Hello, my name is Philippe Moreau. I am professor of Clinical Hematology at the University Hospital of Nantes in France, and I am often asked how is a nonsecretory multiple myeloma diagnosed. In fact, the patient is presenting at the time of diagnosis with bone pain or anemia or hypercalcemia with the so-called CRAB symptoms, and with the bone marrow aspirate and the bone marrow biopsy, we are measuring some abnormal plasma cells within the bone marrow, more than 10%. So we do have the definition of multiple myeloma with CRAB symptoms and with abnormal plasma cells within the bone marrow, but these patients are never secreting proteins, the M-spike, M-component, neither in the serum nor in the urine. This is the definition of a nonsecretory multiple myeloma. We have the symptoms and we have abnormal plasma cells within the bone marrow, but we do not have any abnormality in the serum and in the urine.
Reviewed on January 17, 2017 for clinical relevance.