It is defined as monoclonal plasmocytic prolif eration of the bone marrow with the same clinical and. It is typically characterized by production of large amounts of. Hallmark of most multiple myeloma cases is the persistent production of some form of immunoglobulins, a phenomenon that brings the disease to attention. This variant usually poses a diagnostic challenge to. You have free access to this content nonsecretory plasma cell myeloma of the true nonproducer type. Multiple myeloma is a cancer in which the body overproduces plasma cells. Jan 02, 2009 grannai too am a non secretory mm survivor. Clinical course and prognosis of nonsecretory multiple. Nonsecretory myeloma definition of nonsecretory myeloma by. Multiple myeloma affects slightly more men than women. Nonsecretory myeloma is a rare myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal. Multiple myeloma is a monoclonal gammopathy and is the most common primary malignant bone neoplasm in adults. It arises from red marrow due to the monoclonal proliferation of plasma cells and manifests in a wide range of radiographic abnormalities. The findings, discussed in a letter to the editor of the new england journal of medicine, also indicate that oligosecretory myeloma is more prevalent at later stages of the disease.
Nonsecretory myelomas were first described in 1958 by serre, and they constitute 15% of myelomas. Nonsecretory multiple myeloma nonsecretory multiple myeloma rubio. Myeloma introduction a clonal disorder of plasma cells bcells. Jun 14, 2012 my myeloma at this stage was almost non secretory. You have free access to this content non secretory plasma cell myeloma of the true non producer type. Nonsecretory multiple myeloma nsm is a symptomatic myeloma without detectable monoclonal immunoglobulin protein in serum or urine by immunofixation electrophoresis 1,5. The good news is that statistically non secretors live longer, the bad news is that it is more difficult to track our levels. It is estimated to account for 1015% of haematological malignancies and 1% of all malignancies. Nonsecretory myeloma definition of nonsecretory myeloma. Nonsecretory multiple myeloma nsmm is the absence of a detectable monoclonal protein in serum and urine of a multiple myeloma mm patient and immunoglobulin light chain al amyloidosis is a. The disease is characterised by the absence of detectable monoclonal proteins in serum and urine using.
To the best of our knowledge, this is the rst case of nonsecretory multiple myeloma presenting as plasmacytoma of the colon. Nonsecretory multiple myeloma nsmm accounts for 1 5% of all multiple myeloma mm cases. Nonsecretory myeloma nsm is a rare form of my eloma. Nonsecretory multiple myeloma and al amyloidosis presenting. Multiple myeloma is cancer that starts in the bone marrows plasma cells. Fulltext pdf treatment outcomes in patients with newly diagnosed multiple myeloma who are ineligible for stemcell transplantation. Multiple myeloma is a disorder of the bone marrow which accounts for 1015% of all blood cancers and one to two per cent of all malignancies. In healthy people as well as people with myeloma, plasma cells produce antibodies also known as. Hi david i was diagnosed with nonsecretary multiple myeloma a year ago. Nonsecretory myeloma or light chainproducing multiple. Nonsecretory myeloma or light chainproducing multiple myeloma.
It is defined as symptomatic myeloma without detectable monoclonal immunoglobulin on serum or urine electrophoresis. Sharing clinical, therapeutic, and prognostic characteristics with mm, real challenge. A case of nonsecretorymultiple myeloma presenting as primary plasma cell leukaemia in a 65 year old woman is presented. Information about serum flc measurement in nonsecretory myeloma, monoclonal light chain diseases, and reference populations is reported in the literature 15,7, but there is limited data about flcs in. Many core booklets and key medical articles are translated as well. Nonsecretory multiple myeloma nsmm is a rare variant of the classic form of mm, ranging from 1% to 5% of all cases of mm, and has a similar clinical and radiologic presentation except for the absence of monoclonal gammopathy.
Multiple myeloma mm, also known as plasma cell myeloma and simple myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. To determine the prognosis of patients with non secretory myeloma. The subset of these patients with non secretory myeloma a group of patients who do not secrete immunoglobulin or its component parts into either the blood or urinehas been challenging to treat and to assess. Plasma cells are a part of the bodys immune system and produce antibodies that help the body fight infection. Discussion multiple myeloma is a disorder of the bone marrow which accounts for 1015% of all blood cancers and. Pdf multiple myeloma mm is the second most common hematologic malignancy in the us. Non secretory myeloma comprises less than 01% of this spectrum where serum protein electrophoresis and quantitative immunoglobulins remain essentially normal. During my 6 months of remission i was on 8 gms curcumin, essiac tea and cbd oil. Disease bioinformatics research of nonsecretory myeloma has been linked to multiple myeloma, plasmacytoma, neoplasms, monoclonal gammapathies, anemia. Dec 15, 2016 interestingly, it has been observed since the 1950s that a very small subset of the myeloma population is functionally nonsecreting, that is, there is no detectable monoclonal ig by electrophoresis of the serum or urine. The clinical picture of nsm is different from that of secretory myeloma, as nsm patients usually have improved hemoglobin levels, lower esr values, higher neurological presentation incidence, less aggressive osteolysis, low risk of renal myeloma, lower hypercalcemia incidence, and improved immunoglobulin levels. The good news is that statistically non secretors live longer, the bad news is that it is more difficult to.
Cyclophosphamide bortezomib dexamethasone cyclobordex. Mar 31, 2015 multiple myeloma is a cancer in which the body overproduces plasma cells. Information about serum flc measurement in nonsecretory myeloma, monoclonal light chain diseases, and reference populations is reported in the literature 15,7, but there is limited data about flcs in renal disease, monoclonal gammopathy of undetermined significance mgus, and myeloma patients after autologous stem cell transplants. Kaufman, md 3 numerous small series of patients suggest that the prognosis for. Aug 24, 2012 a type of test called the free light chain assay can frequently detect oligosecretory disease in multiple myeloma patients. Clinical course and prognosis of nonsecretory multiple myeloma. Survival of nonsecretory multiple myeloma patients. The disease is characterised by the absence of detectable monoclonal proteins in serum and urine using immunofixation electrophoresis ife, although the degree of bone marrow plasma cell infiltration is similar to that found in secretory patients. This subset of true nsmm has become even smaller over time, as the advent of the serum free light chain assay has resulted in the majority of nsmm patients being recategorized as lightchain mm that is, mm cells that produce only the lightchain component of ig. In healthy people as well as people with myeloma, plasma cells produce antibodies also known as immunoglobulins that help the body fight infection. Each plasma cell produces one type of immunoglobulin, and the body produces many types of plasma cells. Nonsecretory multiple myeloma nsmm is a rare clinical and biological variant of the classic form of mm characterized by the absence of monoclonal. Read about multiple myeloma prognosis, life expectancy, stages, treatment, diagnosis, and causes. Overview of multiple myeloma, risk factors, treatment approaches.
A rare variant of multiple myeloma article pdf available in journal of the college of physicians and surgeonspakistan. Case report nonsecretory multiple myeloma presenting as an. Pdf nonsecretory myeloma is a myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal. We studied 124 patients diagnosed with multiple myeloma who had no monoclonal protein detected on serum and urine immunofixation at diagnosis and on all subsequent followup testing non secretory myeloma. Bone marrow plasmacytosis as well as production of. Multiple myeloma mm, risk factors, disease progression, therapy, symptomatic, treatment. Cancer articles and journals intl myeloma foundation. Introduction multiple myeloma mm is a mature bcell neoplastic proliferative disease as well as is additionally referred to as plasma cell myeloma, myelomatosis, or kahler disease 1. Multiple myeloma mm is an incurable malignancy arising from postgerminal b lymphocytes. The findings, discussed in a letter to the editor of the new england. The first case of this variant was described in 1958 3. Individuals with smoldering multiple myeloma may eventually develop multiple myeloma. Introduction multiple myeloma mm is a mature bcell neoplastic proliferative disease as well as.
We are presenting a case report of this rare variant involving the sternum of an adult male. Myeloma is characterized by the clonal infiltration of the marrow by plasma cells that typically produce a serum or urine paraprotein. Nonsecretory plasma cell myeloma of the true nonproducer. To determine the prognosis of patients with nonsecretory myeloma. Multiple myeloma mm is the second most common hematologic neoplasm in the us, with 30,000 new cases annually. The treatment of patients with multiple myeloma has dramatically changed over the past 10 years due to an improved understanding of plasma cell biology and the development of new targets. However, a small subset of mm called nonsecretory multiple myeloma nsmm produces no detectable ig. Myeloma group this is a controlled document and therefore must not be changed of mm.
A case report ana rita caldasa, b, mariana brandaoa, antonio marinhoa abstract nonsecretory multiple myeloma nsmm is a rare variant of the classic form of mm that has a similar clinical and radiologic presentation except for the absence of the mprotein in serum andor urine. The disease is characterised by the absence of detectable monoclonal proteins in serum. Patients with multiple myeloma mm that present at diagnosis with serum monoclonal protein mig of monoclonal protein nonsecretory are commonly excluded from participation in clinical trials due to undesirable disease. All are available free of charge online and in printed copy by mail. Hi david i was diagnosed with non secretary multiple myeloma a year ago. Nonsecretory multiple myeloma presenting as primary plasma cell. Approximately 9597% of myelomas are of the secretory type, i. The study of nonsecretory myeloma has been mentioned in research publications which can be found using our bioinformatics tool below. However, there is a subset of multiple myeloma patients who do not secrete immunoglobulin or its component parts into either the blood or urine, hence called non secretory myeloma. Non secretory myeloma or light chainproducing multiple myeloma. Introduction multiple myeloma is a malignant neoplasm of the bone marrow and accounts for approximately % of all hema.
Plasma cell leukemia is characterized by the presence of excessive amounts of plasma cells in the blood. Myeloma can evolve and turn into a very low secretory or non secretory type. Survival of nonsecretory multiple myeloma patients improves. The potential value of more sensitive quantitative diagnostic techniques for this disease is being studied. Kaufman, md 3 numerous small series of patients suggest that the prognosis for nonsecretory myeloma patients is likely no worse than the prognosis for patients with traditional secretory myeloma, and in some. Multiple myeloma is a cancer of the plasma cells in the bone marrow seek medical care for unexplained pain, nausea, vomiting, weight loss, vision problems, or chronic tingling or numbness there is no cure. International myeloma foundation headquarters 12650 riverside drive, suite 206 north hollywood, ca 91607, usa tel. Multiple myeloma mm is the second most common hematologic malignancy in the us. Multiple myeloma nord national organization for rare. Nonsecretory multiple myeloma nsmm is the absence of a detectable monoclonal protein in serum and urine of a multiple myeloma mm patient and immunoglobulin light chain al amyloidosis is a significantly rare complication.
Overview of multiple myeloma, risk factors, treatment. Multiple myeloma is the secondmost prevalent blood cancer 10% after non hodgkins lymphoma. Among 186 patients with multiple myeloma mm, five women were diagnosed as having mm without m. Nonsecretory myeloma comprises less than 01% of this spectrum where serum protein electrophoresis and quantitative immunoglobulins remain essentially normal. Non secretory myeloma exists when an individual with multiple myeloma does not produce mprotein in either the urine or blood serum.
Are you in need of the most current information about multiple myeloma. Nonsecretory multiple myeloma relapsing as extramedullary liver. Nonsecretory myeloma was associated with a higher incidence of neurological presentation, minimal lytic bone disease, a lower median percentage of plasma cells in the marrow and a lower incidence. Survival of nonsecretory multiple myeloma patients improves over last decade by maike haehle from the myeloma beacon results of a recent retrospective study conducted at the mayo clinic indicate that the survival of patients with nonsecretory multiple myeloma has improved over the last decade. We knew i relapsed because my arm broke and there were a lot of myeloma cells in the arm when the surgeon did the op. Nonsecretory multiple myeloma nsmm is a rare variant of mm and accounts for approximately. A case of nsmm with al amyloidosis and nephrotic range proteinuria is presented. Free light chain report was available when the bone marrow biopsy report was already confirming the multiple myeloma diagnosis. The serum protein is often characterized by an intact immunoglobulin heavy and light chain, or it may be characterized by the light chain alone. Multiple myeloma mm is a plasma cell disorder associated with clonal proliferation of plasma cells. Nonsecretory myeloma is a rare myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal plasma cells. A rare case of nonsecretory multiple myeloma in lagos. Myeloma group this is a controlled document and therefore must not be changed mm. Symptoms and signs include anemia, skin lesions, weakness, and bone fractures.