Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure

Table 1

Clinical features and laboratory data.

	Case 1	Case 2
Age (yrs)/gender	63/F	58/M
Chief complaints	Lightheadedness	Nausea
	Drowsiness	Dysgeusia
	Blurred vision	Oliguria
Major clinical features	Retinopathy (group 3)	Renal failure (group 3)
Laboratory data on admission
WBC (/µL)	6,900	8,200
Hb (g/dL)	7.9	8.2
Platelet counts (/µL)	124,000	107,000
PB smear	Rouleaux formation	Rouleaux formation
CRP (mg/dL)	0.19	1.15
LDH (U/L)	174	102
Total protein (g/dL)	9.2	9.3
Albumin (g/dL)	2.1	3.2
Serum BUN (mg/dL)	20.9	124.4
Creatinine (mg/dL)	1.25	11.1
Na (mmol/L)	135	137
K (mmol/L)	4.3	7.6
Cl (mmol/L)	98	112
IgG (mg/dL)	427	473
IgA (mg/dL)	137	20
IgM (mg/dL)	6,080	3,603
Beta-2-MG (mg/dL)	4.0	36.5
sIL-2R (U/L)	767	NT
Monoclonal protein	IgM-kappa	IgM-kappa
Proteinuria	2+	2+
MYD88	NT	NT
Treatment
Initial management and chemotherapy induction	DFPP/PE/rituximab/2-CDA	Hemodialysis
		Rituximab/bendamustine
Maintenance	Rituximab/thalidomide	None
Outcome
Alive (yrs)	8+	0.5

Defined by Menke et al. [14]; defined by Chauvet et al. [21], Vos et al. [11], and Audard et al. [20]; died of severe pneumonia after the sixth cycle of rituximab/bendamustine. NT = not tested, MYD88 = myeloid differentiation 88, DFPP = double-filtration plasmapheresis, PE = plasma exchange, 2-CDA = 2-chloro-2′-deoxyadenosine.