Waldenstr?m Macroglobulinemia Diagnosis
Early and accurate diagnosis of Waldenstr?m macroglobulinemia (WM) gives you the best chance of successfully managing this disease. Because it is rare, it is important to get care from a team experienced in both recognizing and treating the disease.
MD Anderson¡¯s experts are among the most experienced in the country at recognizing WM.
Waldenstr?m Macroglobulinemia Diagnostic Tests
If you have signs or symptoms that suggest Waldenstr?m macroglobulinemia, your doctor will examine you and ask you questions about your health and medical history.
One or more of the following tests may be used to find out if you have WM. If treatment is needed, these tests may also be used to find out if it is working.
Biopsy: A biopsy is the only way to definitively diagnose Waldenstr?m macroglobulinemia. During a biopsy, a small tissue sample is removed and examined under a microscope for cancer cells.
The two most common types of biopsies used to diagnose Waldenstr?m macroglobulinemia are:
- Bone marrow aspiration and biopsy: Doctors use a needle to remove a sample of bone marrow from a large bone, usually the pelvis. All patients receive local anesthesia. Some may also get light sedation.
- Lymph node biopsy: A small piece of tissue is removed from a lymph node and examined under a microscope. Sometimes the entire node is removed.
Blood and urine tests: Blood and urine tests are used to determine and track the levels of abnormal proteins produced by WM. In the blood, these proteins are called monoclonal proteins (M proteins) or paraproteins. In the urine, these proteins are known as Bence Jones proteins.
Doctors will also run blood tests to determine how thick the patient¡¯s blood is, since thick blood is a symptom of Waldenstr?m macroglobulinemia.
Waldenstr?m macroglobulinemia patients will also undergo routine blood tests to measure their organ function and complete blood count.
Imaging exams: Imaging exams are used to look for cancer inside the body. They can help locate tumors and track how the body responds to treatment. There are many types of imaging exams. The most common imaging exams used for WM include:
- CT or CAT (computed axial tomography) scans
- PET (positron emission tomography) scans
Bone marrow biopsy explained: Process, pain management and results
A bone marrow biopsy is a procedure that helps diagnose diseases and other conditions in the blood and bone marrow. MD Anderson performs about 10,000 of these procedures each year.
Here, I¡¯ll address common questions about bone marrow biopsies.
What is bone marrow?
Bone marrow is the soft, spongy tissue located inside your bones. Red blood cells, white blood cells and platelets all come from bone marrow.
Why would a doctor order a bone marrow biopsy?
Your doctor might order a bone marrow biopsy
- if you have an abnormal blood count,
- to help diagnose medical conditions, such as anemia, leukemia and other cancers,
- to see if the cancer has spread to the bone marrow and/or
- to determine if treatment is working.
How is a bone marrow biopsy different from a bone marrow aspiration?
A bone marrow biopsy and a bone marrow aspiration both sample bone marrow to help diagnose disease.
A bone marrow biopsy samples a solid piece of the bone marrow. A bone marrow aspiration takes a sample of the fluid part of your bone marrow.
We usually perform both procedures on a patient because we want to get as much information as possible to make a correct diagnosis.
What types of cancer can a bone marrow biopsy help diagnose?
We perform bone marrow biopsies to help diagnose blood cancers like leukemia, lymphoma and multiple myeloma.
Bone marrow biopsies can also help us determine the cancer¡¯s stage. We can see if the cancer has spread to the bone marrow, particularly in prostate cancer or breast cancer.
What can I expect during a bone marrow biopsy?
You don¡¯t need to do any preparation before a bone marrow biopsy.
The procedure
A bone marrow biopsy is an outpatient procedure. You don¡¯t have to stay overnight in the hospital afterward.
Usually, we¡¯ll biopsy the pelvic bone. First, your provider will numb the area with a local anesthetic. You may feel a prick as they inject the anesthetic, which goes through the skin and down to the bone. Then they¡¯ll insert a special needle through the skin. A small syringe attached to the needle sucks out liquid from your bone marrow. This is a bone marrow aspiration. Then, your provider will insert a small hollow needle to remove a piece of solid tissue from your bone marrow. This is a bone marrow biopsy.
After the samples are collected, your provider will apply pressure to the area to stop bleeding and cover the wound with a bandage.
The entire procedure takes about 20 minutes.
Managing pain
If you are anxious or extremely sensitive to pain, you may be given short-term anesthesia through an IV. This will put you to sleep during the procedure. After the biopsy is completed, you will go to a room to recover. You will need someone to drive you home.
A bone marrow biopsy is not completely painless, but we can control the pain by using local anesthetic or, if necessary, short-term anesthesia. You may experience some discomfort at the biopsy site after the procedure, but it¡¯s very tolerable.
Recovery after the procedure
You should not shower or bathe for a couple of days after your bone marrow biopsy. We want to protect the wound from getting wet, so it doesn¡¯t get infected.
You can resume all normal activities that day. Your provider will give you additional instructions for aftercare. Be sure to follow their advice as you recover.??
Getting your results
A pathologist will analyze your bone marrow samples and share the findings with your provider. Then, your provider will go over the results with you and discuss the next steps.
, specializes in treating leukemia and is medical director of the Bone Marrow Aspiration Clinic at MD Anderson.?
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