These cases should have no symptoms or findings of end organ dysfunction attributed to Waldenström macroglobulinemia such as anemia, decreases in any white blood cell count, cold agglutinin disease, hyperviscosity of blood, lymphadenopathy, hepatomegaly, splenomegaly, peripheral neuropathy, cryoglobulinemia, or constitutional symptoms.As determined by a Mayo Clinic study of 48 individuals, smoldering Waldenström macroglobulinemias risk of progression to Waldenström macroglobulinemia is estimated to be ~12% per year and then falling of sharply for at least the next 5 years to 2% per year. In this study the only factor predictive of a more rapid progress was a finding of anemia (hemoglobin level <115 grams/liter). During a 15-year follow-up, the Clinic subsequently reported that patients progressed to Waldenström macroglobulinemia, amyloidosis, or a related IgM-associated neoplasm at a rate of 6%, 39%, 59%, and 68% after the first, third, fifth, and tenth year, respectively. However, the Southwest Oncology Group in a study on 231 individuals reported that the smoldering disease progressed to overt Waldenström macroglobulinemia over 9 years in only 26% of cases. Light chain SMM
Light chain smoldering multiple myeloma (light chain SMM) was previously termed idiopathic Bence Jones proteinuria. The condition is currently diagnosed in asymptomatic individuals who have a 24-hour urinary Bence Jones, i.e. light chain myeloma protein level, that is >0.5 grams and/or bone marrow plasma cells that are 10% to <60% of nucleated cells.
Vocal cord hemorrhage occurs when a blood vessel in the vocal cords ruptures, which results in leakage of blood into the superficial lamina propria and dysphonia (hoarseness). The rupture usually results from overly forceful or incorrect vocalization, and may be a one-time occurrence or occur repeatedly. According to News Medical.net, "professional singers are at an increased risk of vocal hemorrhage, particularly in cases where gruelling performance schedules are followed". The treatment is  vocal rest as failure to rest the voice can result in permanent scarring. == References ==