There are two main myeloma groups:
Active myeloma: Also known as symptomatic myeloma, which can present with any of the following signs and symptoms:
- Areas of damaged bone (osteolytic lesions) that can be seen in an X-ray
- Bone fractures
- Bone or soft tissue tumor(s) containing myeloma cells
- Presence of M protein in urine or blood
- Hypercalcemia (high calcium level in the blood)
- Kidney complications
Smoldering myeloma: A slow-growing, precancerous myeloma marked by an increased number of plasma cells and M protein but without symptoms. Once detected, patients are closely monitored for progression, but no treatment is immediately given. About 50% of patients diagnosed with this condition will develop active myeloma within five years.
Heavy Chain Myeloma: Heavy chain myeloma impacts the large subunit of the antibody structure and is classified by the type of abnormal antibodies, or immunoglobulins, produced. There are five main immunoglobulin types: G, A, M, E, or D.
Typically, only one type of immunoglobulin is overproduced in myeloma.
- IgG is the most common, impacting approximately 60 – 70% of patients.
- IgA affects approximately 20% of patients.
- IgM, IgE, and IgD are rare.
Light Chain (Bence Jones) Myeloma: The body only produces the light chain component of the immunoglobulin. It is usually more aggressive than heavy chain myeloma. It affects approximately 15% of myeloma patients. Symptoms can include weakness, bone pain, and kidney dysfunction, though not all patients will have symptoms at diagnosis.
Non-Secretory Myeloma: A rare myeloma diagnosed in 1 – 5% of patients. Because M proteins are produced in small amounts or not at all, a specific test to measure kappa and lambda free light chains is used to monitor the disease.
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- [Kahler's disease. Multiple myeloma] - PubMed (nih.gov)
- Types of Multiple Myeloma: Common, Rare and More (cancercenter.com)
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- Types of Multiple Myeloma | International Myeloma Foundation
- Slowing the Progression of Smoldering Myeloma - NCI (cancer.gov)
- Immunoglobulin Structure and Classes | Thermo Fisher Scientific - US