{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:37:09Z","timestamp":1791995829183,"version":"4.4.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Renal injury related to Waldenstr\u00f6m macroglobulinemia (WM) occurs in approximately 3% of patients. Kidney biopsy is crucial to discriminate between distinct histopathological entities such as glomerular (amyloidotic and non\u2010amyloidotic), tubulo\u2010interstitial and non\u2010paraprotein mediated renal damage. In this context, disease characterization, management, relationship between renal, and hematological response have been poorly explored.<\/jats:p><jats:p>We collected clinical, genetic and laboratory data of seven cases of biopsy\u2010proven renal involvement by WM managed at our academic center and focused on three cases we judged paradigmatic discussing their histopathological patterns, clinical features, and therapeutic options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>In this illustrative case series, we confirm that serum creatinine levels and 24\u2009h proteinuria are parameters that when altered should prompt the clinical suspicion of WM\u2010related renal involvement, even if at present there are not precise cut\u2010off levels recommending the execution of a renal biopsy. In our series AL Amyloidosis (<jats:italic>n<\/jats:italic>\u2009=\u20093\/7) and tubulo\u2010interstitial infiltration by lymphoma cells (<jats:italic>n<\/jats:italic>\u2009=\u20093\/7) were the two more represented entities. BTKi did not seem to improve renal function (Case 1), while bortezomib\u2010based regimens demonstrated a beneficial activity on the hematological and organ response, even when used as second\u2010line therapy after chemoimmunotherapy (Case 3) and also with coexistence of anti\u2010MAG neuropathy (Case 2). In case of poor response to bortezomib, standard chemoimmunotherapy (CIT), such as rituximab\u2010bendamustine, represents an effective option (Case 1, 6, and 7). In our series, CIT generates durable responses more frequently in cases with amyloidogenic renal damage (Case 1, 5, and 7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this illustrative case series, we confirm that serum creatinine levels and 24\u2009h proteinuria are parameters that when altered should prompt the clinical suspicion of WM\u2010related renal involvement, even if at present there are not precise cut\u2010off levels recommending the execution of a renal biopsy. Studies with higher numerosity are needed to better clarify the pathological and clinical features of renal involvement during WM and to determine the potential benefit of different therapeutic regimens according to the histopathological subtypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.2062","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T15:31:03Z","timestamp":1714059063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["When Waldenstr\u00f6m macroglobulinemia hits the kidney: Description of a case series and management of a \u201crare in rare\u201d scenario"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1352-306X","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Danesin","sequence":"first","affiliation":[{"name":"Hematology Unit, Department of Medicine University of Padova  Padova 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