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Non-secretory plasma cell myeloma lacking light chain expression
Non-secretory myeloma is a rare subtype of plasma cell myeloma.
The initial work-up used for diagnosing non-secretory myeloma is no different than the standard multiple myeloma. The diagnosis of non-secretory myeloma relies on presence of monoclonal plasma cells established by immunophenotyping. Lack of light chain expression in non-secretory myeloma poses a diagnostic challenge.
The addition of immunohistochemical stain for heavy chain and Cyclin D1 may aid in definitive diagnosis.
A high incidence (83%) of t(11;14) (q13;q32) is present in non-secretory myeloma; which can be detected by karyotyping or fluorescence in situ hybridization (FISH).
Due to the rarity of the disease; there is no enough data to support using different treatment regimen other than the standard multiple myeloma regimen.
Monitoring patients with non-secretory myeloma is challenging; since we can us serum or urine Ig level in detecting response to therapy.
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