Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Aug 18;9(1):e2017053.
doi: 10.4084/MJHID.2017.053. eCollection 2017.

Non-Secretory Myeloma: Ready for a new Definition?

Alessandro Corso  1 , Silvia Mangiacavalli  1
Affiliations
Review

Non-Secretory Myeloma: Ready for a new Definition?

Alessandro Corso et al. Mediterr J Hematol Infect Dis. .

Abstract

Non-secretory myeloma is a rare myeloma subtype whose diagnosis, until a few years ago, was established by demonstration of monoclonal plasma cells ≥10% in the bone marrow and by negative results on serum and urine electrophoresis and immunofixation studies. However, this type of myeloma could be misdiagnosed if the workup does not include an accurate study of serum free light chain test since some of the patients diagnosed as non-secretory could be light chain only with small amounts monoclonal proteinuria. Due to this limit in classification, all the information available today, generally coming from retrospective studies including patients studied completely and incompletely, could be misleading. A new definition is, thus, needed to distinguish between the true non-secretory, with a possible better prognosis, and the other forms of oligo-secretory myeloma with a prognosis more similar to the secretory form of myeloma. With all the data of the literature, the availability of laboratory and radiological tools, times are mature to depict a new definition of nonsecretory myeloma that deserves a peculiar work up and different response evaluation and, may be, a different therapeutic approach.

Keywords: Non-secretory myeloma; free light chain; myeloma subtype.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors have declared that no competing interests exist.

References

    1. Rajkumar SV. Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol. 2016;91(7):719–34. doi: 10.1002/ajh.24402. https://doi.org/10.1002/ajh.24402. - DOI - DOI - PMC - PubMed
    1. Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15:e538–e548. https://doi.org/10.1016/S1470-2045(14)70442-5. - DOI - PubMed
    1. AIRTUM Working Group. Busco S, Buzzoni C, Mallone S, Trama A, Castaing M, Bella F, et al. Italian cancer figures--Report 2015: The burden of rare cancers in Italy. Epidemiol Prev. 2016 Jan-Feb;40(1 Suppl 2):1–120. - PubMed
    1. Rajkumar SV, Harousseau JL, Durie B, et al. Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1. Blood. 2011;117:4691–5. https://doi.org/10.1182/blood-2010-10-299487. - DOI - PMC - PubMed
    1. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak MF, Therneau TM, Greipp PR. Review of 1,027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proc. 2003;78:21–33. https://doi.org/10.4065/78.1.21. - DOI - PubMed