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Br J Haematol. 2017 Mar;176(5):728-742. doi: 10.1111/bjh.14492. Epub 2017 Feb 15.

Investigation and management of IgM and Waldenström-associated peripheral neuropathies: recommendations from the IWWM-8 consensus panel.

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Waldenström Clinic, Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.
Department of Haematology, Academic Medical Centre, Amsterdam, the Netherlands.
Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
Department of Haematology, North Estonia Medical Centre, Tallinn, Estonia.
AP-HP Hôpital Pitié Salpêtrière, UPMC Univ. Paris 6 GRC-11, Grechy, Paris, France.
Centre for Research and Treatment of Systemic Amyloidosis, University of Pavia, Pavia, Italy.
Cancer Centre, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands.
Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK.


Paraproteinaemic neuropathies are a heterogeneous group of disorders most frequently associated with IgM monoclonal gammopathies including Waldenström macroglobulinaemia (WM). Their consequences are significant for affected patients, and their management challenging for their physicians. The variability in clinical presentation and time course hamper classification and management. The indications for invasive investigations such as cerebrospinal fluid analysis, nerve conduction tests and sensory nerve biopsies are unclear, and the optimum way to measure clinical response to treatment unknown. When to intervene and and how to treat, also present challenges to physicians. As part of its latest deliberations at the International Workshops on WM (IWWM) in London, UK (August 2014), the IWWM8 panel have proposed a consensus approach to the diagnosis and management of peripheral neuropathies associated with IgM monoclonal gammopathies, including WM. Importantly, a consensus regarding the use of clinical outcome measures and recommended models of care for this group of patients is discussed, as well as appropriate treatment interventions.


IgM; Waldenstrom macroglobulinaemia; paraproteinaemic neuropathy

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