the increase in assorted plasma proteins and fibrinogen in blood plasma stimulated by a variety of causes (e.g. The findings support the use of serum IgM level >60 g/l as a criterion for initiation of therapy in an otherwise asymptomatic WM patient.ĬXCR4 mutation MYD88 mutation Waldenström macroglobulinaemia hyperviscosity immunoglobulin M. Plasma Viscosity, gives a measure of the acute phase response i.e. Symptomatic hyperviscosity did not impact overall survival (P = 0♱2). Adjusting for other clinical factors, the odds of developing symptomatic hyperviscosity were 370-fold higher with serum IgM levels >60 g/l, and showed an association with CXCR4 mutational status. A serum IgM level >60 g/l at diagnosis was associated with a median time to symptomatic hyperviscosity of 3 months, whereas the median time for patients with serum IgM level of 50♰1-60 g/l was approximately 3 years. Forty-four patients (36%) had symptomatic hyperviscosity at the time of WM diagnosis. The median serum IgM level at the time of symptomatic hyperviscosity was 61♸ g/l (range 31-124 g/l). We carried out a large retrospective study in 825 newly diagnosed WM patients, of who 113 (14%) developed symptomatic hyperviscosity. Identifying patients at high risk of symptomatic hyperviscosity might support the decision to treat asymptomatic patients before irreversible damage occurs. Prompt intervention is required to prevent catastrophic events, such as retinal or central nervous system bleeding. Symptomatic hyperviscosity is a common clinical manifestation in patients with Waldenström macroglobulinaemia (WM) and high serum IgM levels.
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