Not just amyloidosis: the spectrum of Waldenstrom's macroglobulinemia-associated renal disease.

Abstract

Renal involvement in Waldenström's macroglobulinemia (WM) is a rare but clinically significant complication that is often underrecognized and inadequately described in the scientific literature. When kidney damage occurs, it negatively impacts both patient prognosis and renal outcomes, highlighting the importance of early recognition and targeted therapy. While B-cell directed treatment is crucial, therapeutic strategies remain non-standardized, and much of the existing literature predates the widespread use of Bruton's tyrosine kinase (BTK) inhibitors. In this manuscript, we present a case of WM-associated heavy and light chain deposition disease successfully treated with the second-generation BTK inhibitor zanubrutinib, emphasizing the potential role of novel targeted agents in this setting. Additionally, we provide a brief review of renal complications associated with WM and discuss some therapeutic considerations. However, the available data are heterogeneous and insufficient to draw definitive conclusions regarding the relationship between clinical outcomes and specific treatment strategies.