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What is waldenstrom macroglobulinemia?
Created by Matthew McPheeters.
Want to join the conversation?
- Question about memory cells. After these cells fight off the original infection their number decreases. What if a person gets an injury and loses those few memory cells? Does the person lose their memory of the original infection or do the memory cells retreat to the bone marrow or some other place in the body that's more protective? Thanks.(4 votes)
- Thanks for asking this question, it made me think. If a person loses memory cells, they will be vulnerable to that infection. That is the main issue with HIV, it takes out memory T helper cells, and leaves the person wide open for infections they used to be able to overcome such as oral yeast. The second part made me look around and I found a summary of an article from 2009.http://www.the-scientist.com/?articles.view/articleNo/27382/title/Home-of-immune-memory-found/
May 7, 2009 New findings overturn a major model of where immune memory is stored. Rather than circulating throughout the body, as researchers had thought, memory T-cells actually reside in a comfortable niche in the bone marrow waiting for the next chance to fight infection, according to a link url:new article;http://www.cell.com/immunity/abstract/S1074-7613(09)00187-3 published online in _Immunity_ today (May 7th).
To test whether memory T cells stayed in circulation or retreated to the bone marrow, Radbruch and first author Koji Tokoyoda, also at the German Rheumatology Center, infected a mouse with a pathogen, and then searched for the T-cells specific to that pathogen at different time points. As expected, the specific T-effector cells at first proliferated to fight the infection. Four days in, researchers detected the memory cells mainly located in the lymphoid organs and spleen. But 3-8 weeks after infection -- by which time the remaining cells would have turned into memory cells -- the researchers searched again for those pathogen-specific cells and found that more than 80% of them were now in the bone marrow. Thanks, this was fun!(10 votes)
- How does Mb. Waldenström differ from Multiple Myloma?
They are both plasma cell diseases which produce IgM.(4 votes)- Multiple Myeloma doesn't necessarily have to produce IgM, plus the symptoms are different and the pathogenesis ie the way the disease causes the symptoms is also different.(3 votes)
- why cant just do BMT for the treatment?(3 votes)
- You would still face the same problems that currently face BMTs for more common cancers such as myeloma and leukaemia. BMT is not that easy (yet). For a start there simply aren't enough donors, and stem cell research is not quite there yet.
for reviews, see:
https://www.nature.com/articles/1705865
https://www.cancerquest.org/index.php/patients/treatments/bone-marrow-transplantation(1 vote)
- do all cancer start in the bone marrow?(0 votes)
- Multiple Myeloma is a cancer of plasma cells specifically, which are white blood cell producing precursors, sort of like production plants, and blood-producing cells like these exist in adults in the bone marrow, therefore this particular kind of cancer starts in the bone marrow.(4 votes)
Video transcript
- [Voiceover] In order to discuss Waldenstrom macroglobulinemia,
I'm gonna start with a story and this story is set
in Sweden in the 1940s. And at that time there
was a young physician in Sweden by the name of Jan Waldenstrom and he noticed a peculiar constellation of symptoms in a few of his patients and these symptoms included
bleeding, some visual changes, such as double vision and blurry vision, headaches, and generalized weakness. Now, these four symptoms
on their own weren't necessarily that alarming,
but the surprising thing was when he went to draw their blood to perform tests on them,
he noticed that it was a little bit more difficult to draw their blood than it was for other patients. It was almost as if
their blood was thicker and as he was thinking about
all these different patients, he wondered if all these
findings might be related. And in fact they were, so
he named this constellation of symptoms hyperviscosity syndrome which literally means thick blood. Now, it turns out that
these patients had a rare form of cancer in their blood, and this disease is now named after this Swedish physician who discovered it. It's known as Waldenstrom
macroglobulinemia. So now that we know what Waldenstrom macroglobulinemia looks
like, what exactly is it? Well, it's a disease that
occurs in the bone marrow. So let's draw in a bone
here and the bone marrow is the center portion of
the bone and it's where blood cells are produced. So I want to highlight
a few types of cells that are located here in the bone marrow. The first type of cell
I'll put in here in red, and these cells produce red blood cells. And then another cell in here are the precursors to platelets. And then the last type I'm
gonna put in green here and these cells are the
precursors to plasma cells. So Waldenstrom
macroglobulinemia is a disease of these cells, these
precursors to plasma cells and for this reason it's
considered a plasma cell dyscrasia. So I'll just write that in over here, and dyscrasia really
just means dysfunction, so I'm gonna just cross it out
and write here, dysfunction. 'Cause that's a, I think
that's a little bit easier way of understanding
what plasma cell dyscrasias are. They're just really
dysfunction of plasma cells. So normally these precursor
cells make plasma cells and then plasma cells make antibodies which I'll just draw in here. Now, antibodies are also
known as immunoglobulins and I'm gonna just abbreviate that IG. IG for immunoglobulins. Now what happens in
Waldenstrom macroglobulinemia is that these plasma cell precursor cells, they become neoplastic, or cancerous and this means that they grow
and replicate uncontrollably. So let me just draw that in here, and I'm gonna represent
these dysfunctional plasma cell precursor cells
with a solid filled in circle and so they replicate and grow and as they do this they
produce a large amount of immunoglobulins and they're actually producing a specific type of
immunoglobulin known as IGM. So let me just add an M here. So, an immunoglobulin
looks something like this. Well, an IGM is a specific
type of immunoglobulin that's actually a combination
of five immunoglobulins, so it looks something like that. When you have these
dysfunctional or neoplastic plasma cells, they're
producing lots of this IGM. And IGM is the largest of
all of the immunoglobulins and it's a protein, so as you're producing all of these proteins, they
actually start to clog up the small vessels in
the small blood vessels and this results in the symptoms of hyperviscosity syndrome,
such as the bleeding, visual changes, headaches, weakness, and definitely this
thickening of the blood. So now we have a general
understanding of the pathophysiology of
Waldenstrom macroglobulinemia and that it's a cancer
of these plasma cell precursor cells that produce large amounts of IGM resulting in this
hyperviscosity syndrome. Well, how is it diagnosed? Well, the best way to diagnose Waldenstrom macroglobulinemia is with
a bone marrow biopsy. And the biopsy will actually
show these cancerous cells. Now, unfortunately,
Waldenstrom macroglobulinemia is not a disease that we can cure, but we can treat it and
there's really two aims to the treatment of
Waldenstrom macroglobulinemia and the first is symptomatic. And by this I mean treating the symptoms of hyperviscosity syndrome. And to do this, individuals
go through a procedure known as plasmapheresis,
and what this means is that the blood is kinda
removed from the body and all of these
immunoglobulins are filtered out and then the blood is
returned to the body. So that's kind of a simple explanation of what plasmapheresis is. So, if you remove these immunoglobulins, you're not gonna have the
clogging up of the blood vessels and you won't have the symptoms of hyperviscosity syndrome. But this is really just
treating the symptoms. It's not doing anything
to the underlying disease. So the other aim of treatment is to decrease the disease progression. Like I said, it can't be cured, but you can slow the disease progression. And this is accomplished with different regimens of chemotherapy. So, Waldenstrom
macroglobulinemia is a plasma cell dyscrasia, or
dysfunction of plasma cells in which there is a overproduction of the immunoglobulin IGM and this results in thickening of the
blood in a condition known as hyperviscosity syndrome,
which is demonstrated by increased bleeding, some
visual changes, headaches, weakness, and this obvious
thickness of the blood.