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Myeloma (cont.)

More Myeloma Overview

Other complications of myeloma may include the following:

  • Cryoglobulinemia: People with this rare condition produce a protein that precipitates, or falls out of solution, when the blood is exposed to cold temperatures.
  • Amyloidosis: This rare complication occurs mostly in people whose myeloma produces the light chain components of immunoglobulins. The light chains combine with other substances in the blood to form a sticky protein called amyloid, which impairs the function of whichever organ in which it may accumulate.

Different types of myeloma are classified by the type of immunoglobulin produced by the abnormal plasma cells. Immunoglobulins (Ig) are made up of two components: light chains and heavy chains and further classified by the type of light (kappa or lambda) or heavy (alpha [IgA], gamma [IgG], mu [IgM], delta [IgD], and epsilon [IgE]) chains.

  • The most common monoclonal protein in myeloma is the IgG type. This means that the immunoglobulin is comprised of two IgG heavy chains and two light chains, either two kappa or two lambda. When the abnormal M protein is identified in myeloma, it is most often an IgG kappa type. However, any other combination is possible.
  • Less common, but still prevalent, are IgA-producing myeloma cells.
  • IgM myeloma is much less common. In this entity, better known as Waldenstrom's macroglobulinemia (WM)the plasma cells have a sdifferent appearance from those typically seen in multiple myeloma. They are described as lymphoplasmacytic.
  • IgD and IgE myelomas are very rare.
  • Some myelomas produce an incomplete immunoglobulin consisting of light chains only, known as Bence-Jones proteins, which are not identified by blood tests but readily identified in urine.
  • Some rare diseases are associated with plasma cell overproduction of heavy chains only. These are referred to as heavy chain diseases. Heavy chain diseases may or may not be similar to myeloma in their characteristics.
  • Nonsecretory myeloma occurs in about 1% of myelomas and represents malignant plasma cells that do not produce any immunoglobulin chains, heavy or light.

A plasma cell disorder related to myeloma is called monoclonal gammopathy of undetermined significance, or MGUS. MGUS is not cancerous. MGUS is believed to be a premyeloma condition, although not all patients with MGUS develop myeloma. About 30% to 40% of people with MGUS, given sufficient time, may progress to develop myeloma.

  • People with MGUS produce small amounts of monoclonal protein, but they have none of the symptoms or complications of myeloma.
  • MGUS is much more common than myeloma. The incidence of MGUS increases with age. It is uncommon in young individuals and reaches an incidence of approximately 3% in people aged 70 years and older.

Incidence

Myeloma is the second most common blood cancer, but it is not a common cancer; 24,050 people were diagnosed with myeloma in the United States in 2014, with men diagnosed with the condition slightly more frequently diagnosed with the condition than women. The mortality statistic in the U.S. was 11,090 in 2014.

  • Myeloma is predominantly a cancer of older people. More than 75% of people diagnosed with myeloma in 2014 are aged 60 years or older.
  • Myeloma is nearly twice as common in African Americans as in Americans of European, Hispanic, or Asian descent.
Medically Reviewed by a Doctor on 4/2/2015
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Read What Your Physician is Reading on Medscape

Myeloma »

Multiple myeloma (MM) is characterized by neoplastic proliferation of plasma cells involving more than 10% of the bone marrow.

Read More on Medscape Reference »


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