What is myeloma?
What is myeloma?
Myeloma affects white blood cells called plasma cells. Plasma cells are made inside your bone marrow, the spongy material inside some of your bones.
The role of plasma cells is to make antibodies. These are proteins that circulate in your blood, finding and killing germs such as viruses, bacteria and fungus which cause infections.
In myeloma, something goes wrong with your plasma cells. They start making antibodies that don’t work properly and can’t kill germs effectively. So you may have infections that last longer and are more frequent than usual.
These abnormal plasma cells – or myeloma cells – also grow more quickly than they should. They crowd your bone marrow so there isn’t enough room for other blood cells to be made. This leads to other symptoms of myeloma, such as anaemia, which can make you feel tired.
Myeloma is often referred to as multiple myeloma because it affects the bone marrow in more than one place and can affect other parts of the body.
Multiple myeloma and myeloma are different names for the same disease.
Myeloma can be smouldering or active.
People with smouldering myeloma don’t have any symptoms of myeloma. They are often diagnosed by chance following a blood test for something else.
Smouldering myeloma is also called asymptomatic myeloma because of the lack of symptoms.
- If you have active myeloma, you will usually have some symptoms and will normally start treatment quite quickly.
- If you have smouldering myeloma, you may not need treatment for a while, or perhaps never. You will be monitored regularly until your doctor recommends you start treatment. This approach is called watch and wait or active monitoring.
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Myeloma and paraproteins
Antibodies are complex Y-shaped proteins, made up of chemical structures called heavy chains and light chains. You may also hear them called immunoglobulins.
The abnormal antibodies produced by myeloma cells are known as paraproteins. They are sometimes called other names like M-protein, M-band or M-spike – these terms all mean the same thing. If there is paraprotein in your blood, it may be a sign that you have myeloma.
Most people with a diagnosis of myeloma will have regular blood tests to monitor the level of paraprotein in their blood. But in some types of myeloma, the myeloma cells don’t produce paraprotein. So it will be monitored in other ways.
Light chain myeloma
One in five people with myeloma (20%) have light chain myeloma. In light chain myeloma, the myeloma cells don’t produce whole paraproteins, just the light chain parts. Regular tests will monitor the level of light chains in the blood, and sometimes in the urine.
Find out more about tests for myeloma.
Around three people in a hundred with myeloma (3%) have non-secretory myeloma. In this type of myeloma, the myeloma cells don’t produce any paraprotein or light chains.
Sometimes, the myeloma cells produce a very small amount of paraprotein or light chains. This is known as oligo-secretory myeloma.
Non-secretory and oligo-secretory myeloma are hard to detect using blood tests. That’s why doctors and research scientists sometimes describe these types of myeloma as “non-measurable” myeloma. Tests may look normal, or almost normal, although there may be other changes seen in the blood.
If this is the case for you, then blood and urine tests may not be enough to check on your condition, so your doctor will monitor you using bone marrow samples and scans.
Find out more about the different types of myeloma.
"Don’t feel you have to learn all the terminology on day one – it’s natural to feel confused at first but you will get the hang of it."
Ian, living with myeloma since 2019
Read about how people like Ian are coping with a myeloma diagnosis.