there is no skeletal disease, no hypogammaglobinaemia, and no Bence Jones protein
observe if in doubt since there is no advantage to early treatment of asymptomatic multiple myeloma
smouldering (asymptomatic) multiple myeloma
symptomatic multiple myeloma
plasmacytoma (1)
reactive polyclonal hypergammaglobulinaemia - distinguished on basis of single or polyclonal spike
other malignant lymphoproliferative diseases:
Waldenstrom's macroglobulinaemia
lymphomas
primary amyloidosis
osteosclerotic myeloma
Reference:
Sive, J., Cuthill, K., Hunter, H., Kazmi, M., Pratt, G., Smith, D. and (2021), Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br. J. Haematol., 193: 245-268.
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