OVERVIEW
Multiple myeloma is a clonal bone marrow disease characterized by the neoplastic transformation of terminally differentiated B cells that secrete a homogeneous (monoclonal) immunoglobin called an M-protein or paraprotein. Multiple myeloma is characterized by excess bone marrow plasma cells, monoclonal proteins, osteolytic bone lesions, renal impairment, anemia, and immunodeficiency.
Myeloma can progress through stages that in some cases may include a pre-malignant monoclonal expansion of plasma cells called monoclonal gammopathy of undetermined significance (MGUS) which is characterized by <10% plasma cells in the bone marrow, monoclonal protein spike, and no end organ damage. It may also include smoldering myeloma or asymptomatic myeloma which shows 10-30% plasma cells in the bone marrow but no osteolytic lesions, anemia or other features of malignant myeloma.
TESTING AVAILABLE
At diagnosis CGL offers both FISH analysis, used to identify cytogenetic abnormalities of prognostic significance, and clonotype determination, used to identify the IgH-VDJ or IK-VJ rearrangement present in the clonal population.