Report of Consensus Panel 3 from the 11thInternational Workshop on Waldenström's Macroglobulinemia: Recommendations for Molecular Diagnosis in Waldenström's Macroglobulinemia

Apart from the MYD88L265Pmutation, extensive information exists on the molecular mechanisms in Waldenström's Macroglobulinemia and its potential utility in the diagnosis and treatment tailoring. However, no consensus recommendations are yet available. Consensus Panel 3 (CP3) of the 11thInternational Workshop on Waldenström's Macroglobulinemia (IWWM-11) was tasked with reviewing the current molecular necessities and best way to access the minimum data required for a correct diagnosis and monitoring. Key recommendations from IWWM-11 CP3 included: 1) molecular studies are warranted for patients in whom therapy is going to be started; such studies should also be done in those whose bone marrow (BM) material is sampled based on clinical issues; 2) molecular studies considered essential for these situations are those that clarify the status of 6q and 17p chromosomes, and MYD88, CXCR4, and TP53genes. These tests in other situations, and/or other tests, are considered optional; 3) independently of the use of more sensitive and/or specific techniques, the minimum requirements are Allele Specific Polymerase Chain Reaction for MYD88L265Pand CXCR4S338Xusing whole BM, and Fluorescence in situ hybridization for 6q and 17p and sequencing for CXCR4and TP53using CD19+ enriched BM; 4) these requirements refer to all patients; therefore, sample should be sent to specialized centers.