Types of myeloma
A guide to the different types of myeloma, including heavy chain, light chain, and non-secretory, plus related conditions like plasmacytoma and AL amyloidosis.
Myeloma is often described as being a very individual disease, with the symptoms experienced and response to treatment varying greatly. Some of these differences are because of the different biological subtypes of myeloma.
Types of myeloma
One of the ways of classifying myeloma is based on the type of abnormal immunoglobulin, or paraprotein, that the myeloma cells produce. Each immunoglobulin (called Ig for short) is a Y-shaped structure that is made up of two heavy chains and two light chains.
There are five possible types of heavy chains, and these are labelled using the letters G, A, D, E and M.
There are two possible types of light chains, and these are labelled using the Greek letters kappa (ƙ) and lambda (ƛ)
Each individual immunoglobulin can have only one of the five possible heavy chains and only one of the two possible light chains.
In the below table we have described the different types of myeloma and their features.
| Type of myeloma | Features | Example |
| Heavy chain myeloma | This can be IgG, IgA, IgM, IgD, or IgE myeloma, depending on which heavy chain is producing a paraprotein + either the light chain kappa or lambda. | A common heavy chain type is called IgG kappa myeloma. |
| Light chain myeloma (also called Bence Jones myeloma) | This is when kappa or lambda light chains break away from the heavy chain and start to be produced on their own. These are called free light chains or Bence Jones protein. | A common light chain type is called lambda light chain myeloma. |
| Biclonal myeloma (also called double myeloma) | This happens when the myeloma cells start to produce two different types of paraprotein. | A type of biclonal myeloma is when IgG kappa and IgA lambda paraprotein are produced by the myeloma cells. |
| Oligosecretory myeloma | This is when myeloma cells produce very small amounts of paraprotein that can’t be detected on standard blood or urine (wee) tests. | This is a single type of myeloma that is always called oligosecretory myeloma. |
| Non-secretory myeloma | This is when myeloma cells produce no paraprotein that we can detect in the blood or urine (wee), making it more difficult to diagnose and monitor. | This is a single type of myeloma that is always called non-secretory myeloma. |
Myeloma related conditions
As well as the different Ig types of myeloma, there are a number of myeloma-related conditions, which include plasmacytoma, plasma cell leukaemia, and AL amyloidosis. These conditions are all rarer than myeloma itself.
What is plasmacytoma?
In some people, abnormal plasma cells collect in the bone or tissue, forming a tumour called a plasmacytoma. A plasmacytoma can develop on its own, or alongside other features of myeloma. If one plasmacytoma develops on its own, it is called a solitary plasmacytoma, and can be treated with localised radiotherapy. If a plasmacytoma develops along with other features of myeloma, it needs treatment that travels through the bloodstream, reaching and affecting cells all over the body (systemic therapy).
What is plasma cell leukaemia?
Plasma cell leukaemia (PCL) is an aggressive form of myeloma where the myeloma cells that are usually contained to the bone marrow can be found circulating in the bloodstream. PCL may be present at the time of your initial diagnosis (where it is called primary PCL), or may develop later in the course of your myeloma (where it is called secondary PCL). PCL usually needs intensive treatment and close monitoring. Your doctor will talk with you about different treatment options and what they recommend for you, which will depend on the stage of your PCL, your age, and overall health. You will usually start treatment as soon as possible.
What is AL amyloidosis?
AL (amyloid light chain) amyloidosis is a condition where light chains are deposited in tissues and organs throughout the body. The light chains can bind to tissues in the heart, liver, spleen, nerves and kidneys rather than being removed from the body through the kidneys. Some people are diagnosed with just AL amyloidosis or both myeloma and AL amyloidosis together. Like myeloma, AL amyloidosis is a relapsing and remitting condition. While it cannot be cured, treatment can be effective in controlling AL, reducing symptoms and improving your quality of life.
Keep Learning, stay empowered
Myeloma is unique, and knowledge is one of your greatest tools. Learning more can help you make informed decisions and feel more in control. Explore our other pages below to better understand your treatment options, connect with support, and learn how to manage life with myeloma.
-
When myeloma returns
Understand why myeloma returns or doesn’t respond to treatment and the things you and your haematologist will consider when starting a new treatment.
-
Signs and symptoms
Understand the common CRAB symptoms of myeloma (Calcium, Renal, Anaemia, Bone) and other key signs like fatigue and infections. Learn what symptoms signal the need for treatment.
-
What is myeloma
Myeloma is a blood cancer that develops from plasma cells in the bone marrow. While not yet curable, it is a manageable, relapsing-remitting condition with evolving treatments…
Connect with us
Stay informed with the latest myeloma research, treatment updates, and support resources. We offer tailored newsletters for both patients and healthcare professionals with relevant information and community updates.
