Hello 1oldsoul and thanks for the response. You asked about the determining factor from my biopsy that changed my diagnosis. I have copied and pasted that factor from my Va medical records below.

"MYD88 p.L252P was identified.
This finding supports the diagnosis of lymphoplasmacytic lymphoma / Waldenstrom macroglobulinemia."

My blood work does not indicate anemia, but all of my relevant immune system metrics are borderline low. They are not recommending treatment of any kind at this time due to my severe COPD. According to the VA docs treatment may harm and even be fatal. They've been very unclear as to any future treatment and are waiting and watching.

I requested that VA pay for a second opinion at the Rochester Mayo clinic (I am a veteran), but my request was turned down. I don't think VA has experts who specialize in WM due to the relative rarity of WM even though they may treat it occasionally.

Your post indictes that we may be at the same stage for WM. If you choose to have a biopsy. It may be that yor doctor will recommend 'watch and wait' for you as well. My goal now is to find a doctor who has experience treating WM patients who also have COPD. I think I have a better chance by going to Mayo where they treat hundreds of patients every year. I just don't know how to go about contacting Mayo.

Once again, thanks for the reply, and please stay in touch.