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GET THE CORRECT DIAGNOSIS

Recent studies confirm the importance diagnosing myeloma as early as possible. Myeloma is a very individual disease—often slow-moving, sometimes much more aggressive. A skilled myeloma specialist will be able to determine the best approach in your individual situation. 

07.01.15

I’ve undergone lab tests. How do I know if I have multiple myeloma?

Once you undergo the proper tests, the presence of myeloma can be assessed using the International Myeloma Working Group diagnostic criteria for multiple myeloma:

Clonal bone marrow plasma cells ≥10% or biopsy-proven bony or extramedullary plasmacytoma* and any one or more of the following myeloma defining events:

Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically:

• Hypercalcaemia: serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
• Renal insufficiency: creatinine clearance <40 mL per minute or serum creatinine >177 μmol/L (>2 mg/dL)
• Anemia: hemoglobin value of >20 g/L below the lower limit of normal, or a hemoglobin value <100 g/L
• Bone lesions: one or more osteolytic lesions on skeletal radiography, CT, or PET-CT

Any one or more of the following biomarkers of malignancy:

• Clonal bone marrow plasma cell percentage ≥60%
• Involved:uninvolved serum free light chain ratio ≥100
• >1 focal lesions on MRI studies

If the above criteria are not met, you may have a precursor (“pre-myeloma”) state that falls into one of three categories:

MGUS- monoclonal gammopathy of undetermined significance
Smoldering myeloma (low risk)
Smoldering myeloma (high risk)

My doctor says I have IgG myeloma, what does that mean?

Types of Myeloma

  • IgG myeloma with κ or λ light chains
    • 65% of myeloma patients
    • Has usual features of myeloma      
  • IgA myeloma with κ or λ light chains
    • Next-most common type
    • Sometimes characterized by tumors outside the bone       
  • IgD, IgE, and IgM myeloma
    • Rare types
    • IgD can be accompanied by plasma-cell leukemia and can cause kidney damage
  • “Light chain” or “Bence Jones myeloma” (10% of myeloma patients)
    • Most likely to cause kidney damage, and/or lead to deposits of light chains in kidneys and/or on nerves or other organs.
  • “Non-secretory” myeloma (1%-2% of myeloma patients)

©2015 International Myeloma Foundation

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