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COMy 2026 | How do the clinicopathological features of IgM-MM and WM differ?
In this video, Steven Treon, MD, PhD, FRCP, Dana-Farber Cancer Institute, Boston, MA, discusses how the clinicopathological features of IgM-multiple myeloma (MM) and Waldenström’s macroglobulinemia (WM) differ, highlighting that clinicians should be aware of high IgM levels, cyclin D1 overexpression, 4;11 translocation, and MYD88 mutations. This interview took place at the 12th World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
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Transcript
Yeah, actually, you know, a lot of work has been done in distinguishing IgM myeloma from Waldenström’s is a problem we often encounter. I think it is important for clinicians to become suspicious of IgM myeloma when they see very high IgM levels. The median IgM levels in at least one or two studies is in the 6,000 to 8,000 milligram per deciliter range. So one should become suspicious. And I think just clinically and pathologically, look for cyclin D1 overexpression, which segues with IgM myeloma...
Yeah, actually, you know, a lot of work has been done in distinguishing IgM myeloma from Waldenström’s is a problem we often encounter. I think it is important for clinicians to become suspicious of IgM myeloma when they see very high IgM levels. The median IgM levels in at least one or two studies is in the 6,000 to 8,000 milligram per deciliter range. So one should become suspicious. And I think just clinically and pathologically, look for cyclin D1 overexpression, which segues with IgM myeloma. Look for translocation t(11;14) using FISH, which again segues with IgM myeloma. And definitely check for MYD88 mutations because the MYD88 mutations are not present in IgM myeloma, but we find them in Waldenström’s. Of course, we find them at a rate of 95% to 97%. And you don’t see them in IgM myeloma.
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