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WHO Classification of Tumours
Non-secretory myeloma
Tumours of haematopoietic and lymphoid tissues


Definition

In approximately 3% of plasma cell myelomas there is absence of an M-protein on immunofixation electrophoresis
Click to access Pubmed
(2003)
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group.
Br J Haematol 121: 749-57




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Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR (2003)
Review of 1027 patients with newly diagnosed multiple myeloma.
Mayo Clin Proc 78: 21-33



. Cytoplasmic M-protein is present in the neoplastic plasma cells in about 85% of these when evaluated by immunohistochemistry, consistent with impaired secretion of Ig
Click to access Pubmed
(2003)
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group.
Br J Haematol 121: 749-57



. In about 15% of these patients, no cytoplasmic Ig synthesis is detected (non-producer myeloma). Acquired mutations of the Ig light chain variable genes or alteration in the light chain constant region have been implicated in the pathogenesis of the non-secretory state
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Coriu D, Weaver K, Schell M, Eulitz M, Murphy CL, Weiss DT, Solomon A (2004)
A molecular basis for nonsecretory myeloma.
Blood 104: 829-31




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Dul JL, Argon Y (1990)
A single amino acid substitution in the variable region of the light chain specifically blocks immunoglobulin secretion.
Proc Natl Acad Sci U S A 87: 8135-9



. In up to two-thirds of cases, however, elevated serum free light chains and/or an abnormal free light chain ratio are detectable, suggesting that many are at least minimally secretory
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Drayson M, Tang LX, Drew R, Mead GP, Carr-Smith H, Bradwell AR (2001)
Serum free light-chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma.
Blood 97: 2900-2



. The clinical features of non-secretory myeloma are similar to other plasma cell myelomas except for a lower incidence of renal insufficiency and hypercalcemia and less depression of normal Ig
Click to access Pubmed
(2003)
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group.
Br J Haematol 121: 749-57




Click to access Pubmed
Smith DB, Harris M, Gowland E, Chang J, Scarffe JH (1986)
Non-secretory multiple myeloma: a report of 13 cases with a review of the literature.
Hematol Oncol 4: 307-13



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> Related Topics
Definition: Plasma cell neoplasms
Introduction: Classification of lymphoid neoplasms