Waldenstrom's macroglobulinaemia: to treat or not to treat?

Waldenstrom's macroglobulinaemia (WM) is a rare lymphoproliferative disorder. It is mostly seen in the elderly population with a median age of 65 years at the time of diagnosis. The clinical presentation is variable and the patient may be entirely asymptomatic. The slow progressive nature of the disease allows many patients to survive for more than 5 years. At times it may be difficult for a clinician to determine the timing of therapy. We present an interesting case of WM that highlights the typical course of the disease and timing of its management.