What is lymphoplasmacytic lymphoma?
Lymphoplasmacytic lymphoma (LPL) is a type of blood cancer that usually develops in the bone marrow, when a type of white blood cell – the B-cells – develop incorrectly. Even though these abnormal cells aren’t of use to the body, they keep on multiplying until they crowd out the other useful blood cells. This build-up of abnormal B-cells creates some of the common LPL symptoms, such as fatigue, increased infections, and easy bruising.
What’s the difference between lymphoplasmacytic lymphoma (LPL) and Waldenstrom’s macroglobulinaemia (WM)?
LPL and WM are very similar and you may hear the terms used interchangeably. However, WM is actually a type of LPL.
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Healthy B-cells (a type of white blood cell) produce antibodies to fight infection. There are five different types of antibodies (also known as immunoglobulins) which are IgM, IgG, IgA, IgE and IgD.
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Everyone with LPL (including WM) has abnormal B-cells, which produce large amounts of one of these antibodies. In those with WM, abnormal B-cells produce large amounts of abnormal IgM only (Immunoglobulin M). Of every 20 people with LPL, 19 will have WM.
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One in 20 cases of LPL are not WM. People with LPL that isn’t WM have B-cells that produce higher quantities of immunoglobulins that aren’t IgM (so IgG, IgA, IgD or IgE). In some situations, they may have abnormal B-cells producing no abnormal immunoglobulins at all. This means they may not have the symptoms experienced by people with WM that are related to the abnormal levels of IgM.
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So, all WM is a type of LPL, but not all LPL is WM.
Does this mean my treatment differs from WM patients?
In short, no. The abnormal B-cells are treated the same in people with LPL and WM. Depending on your individual circumstances, you may not receive treatment for some time (called active monitoring) or you may need to start treatment right away.
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Those with WM produce too much of IgM antibodies which can cause very specific symptoms (headaches, bleeding, bruising, cold extremities, nerve problems) that may require treatment. These symptoms are specific to WM and are not normally be seen in in people with LPL that isn’t WM.