When to start treatment

Category

Test results

Need for treatment

• no SLiM–CRAB features
• low level of paraprotein in blood or urine (less than 30 g/L)
• low level of myeloma cells in the bone marrow (less than 10% clonal
  plasma cells)

• not cancer; needs active monitoring as it may progress to myeloma
• only about 1% of people with MGUS develop myeloma

• no SLiM–CRAB features
• medium level of paraprotein in blood or urine (more than 30 g/L)
  and/or
• myeloma cells in the bone marrow (10–59% clonal plasma cells)

• usually doesn’t need treatment straightaway
• may progress to active myeloma, needs active monitoring

• has SLiM–CRAB features
• high level of paraprotein in blood or urine
• one of the following: myeloma cells in the bone marrow (more than 60% clonal plasma cells); ratio of abnormal to normal light chains is less than 100; abnormal MRI with more than one (greater than 5 mm) focal lytic lesion (bone lesion)

• active myeloma requires treatment