Optional banner to alert visitors of an upcoming event. You can link the event here.

RegisterLogin
RegisterLogin

There are several conditions that are associated with, and often precursors to, a multiple myeloma diagnosis. Click through the slides below to find out more information.

The table below, taken from Myeloma UK, summarises the simplified criteria of how MGUS, smouldering myeloma and active myeloma are diagnosed:

 

MGUS Smouldering/Asymptomatic myeloma Active myeloma
Less than 10% myeloma
cells in the bone marrow		 10-60% myeloma cells in the bone marrow


And/or

 At least 10% myeloma cells in the bone marrow

Plus any one or more of the following test results or signs of organ damage:
Paraprotein level in the blood of less than 30g/L Paraprotein level in the blood of 30g/L or more, and/or urinary monoclonal protein 500mg or more per 24hrs Evidence from test results in the absence of organ damage:

  • Serum free light chain ration 100 or more
  • 60% or more myeloma cells in the bone marrow
  • More than one bone lesion that is at least 5mm or larger in size as picked up by an MRI scan
No symptoms of organ damage (normal kidney function, no anaemia, no bone lesions) No symptoms of organ damage (normal kidney function, no anaemia, no bone lesions) Evidence of organ damage:

  • Serum calcium >2.75 mmol/L
  • Kidney damage – indicated by creatinine clearance <40mL/min or serum creatinine >2mg/dL
  • Anaemia – indicated by haemoglobin <100g/L
  • Bone lesions – one or more shown on X-rays, CT or PET/CT scan
Does not require
treatment but will be monitored		 Is not normally treated but will be monitored Requires treatment

Additional resources

Link: Multiple myeloma – Differentials, BMJ Best Practice
Link: Multiple Myeloma Precursor Disease, Journal of the American Medical Association Vol 304:21 (2010)
Link: Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study, Blood Vol 113:22 (2009)
Link: Multiple myeloma, The Lancet Vol 397:10272 (2021)
Link: Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendation from a European Expert Panel, Journal of Hematology and Oncology 11:10 (2018)
Link: MGUS Infosheet, Myeloma UK (2019)
Link: Smouldering myeloma Infosheet, Myeloma UK (2018)
Link: Solitary plasmacytoma Infosheet, Myeloma UK (2019)
Link: AL amyloidosis, Myeloma UK

Back to
RegisterLogin

NEW: GPs Talk Cancer podcast. Listen to our first episode.

Listen Now