Myeloma is a blanket term for various types of blood cancer. The different types of myeloma refer to the type of cell in which the cancer started. A physician needs to know your myeloma type in order to find the right treatment.

The Different Types of Myeloma:

1. Types of Immunoglobulin

While the different types of myeloma are varied, the main type is found in cancerous plasma cells. Plasma cells create immunoglobulins, containing two chains of long protein, and two chains of short protein. There are five types of immunoglobulin and these are A, D, E, G, and M. In the different types of myeloma, a different immunoglobulin is affected. The most common form is IgG, and the rarest are IgE, IgD, and IgM. Nevertheless, they all receive the same treatment.

2. Light Chain Myeloma

In 20% of myeloma patients, immunoglobulins are not produced completely, so that they have only the short (light chain) protein chains. Two types exist, which are kappa and lambda. These chains can be measured in the urine and are known as the BJP – Bence Jones protein. This can be measured through a serum free light chain test, in which physicians can compare the kappa to lambda ratio. If the ratio is not normal, it can indicate myeloma.

3. Non Secretory Myeloma

In around 3% of myeloma patients, almost no paraprotein (immunoglobulin) is produce. A diagnosis is then also very difficult. However, it can sometimes be picked up with a serum free light chain test, but bone marrow tests are almost always required.

Myeloma Related Conditions:

1. Monoclonal Gammopathy of Undetermined Significance (MGUS)

Here, the plasma creates too many paraproteins. MGUS is often diagnosed by chance in routine checkups. This is because it is asymptomatic and has few effects on health. It is diagnosed in people who have:

  • Less than 30g/l of paraprotein
  • Less than 10% of plasma cells in bone marrow
  • No other related conditions
  • No problems with tissues or organs

MGUS usually isn't treated. However, patients are monitored because they are more likely to get myeloma. Around 1% of MGUS patients develop myeloma every year.

2. Plasmacytoma

This is a tumor created by a single type of plasma cell. They can be found in soft tissue or in bone. If it is only found in one area, it is known as solitary plasmacytoma. Some people have multiple solitary plasmacytoma. These plasmacytomas are very similar to the buildup of plasma cells common in multiple myeloma patients. Around 50% of plasmacytoma patients develop myeloma. Radiation therapy is usually the best course of treatment.

3. Amyloidosis

Amyloidosis defines multiple conditions caused by the amyloid protein that the plasma cells create. It collects in different organs, causing damage. Around 10% to 15% of myeloma patients also develop amyloidosis. However, those with amyloidosis rarely develop myeloma. Chemotherapy and myeloma drugs have been effective against amyloidosis. It is not clear why there seems to be a strong link between myeloma and amyloidosis, but not the other way around, particularly because the two conditions respond to the same treatment.