diagnosis. J Pathol. 2010;220:461-474.
94. Allez M, Mariette X, Linares G, et al. Low-grade MALT lymphoma mimicking Waldenstrom macroglobulinemia. Leukemia. 1999;13:484-485. (Pubitemid 29108089)
95. Valdez R, Finn WG, Ross CW. Waldenstrom macroglobulinemia caused by extranodal marginal zone B-cell lymphoma. Am J Clin Pathol. 2001;116:683-690. (Pubitemid 34453208)
96. Mikolaenko I, Listinsky CM. Systemic CD5+ MALT lymphoma: presentation with Waldenstrom syndrome. Ann Diagn Pathol. 2009;13:272-277.
97. Du MQ. MALT lymphoma: many roads lead to nuclear factor-kB activation. Histopathology. 2011;58:26-38.
98. Yin CC, Lin P, Carney DA, et al. Chronic lymphocytic leukemia/small lymphocytic lymphoma associated with IgM paraprotein. Am J Clin Pathol. 2005;123:594-602. (Pubitemid 40418555)
99. Visco C, Hoeller S, Malik JT, et al. Molecular characteristics of mantle cell lymphoma presenting with clonal plasma cell component. Am J Surg Pathol. 2011;35:177-189.
100. Shaheen S, Talwalkar SS, Medeiros LJ. Multiple myeloma and immunosecretory disorders: an update. Adv Anat Pathol. 2008;15:196-210.
101. Schuster SR, Rajkumar SV, Dispenzieri A, et al. IgM multiple myeloma: disease definition, prognosis, and differentiation from Waldenstrom's macroglobulinemia. Am J Hematol. 2010;85:853-855.
102. Owen RG, Feyler S, O'Connor SJM, et al. Defining IgM myeloma. Am J Hematol. 2011;86:717.
103. Greco A, Tedeschi A, Varettoni M, et al. Factors predicting transformation of asymptomatic IgM monoclonal gammopathy. Clin Lymphoma Myeloma Leukemia. 2011; 11:77-79.
104. Ocio EM, del Carpio D, Caballero A, et al. Differential diagnosis of IgM MGUS and WM according to B-lymphoid infiltration by morphology and flow cytometry. Clin Lymphoma Myeloma Leukemia. 2011;11:93-95.
105. Schop RFJ, Van Wier SA, Xu R, et al. 6q deletion discriminates Waldenström macroglobulinemia from IgM monoclonal gammopathy of undetermined significance. Cancer Genet Cytogenet. 2006;169:150-153. (Pubitemid 44382607)