What are the types of multiple myeloma?

Multiple myeloma: Several bones are affected. This is the most common type.
Plasmacytoma: Myeloma cells collect in a single bone and form a tumour called a solitary plasmacytoma. Usually treated with radiotherapy and you will be monitored with blood tests in case you go on to develop multiple myeloma.
Non-secretory myeloma: A rare type of myeloma. There are no paraproteins in the blood or urine.

Subtypes of multiple myeloma

These are based on the type of abnormal immunoglobulin (Ig) made by the myeloma cell.

Normally there are five types of immunoglobulin: IgA, IgD, IgE, IgG and IgM.
They each have different functions in fighting disease.
The letters A, D, E, G and M refer to the type of heavy protein chains in the immunoglobulins.
The immunoglobulins also have light chains of proteins, which can be called kappa (K) or lambda (L).
You will only develop one abnormal immunoglobulin.
The most common one in myeloma is IgG.
The next most common one is IgA.
IgE, IgG and IgM are all quite rare.

For more information about your subtype, talk to your doctor or nurse.

Conditions related to multiple myeloma

Multiple myeloma is just one of many disorders of the plasma cells. There are some conditions that may lead to multiple myeloma but this does not always happen. If you are diagnosed with any of these conditions, you will be closely monitored with blood tests for a number of years. You will only be treated if the condition develops into multiple myeloma.

Monoclonal gammopathy of uncertain significance (MGUS)

There are raised levels of abnormal proteins (monoclonal protein, or M protein) in your bloodstream but no other signs of multiple myeloma. MGUS is often found by chance in a blood test for a routine check-up. This is because MGUS doesn’t usually cause symptoms. MGUS doesn’t usually need treatment because it is not causing problems.

However, you will have regular check-ups and you will also be advised to check with your doctor if you develop any unexplained new symptoms such as constant pain in a bone such as your back, ribs, hip or pelvis. You will also be advised to report any recurring infections, tiredness and or breathlessness.

Most people with MGUS never develop any symptoms, but a small number of those diagnosed with MGUS can go on to develop myeloma. Even though this is unlikely for most it still leaves most people diagnosed with MGUS worrying. If you’re worried, we would suggest you speak to your haematologist and nurse specialist as it is a lot of information to take in and seek help from the cancer nurses with the Irish Cancer Society.

Smouldering myeloma

A very slow growing form of myeloma. Paraproteins are found in your blood but usually there are no symptoms and no treatment is needed. It is also called indolent myeloma.

Amyloidosis

During the course of their disease, some multiple myeloma patients may develop amyloidosis. This is a condition related to multiple myeloma. Here large amounts of an abnormal protein called amyloid are found in your body.

This happens when plasma cells in your bone marrow make antibodies that cannot be broken down. Parts of these abnormal antibodies called light chains stick to one another and collect in body organs such as your kidney, heart or liver.

About 10 to 15 in every 100 people with multiple myeloma will develop amyloidosis. But it is rare for people with amyloidosis to develop multiple myeloma. A SAP scan of your body is one test that diagnoses amyloidosis. The treatment is very like the treatment of multiple myeloma, in particular using chemotherapy.