Types Ninety percent of multiple myeloma cases involve the bone marrow . There are several types, each with its distinctive features and each producing a variety of diagnostic findings and symptoms:
• Patients with smoldering multiple myeloma (SMM) have enough myeloma cells in the bone marrow and a
large amount of an abnormal protein (monoclonal or M-protein) in the blood to indicate multiple myeloma,
but they do not have the anemia , kidney failure or skeletal lesions that are also characteristic of the disease.
There are no symptoms.
• Patients with plasma cell leukemia have large numbers of plasma cells circulating in the blood. Plasma cell
leukemia may be the first feature of multiple myeloma leading to a diagnosis or it may occur late in its course
after a resistance to chemotherapy has developed.
• With non-secretory myeloma, patients have abnormal plasma cells in the bone marrow and frequently have
holes (lytic lesions) in the skeleton, but no abnormal protein is detectable in the blood or urine.
• Osteosclerotic myeloma (POEMS syndrome) patients usually have pain, burning, numbness and weakness
produced by the involvement of nerves by the disease (polyneuropathy). The liver and spleen are often
enlarged; there may be a darkening of the skin and increased growth of body hair. The breasts may become
enlarged and the testicles smaller. Bone x-rays usually reveal dense (sclerotic) areas in the bone. Anemia,
kidney failure and fractures are rare with this type.
