The UK charity for Waldenstrom’s macroglobulinaemia – a rare type of blood cancer
Support Line: 0300 373 8500

Blood Tests & WM

When you’re diagnosed with WM, you’ll have regular blood tests to monitor your ongoing health. Doctors are looking for changes in things like the thickness of your blood, the number of blood cells and protein levels, which could indicate changes in your WM.

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Consultant discussing stem cell transplant with wm patient

What is a blood test?

A blood test involves taking a small sample of your blood, usually from a vein in your arm, using a tiny needle. It’s quick, takes just a few minutes, and may cause a small pinch or bruise.

Depending on what your doctor is checking for, you may need to give more than one tube of blood. Your samples are sent to different labs—some look at your blood cells, while others check things like salts, proteins, or how well your liver and kidneys are working.

Your healthcare team will go over the results with you, which may take a few days to a couple of weeks. If you feel nervous or have felt dizzy or faint during blood tests before, let your team know—they’re there to help.

Why do I need blood tests?

Blood tests help your team see how your Waldenstrom’s macroglobulinaemia is behaving—whether it’s stable, improving, or getting worse.

They’re just one part of the picture, though. Blood results can vary a lot from person to person. What’s “normal” for one person might not be for another, so it’s important not to rely on them alone.

Be sure to share any symptoms you’re having with your doctor. How you feel is just as important in deciding whether you need more tests or treatment.

What kinds of blood tests will I have?

There are many types of blood tests used to help diagnose and monitor Waldenstrom’s macroglobulinaemia (WM). Your doctor might not use all of them—it depends on your situation and symptoms.

Some tests look at how WM is behaving, while others check how well your organs are working, or if you have other conditions.

Full Blood Count (FBC)

An FBC measures the number of red cells, white cells, and platelets in your blood. You can read more about these different elements here.

In WM, abnormal cells can crowd out healthy ones, leading to low blood counts. This can cause symptoms like anaemia.

You’ll likely have regular FBCs to help your team monitor how your WM is progressing. If your counts drop, it may mean your condition is getting worse—but other things can cause this too, so your team might run more tests to be sure.

Serum Quantitative Immunoglobulins (QIGs)

This test measures the total amount of each major type of immunoglobulin (antibody) in your blood including : IgG, IgA and IgM (which is the one usually raised in Waldenstrom’s macroglobulinaemia).

In WM, faulty B-cells make too much of abnormal immunoglobulin called IgM, which can also be called monoclonal antibodies or paraproteins.

It helps show whether you’re making too much of the abnormal immunoglobulin called IgM  or too little of others (like IgG, which helps protect you from infections).

It helps to give an overview of the antibodies your body is producing and monitoring your WM  diagnosis and ongoing monitoring of WM.

Serum protein electrophoresis (SPEP) and immunofixation (IFE)

These tests look more closely at the specific changes in the abnormal immunoglobulin IgM, also called monoclonal antibodies or paraproteins.

SPEP separates all the proteins in your blood based and shows whether there’s an unusual spike, which could indicate a an abnormal protein. IFE then identifies what that abnormal protein is (e.g., IgM) .Your doctor may also mention an “M-spike”, where an abnormal IgM is present and shows a spike on a graph.

It helps healthcare professionals to monitor paraprotein levels and track progression or response to treatment. These test are more sensitive than QIGs at detecting small amounts of abnormal proteins—but keep in mind that levels can vary from person to person.

Plasma viscosity
This test measures the thickness – or viscosity – of your blood. In people with Waldenstom’s macroglobulinaemia, the abnormal levels of IgM make the blood thicker, causing a condition caused hyperviscosity syndrome (HVS) that needs medical care.

Results from your plasma viscosity test are given in milliPascal second, written as mPas.  If your level is greater than 3mPas, your doctor will consider whether HVS could be the cause of any symptoms.

Cryocrit (cryoglobulin or cryoprotein)

This test is only used if you have signs of cryoglobulinaemia—a condition where proteins clump together when your body temperature drops and block blood flow. It’s a more complex test and isn’t routinely done unless you have related symptoms. Results are either positive or negative.

Blood has to be collected in a prewarmed tube, and the sample has to be kept at body temperature before being refrigerated for at least 72 hours. If the test results are positive and you have symptoms, it can indicate that you have cryoglobulinaemia.

Serum free light chains (SFLC)

People with WM produce abnormal IgM, which are immunoglobulins made up of chains of proteins – two ‘heavy’ chains and two ‘light’ chains. Around 80% of people with Waldenstom’s macroglobulinaemia produce large amounts of light chains that don’t form complete antibodies. These are called ‘free light chains’ and are split into two groups – kappa and lambda.

This test looks at kappa and lambda light chains and whether you are more of one. Your results will be shown in milligrams per litre, written as mg/l. If your ratio between the kappa and lambda significantly increases, it can mean that your WM is progressing. Likewise, if the ratio returns to a more normal number, it might mean that treatment is working.

It’s also useful for related conditions like amyloidosis or lymphoplasmacytic lymphoma (LPL). People with LPL don’t have the higher levels of IgM to monitor, so monitoring the kappa and lambda chains can help doctors to understand how their disease is progressing.

Beta-2 (β2) macroglobulin

This test measures the amount of a protein called beta-2 microglobulin in your blood. Higher levels can suggest your WM is more active and might indicate a poorer outlook—but it’s not used to diagnose WM on its own.

Understanding your blood test results

Blood test results can be tricky to interpret. Your doctor will explain what your numbers mean and whether you need more tests or treatment.

Results usually include a “normal range,” but this can vary. Try not to compare your results to others—what’s normal or concerning for one person might be very different for someone else.

If you’re ever unsure or worried, speak to your healthcare team. They’re there to guide you and help explain what everything means for your unique situation.

Our Support Line is here for You

If you’re concerned about your blood test and would like some help in understanding what they mean–contact our WM Support Line to speak a WM expert.

Call our support line

Call us on 0300 373 8500 Monday-Thursday 9am – 5pm or email support@wmuk.org.uk and we’ll respond within 48 hours.