1. Waldenstrom’s Macroglobulinemia
indolent lymphoma
occurs > 30years, usually > 60years
characterised by
proliferation of lymphoplasmatic and plasma cells
monoclonal immunoglobulin M

2. Waldenstrom’s Macroglobulinemia - clinical presentation
asymptomatic
symptomatic
weight loss
fatigue
lymphadenopathy
hepatosplenomegaly
sensorimotor peripheral neuropathy
hyperviscosity syndrome
generalised neurologic dysfunction (coma)
bleeding diathesis (impaired platelet function)
hypervolemia (progressing to congestive heart failure)
retinal changes (haemorrhages)

3. Waldenstrom’s Macroglobulinemia
Laboratory findings
anaemia, thrombocytopenia
hyperproteinemia
prolongation of APTT, PT
Diagnosis
monoclonal IgM
lymphoplasmatic cells in bone marrow and peripheral blood
Treatment
chemotherapy ( chlorambucil, CHOP )
plasmapheresis

4. Amyloidosis
clinical disorder that results from the extracellular deposition of insoluble fragments of immunoglobulin light or heavy chains
deposits have unique structure and are resistant to proteolysis and degradation
incidence difficult to determine
clinical presentations depend on involved organ

5. Amyloidosis plasma cell myeloma Waldemstrom’s macroglobulinemia
Systemic amyloidosis
immunocytic dyscrasia
plasma cell myeloma
Waldemstrom’s macroglobulinemia
heavy-chain disease
reactive
acute/chronic infection
chronic inflammation
nonlymphoid malignancy
heredofamilial
neuropathic
non-neuropathic
familial mediterranean fever

6. Amyloidosis Localised amyloidosis immunocyte derived cardiac
cerebral plaques
cutaneous
endocrine associated
hereditary
aging

7. Amyloidosis Diagnosis
demonstration of typical apple-green birefrigence under polarizing microscope after Congo red staining
Treatment
disappointing
primary amyloidosis
melphalan + prednisone - response rate 18%
autologous bone marrow transplantation
reactive amyloidosis
control underlying illness
familial amyloidosis
colchicine