When to start treatment

Category

Test results

Need for treatment

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

• not cancer; needs active monitoring as it may progress to myeloma
• one out of every 100 people diagnosed with MGUS develops
  myeloma each year

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

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

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

• active myeloma requires treatment