More than 3 lytic bone lesions. Many investigators favor a simpler system using only beta-2 microglobulin and albumin concentrations to stage patients. Abnormalities of chromosomes 13 and 11q and plasmablastic morphology appear to have predicted poor outcome for a population of patients whose myeloma was treated with high-dose chemotherapy and stem cell rescue. If these tests are negative, the patient has extramedullary plasmacytoma. Macroglobulinemia Macroglobulinemia is a proliferation of plasmacytoid lymphocytes secreting an IgM M-protein.
Patients often have lymphadenopathy and hepatosplenomegaly, but bony lesions are uncommon.
There is no generally accepted staging system. Lymphadenopathy and splenomegaly are found in about one third of patients. IgM leads to an expansion of the plasma volume, a dilutional anemia, and in extreme cases, congestive heart failure. Similar problems with the circulation of blood in the CNS can cause ataxia, nystagmus, vertigo, confusion, and disturbances of consciousness. Patients are asymptomatic, the M-protein is relatively stable, and there is no lymphadenopathy, splenomegaly, or bony lesions.