Nonsecretory Multiple Myeloma (NSMM)

Freelite serum free light chains can be identified in 82% of NSMM patients.

Graph 1

Changes in serum free light chain concentrations and clinical status in 6 patients with nonsecretory Myeloma (Numbers identify each patient).

By definition with current methods, between 1% and 3% of all patients with multiple myeloma have been characterised as nonsecretory multiple myeloma. These patients have no detectable paraprotein in serum or urine of intact immunoglobulin or free light chain. Until recently, diagnosis and monitoring of NSMM has relied on clinical assessment and bone marrow biopsy.
However, in a recent study1 19/28 patients categorised as NSMM were found to have abnormal free kappa/lambda ratios. A further 4 patients had suppression of either free kappa, free lambda or both. This means that for the first time there is a tumour marker available for monitoring treatment and disease progress in these patients.

Newly published uniform response criteria for multiple myeloma (2006) mentioned that the sensitivity of the free light chain (FLC) assay enables assessment of response in Nonsecretory Multiple Myeloma patients, allowing them to be included in clinical trials.2

Freelite enables sensitive quantification of serum free light chains in NSMM and can be used for monitoring of these patients.

Summary

References

  1. Mark Drayson, Liang X. Tang, Roger Drew, Graham P. Mead, Hugh Carr-Smith, and Arthur R. Bradwell.
    "Serum free light-chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma"
    Blood 2001;97:9:2900-2902

    Reference: MKG183 Quantity:

  2. BGM Durie et al.
    "International uniform response criteria for multiple myeloma"
    Leukemia (2006) 20, 1467-1473

    Reference: MKG320 Quantity:

  3. Gene R. Shaw, MD
    "Nonsecretory Plasma Cell Myeloma - Becoming Even More Rare With Serum Free Light-Chain Assay"
    Arch Pathol Lab Med. 2006;130:1212-1215

    Reference: MKG328 Quantity: