Waldenstrom macroglobulinemia (WM) is a rare lymphoproliferative disease that can have an ambiguous clinical presentation. A key component of the pathophysiology of WM is bone marrow infiltration, which most commonly presents as anemia. Other symptoms of WM tend to be generalized and non-specific, which presents a diagnostic challenge. This was the case with our patient as well, when he presented to our outpatient clinic with non-specific symptoms. We present a 79-year-old male with longstanding pancytopenia, polyarthralgia, bilateral pedal edema, decreased appetite, and increased bleeding from wounds. The patient had a complete blood count (CBC) and complete metabolic panel (CMP) done, confirming present anemia, which prompted inpatient treatment and an oncology workup, confirming WM. The patient began a zanubrutinib monotherapy regimen, showing improvement in his pancytopenia, polyarthralgia, and overall symptoms.
pancytopenia, bruton tyrosine kinase inhibitor, cxcr4, kappa-lambda ratio, bone marrow aspirate, hyperviscosity syndrome, monoclonal igm gammopathy, large b-cell lymphoma, Waldenstroms macroglobulinemia, Waldenstrom
Shahab S, Semerdzhiev DI, Reeves J, Daniel A, Martin D, Sukpraprut-Braaten S. Waldenstrom Macroglobulinemia: Clinical Presentation, Diagnosis, and Management in an Elderly Male. Cureus. 2023; 15(8). doi: 10.7759/cureus.44127.