Non-secretory myeloma is a rare type of myeloma, a cancer of your plasma cells. In most cases, myeloma cells release (or secrete) antibodies into your blood and urine. But in non-secretory myeloma, the cancer cells either don’t make or don’t release these antibodies.
- are over 40 years old
- are Black
- are assigned male at birth
- from, or have ancestors from, the Middle East, North Africa, or the Mediterranean
- have been exposed to radiation
- have been exposed to certain chemicals, such as asbestos, pesticides, herbicides, and chemicals used in rubber manufacturing
- Bone pain. This is usually caused by bone lesions that can be seen with an X-ray.
- Unintentional weight loss
- Anemia. This is often more mild in non-secretory myeloma than other types of myeloma.
- High levels of calcium in your blood (hypercalcemia)
- Kidney issues
- Frequent infections
If your doctor suspects you have any type of myeloma, they’ll take a history of your symptoms and when they started, as well as a family history. Then they’ll likely do a full physical exam and a range of blood tests.
- Complete blood count
- Test for creatinine levels, as a measure of kidney function.
- Test for albumin levels
- Test for calcium levels
- Test for immunoglobulin levels. Secretory myelomas affect immunoglobulin levels, so this helps identify the myeloma type. If the result is negative, it may indicate a non-secretory myeloma.
- Serum protein electrophoresis (SPEP). This test measures antibodies in your blood and can find monoclonal antibodies. A negative result may indicate non-secretory melanoma.
- Serum free light chains blood test, which looks only for a particular part of antibodies. If no immunoglobulins are found with SPEP, a negative test here as well can confirm a non-secretory diagnosis.
Your doctor will also likely do a urine test to look for immunoglobulin in your urine. You’ll be asked to collect urine over 24 hours for a more accurate test.
Unlike secretory myeloma, non-secretory won’t show up in your blood. This can make it more difficult to diagnose.
If these blood tests come back negative, your doctor will likely recommend a bone marrow biopsy. In this procedure, the doctor uses a needle to take a piece of your bone marrow. Then, they look at the cells in the marrow to see if they’re abnormal. They can also look at genetic abnormalities the cells might have, which will help predict your prognosis.
Finally, your doctor might recommend any of the following imaging tests to look more fully at your bones:
Treatment for non-secretory myeloma is usually the same as for other types of myeloma. These treatments include:
Combination drug therapy
Depending on how advanced your non-secretory myeloma is and how well your body tolerates the medications, people are usually given a combination of two or three medications, such as:
- monoclonal antibodies, such as daratumumab or elotuzumab
- proteasome inhibitor, such as bortezomib or carfilzomib
- immunomodulatory drugs, such as lenalidomide or pomalidomide
- alkylating agents, such as cyclophosphamide
Stem cell transplant
Stem cell transplants are a common treatment for myeloma. They involve high dose chemotherapy to destroy your bone marrow, then a transplant of healthy stem cells that will make normal bone marrow cells. A stem cell transplant is often done after drug therapy.
Patients with myeloma usually get an “autologous stem cell transplant,“ meaning that your own healthy stem cells are taken and stored, then given back to you after you‘ve undergone treatment like radiation for cancer. This helps your body recover from harsh cancer treatments.
Treatment for associated issues
Non-secretory myeloma can cause secondary issues, such as hypercalcemia. In most cases, these will have to be treated. Treatment might include:
People with non-secretory myeloma are often excluded from clinical trials because it’s a rare and atypical form of myeloma.
But finding other people with your condition can help you:
- cope with your illness
- navigate treatment
- explore your options
- deal with this major life change
To find a support group near you or virtually, ask your doctor or visit one of these sites:
We don’t know as much about the survival rates of non-secretory myeloma as we know about the survival rates of other types of myeloma because it’s so rare. However,
The survival rate of myeloma has been improving over the last several decades. Currently, the 5-year
- 75 percent for localized myeloma
- 53 percent for distant myelomas, also called multiple myeloma
The overall 5-year survival rate for myeloma is 54 percent.
Non-secretory myeloma is rare but very similar to other types of myeloma in terms of symptoms, diagnosis, and treatment.
Although not as much is known about non-secretory myeloma compared with other types of myeloma, there’s some evidence that the prognosis of non-secretory myeloma is better than in other types.
If you have any symptoms of myeloma, including bone pain, unexplained weight loss, and fatigue, see a doctor. If they suspect myeloma, they will likely do a range of tests. Even if initial blood tests are negative, imaging or biopsy may be required to diagnose non-secretory myeloma.