Types of Myeloma

Multiple myeloma has different types and subtypes. These types are based on the immunoglobulin (protein) produced by the myeloma cell. The various immunoglobulins have different functions in the body. Each immunoglobulin is made up of two heavy chains and two light chains.

The five types of heavy protein chains are G, A, D, E, and M.
The two types of light protein chains are kappa (κ) and lambda (λ).

Furthermore, there are different subtypes of myeloma.

Subtypes of immunoglobulins

IgG kappa

IgA kappa

IgD kappa

IgE kappa

IgM kappa

IgG lambda

IgA lambda

IgD lambda

IgE lambda

IgM lambda

Normal plasma cells secrete immunoglobulins (antibodies) to fight infections. Immunoglobulins are proteins that attach to substances entering the body that the body recognizes as foreign. Normal immunoglobulins are called "polyclonal protein." Myeloma cells, which are cancerous plasma cells, secrete monoclonal protein. Monoclonal protein is an abnormal immunoglobulin that cannot properly fight infection.
Healthy plasma cells or myeloma cells can produce immunoglobulins. These immunoglobulins made up of two heavy chains and two light chains that are bound together.

Structure of immunoglobulin in multiple myeloma

The five possible types of immunoglobulin (abbreviated "Ig") are heavy chains: IgG, IgA, IgD, IgE, and IgM.
The possible types of light chains are either kappa (κ) or lambda (λ).
Myeloma cells make immunoglobulins. These immunoglobulins are made up of only one type of heavy chain (G, A, D, E, or M) and one type of light chain (kappa or lambda). The most common type of myeloma is IgG kappa. In IgG kappa myeloma, the myeloma cells produce an immunoglobulin made from two IgG heavy chains bound to two kappa light chains.
About 15% of patients have light chain myeloma. In this type of myeloma, the myeloma cells secrete only light chain protein and no heavy chains. It is also known as "Bence-Jones myeloma" (after the doctor who discovered it).
One to two-percent of patients have "non-secretory myeloma." In non-secretory myeloma, the myeloma cells produce very little or no monoclonal protein of any type.
Your doctor will order tests to identify your type of myeloma. It's important to know which type you have as you will be able to better understand your test results.You will be able to determine if your level of monoclonal protein is stable, increasing, or decreasing.

See the IMF's Patient Handbook if you have been diagnosed with any of the following:

AL amyloidosis
Light chain deposition disease (LCDD)
Waldenström's macroglobulinemia
POEMS syndrome

Types of Myeloma

Disease Type	Description
Myeloma IgG k or λ IgA k or λ Rarer subtypes: IgD, E, or M	Typical myeloma: majority of patients. Monitored by tracking monoclonal protein in serum using SPEP (IgG) and/or quantitative immunoglobulin (QIG) measurement (IgA/D/E). For IgA myeloma quantitative immunoglobulin measurement is often more reliable.
Light Chain only or Bence Jones (BJ) myeloma: k or λ types	Bence Jones myeloma: approximately 15%–20% of patients. Monitored by tracking monoclonal light chains in urine using UPEP and/or with serum free light chain measurements (Freelite®) in the serum. May lead to deposits of light chains in the kidneys and/or nerves.
Non-secretory myeloma:	Less common myeloma: 1%–5% of patients. Since both SPEP and UPEP are negative (no monoclonal spike in serum or urine), disease is monitored using Freelite® testing.
IgM myeloma: k or λ subtypes	IgM myeloma is a very rare subtype. Typically, IgM production occurs in a disease called Waldenström's macrgoglobulinemia, which is more like a lymphoma (lymph node cancer) versus myeloma, which is a bone marrow cancer.

What's Next?

What are possible urgent problems at diagnosis?

Some patients have urgent problems at diagnosis. These problems need medical attention before systemic therapy for myeloma begins.

The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website.

Last Medical Content Review: June 6, 2021