To the best of our knowledge, this is the rst case of nonsecretory multiple myeloma presenting as plasmacytoma of the colon. Individuals with smoldering multiple myeloma may eventually develop multiple myeloma. 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. Nonsecretory plasma cell myeloma of the true nonproducer. Non secretory myeloma exists when an individual with multiple myeloma does not produce mprotein in either the urine or blood serum. 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. Nonsecretory multiple myeloma nsmm accounts for 1 5% of all multiple myeloma mm cases. Plasma cells are a part of the bodys immune system and produce antibodies that help the body fight infection. Multiple myeloma is a cancer in which the body overproduces plasma cells. Jan 02, 2009 grannai too am a non secretory mm survivor. 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.
Hi david i was diagnosed with nonsecretary multiple myeloma a year ago. Pdf nonsecretory myeloma is a myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal. 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. All are available free of charge online and in printed copy by mail. 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. 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. To determine the prognosis of patients with nonsecretory myeloma.
It is defined as symptomatic myeloma without detectable monoclonal immunoglobulin on serum or urine electrophoresis. Read about multiple myeloma prognosis, life expectancy, stages, treatment, diagnosis, and causes. 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. Survival of nonsecretory multiple myeloma patients improves. Hi david i was diagnosed with non secretary multiple myeloma a year ago. This variant usually poses a diagnostic challenge to. The potential value of more sensitive quantitative diagnostic techniques for this disease is being studied. Jun 14, 2012 my myeloma at this stage was almost non secretory. Clinical course and prognosis of nonsecretory multiple. The good news is that statistically non secretors live longer, the bad news is that it is more difficult to track our levels.
Disease bioinformatics research of nonsecretory myeloma has been linked to multiple myeloma, plasmacytoma, neoplasms, monoclonal gammapathies, anemia. It arises from red marrow due to the monoclonal proliferation of plasma cells and manifests in a wide range of radiographic abnormalities. A case of nonsecretorymultiple myeloma presenting as primary plasma cell leukaemia in a 65 year old woman is presented. 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. International myeloma foundation headquarters 12650 riverside drive, suite 206 north hollywood, ca 91607, usa tel. Nonsecretory myeloma is a rare myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal plasma cells.
Nonsecretory myelomas were first described in 1958 by serre, and they constitute 15% of myelomas. Introduction multiple myeloma mm is a mature bcell neoplastic proliferative disease as well as. Myeloma introduction a clonal disorder of plasma cells bcells. Among 186 patients with multiple myeloma mm, five women were diagnosed as having mm without m. Multiple myeloma mm is the second most common hematologic neoplasm in the us, with 30,000 new cases annually. Nonsecretory multiple myeloma and al amyloidosis presenting. 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. We are presenting a case report of this rare variant involving the sternum of an adult male.
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. Mar 31, 2015 multiple myeloma is a cancer in which the body overproduces plasma cells. Myeloma group this is a controlled document and therefore must not be changed of mm. To determine the prognosis of patients with non secretory myeloma. Bone marrow plasmacytosis as well as production of. Kaufman, md 3 numerous small series of patients suggest that the prognosis for.
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. Sharing clinical, therapeutic, and prognostic characteristics with mm, real challenge. Hallmark of most multiple myeloma cases is the persistent production of some form of immunoglobulins, a phenomenon that brings the disease to attention. Each plasma cell produces one type of immunoglobulin, and the body produces many types of plasma cells. A case of nsmm with al amyloidosis and nephrotic range proteinuria is presented. A rare variant of multiple myeloma article pdf available in journal of the college of physicians and surgeonspakistan. 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. Nonsecretory multiple myeloma relapsing as extramedullary liver. It is estimated to account for 1015% of haematological malignancies and 1% of all malignancies.
Cyclophosphamide bortezomib dexamethasone cyclobordex. Nonsecretory multiple myeloma nonsecretory multiple myeloma rubio. Nonsecretory myeloma nsm is a rare form of my eloma. It is typically characterized by production of large amounts of. 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. Plasma cell leukemia is characterized by the presence of excessive amounts of plasma cells in the blood. Aug 24, 2012 a type of test called the free light chain assay can frequently detect oligosecretory disease in multiple myeloma patients. Multiple myeloma is the secondmost prevalent blood cancer 10% after non hodgkins lymphoma. 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. 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. Approximately 9597% of myelomas are of the secretory type, i. Myeloma can evolve and turn into a very low secretory or non secretory type. Many core booklets and key medical articles are translated as well.
Nonsecretory myeloma definition of nonsecretory myeloma. 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 study of nonsecretory myeloma has been mentioned in research publications which can be found using our bioinformatics tool below. 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. Overview of multiple myeloma, risk factors, treatment approaches. Introduction multiple myeloma is a malignant neoplasm of the bone marrow and accounts for approximately % of all hema. Discussion multiple myeloma is a disorder of the bone marrow which accounts for 1015% of all blood cancers and. The first case of this variant was described in 1958 3. In healthy people as well as people with myeloma, plasma cells produce antibodies also known as. 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.
It is defined as monoclonal plasmocytic prolif eration of the bone marrow with the same clinical and. Nonsecretory myeloma or light chainproducing multiple myeloma. Nonsecretory multiple myeloma nsm is a symptomatic myeloma without detectable monoclonal immunoglobulin protein in serum or urine by immunofixation electrophoresis 1,5. The findings, discussed in a letter to the editor of the new england. However, a small subset of mm called nonsecretory multiple myeloma nsmm produces no detectable ig. Overview of multiple myeloma, risk factors, treatment. Multiple myeloma is cancer that starts in the bone marrows plasma cells. Nonsecretory multiple myeloma nsmm is a rare variant of mm and accounts for approximately.
Multiple myeloma nord national organization for rare. Nonsecretory myeloma comprises less than 01% of this spectrum where serum protein electrophoresis and quantitative immunoglobulins remain essentially normal. Multiple myeloma mm is the second most common hematologic malignancy in the us. Nonsecretory myeloma is a rare myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal. Cancer articles and journals intl myeloma foundation. The disease is characterised by the absence of detectable monoclonal proteins in serum. You have free access to this content nonsecretory plasma cell myeloma of the true nonproducer type. Myeloma is characterized by the clonal infiltration of the marrow by plasma cells that typically produce a serum or urine paraprotein.
The serum protein is often characterized by an intact immunoglobulin heavy and light chain, or it may be characterized by the light chain alone. Non secretory myeloma or light chainproducing multiple myeloma. Fulltext pdf treatment outcomes in patients with newly diagnosed multiple myeloma who are ineligible for stemcell transplantation. 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. Symptoms and signs include anemia, skin lesions, weakness, and bone fractures. Case report nonsecretory multiple myeloma presenting as an. Multiple myeloma affects slightly more men than women. Are you in need of the most current information about multiple myeloma.
Multiple myeloma mm is an incurable malignancy arising from postgerminal b lymphocytes. The disease is characterised by the absence of detectable monoclonal proteins in serum and urine using. 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. You have free access to this content non secretory plasma cell myeloma of the true non producer type. Multiple myeloma is a monoclonal gammopathy and is the most common primary malignant bone neoplasm in adults. 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.
Non secretory myeloma comprises less than 01% of this spectrum where serum protein electrophoresis and quantitative immunoglobulins remain essentially normal. In healthy people as well as people with myeloma, plasma cells produce antibodies also known as immunoglobulins that help the body fight infection. Free light chain report was available when the bone marrow biopsy report was already confirming the multiple myeloma diagnosis. 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 good news is that statistically non secretors live longer, the bad news is that it is more difficult to. Nonsecretory multiple myeloma presenting as primary plasma cell. 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.
Myeloma group this is a controlled document and therefore must not be changed mm. A rare case of nonsecretory multiple myeloma in lagos. Pdf multiple myeloma mm is the second most common hematologic malignancy in the us. Nonsecretory myeloma or light chainproducing multiple. Nonsecretory multiple myeloma nsmm is a rare clinical and biological variant of the classic form of mm characterized by the absence of monoclonal. Multiple myeloma mm, risk factors, disease progression, therapy, symptomatic, treatment. Nonsecretory myeloma definition of nonsecretory myeloma by. 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. Clinical course and prognosis of nonsecretory multiple myeloma. Survival of nonsecretory multiple myeloma patients.