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Types of myeloma

Men and women discussing myeloma

This page tells you about the different types of myeloma. There is information below about

 

A quick guide to what's on this page

Types of myeloma

There is really only one main type of myeloma, but in different people, the cancerous plasma cells make different antibodies. Doctors call these antibodies immunoglobulins. In each case of myeloma, only one type of immunoglobulin is overproduced, but this varies from patient to patient.

Light chain myeloma

Some people with myeloma do not produce complete immunoglobulins, they only produce a part. Doctors call this light chain myeloma or Bence Jones myeloma. The light chains are smaller than the complete immunoglobulins and show up in the urine, not the blood. So if you have this type you need urine tests to diagnose and monitor your myeloma.

Non secretory myeloma

In fewer than 2 out of 100 people with myeloma (2%), the immunoglobulin does not show up in the blood or the urine. Doctors call this non secretory myeloma. It is harder to diagnose this type of myeloma. But a new blood test called a serum free light chain test can help detect small amounts of free light chains in the blood. This is useful for diagnosing and monitoring this type of myeloma.

There are other conditions of the plasma cells related to myeloma. These include MGUS, plasmacytoma and amyloidosis.

 

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Types of immunoglobulin

There is really only one main type of myeloma, but in different people, the cancerous plasma cells make different antibodies. Doctors call these antibodies immunoglobulins. In each case of myeloma, only one type of immunoglobulin is overproduced, but this varies from patient to patient. There are 5 basic immunoglobulins – A, G, M, D and E. In myeloma, IgG is the most common, and IgE is the rarest. So, for example, you may be told you have IgG myeloma.

 

Light chain myeloma

About 1 in 5 people with myeloma (20%) do not produce complete immunoglobulins. They only produce part of the immunoglobulin called the light chain (Bence Jones protein). Doctors call this light chain myeloma or Bence Jones myeloma. The light chains are smaller than complete immunoglobulins and show up in the urine, not the blood. So you need urine tests to diagnose and monitor your myeloma if you have this type. There are 2 types of light chains – kappa and lambda.

 

Non secretory myeloma

In fewer than 2 out of every 100 people with myeloma (2%), the immunoglobulin (paraprotein) does not show up in the blood or the urine. So it is harder to diagnose this type of myeloma. Doctors call this non secretory myeloma. But a new blood test for myeloma called a serum free light chain test can help detect small amounts of free light chains in the blood. This is useful for diagnosing and monitoring this type of myeloma.

 

Other conditions related to myeloma

Some other conditions of the plasma cells are related to myeloma, including

MGUS

There is a condition called monoclonal gammopathy of undetermined significance, or MGUS for short. Your plasma cells make too many large protein molecules known as immunoglobulins or paraproteins. These show up in the blood. MGUS is often found by chance, through blood tests carried out as part of a routine check up, or tests for some other medical problem. This is because MGUS does not cause any symptoms, and does not generally affect your health.

MGUS is diagnosed if you have

  • A low level of abnormal paraprotein in your blood (less than 30 g/l)
  • A low level of abnormal plasma cells in your bone marrow (less than 10%)
  • No evidence of certain other related conditions
  • No related problems with organs or tissues

Because it does not seem to do any harm or cause problems, MGUS does not need treating. Some people with MGUS go on to develop myeloma, so your specialist will see you regularly for check ups.

Plasmacytoma

A plasmacytoma is a tumour made up of plasma cells that are all one type. They can be found in bone or soft tissue. Some people have one area of plasmacytoma and this is called solitary plasmacytoma. Some people have more than one plasmacytoma and this is called multiple solitary plasmacytoma. The areas of plasmacytoma are similar to the areas of plasma cells found in people with multiple myeloma. But people with plasmacytoma don't have other symptoms of myeloma. More than half of the people with plasmacytoma will go on to develop myeloma later in life. 

Either single or multiple plasmacytomas can grow outside the bone marrow, for example in the head and neck area. Plasmacytoma that develops outside the bone marrow is called soft tissue plasmacytoma. It usually responds well to radiotherapy treatment.

Amyloidosis

This is really a collection of conditions. An abnormal protein called amyloid is made by the plasma cells. The amyloid collects in body organs, such as the kidney or heart. About 10 to 15 out of every 100 people with myeloma (10 to 15%) either have, or develop, amyloidosis. However, it is rare for people with amyloidosis to develop myeloma. Doctors usually treat amyloidosis with chemotherapy, and use the same drugs that are used for myeloma.

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Updated: 21 November 2013