Facts about Multiple Myeloma

Understanding Multiple Myeloma

Multiple myeloma is a bone marrow cancer. It can affect your bones and kidneys, as well as your levels of healthy blood cells. It is a fairly rare cancer, with just under 35,000 new cases diagnosed each year. Multiple myeloma happens when cancerous plasma cells (white blood cells that make antibodies) build up in your marrow and crowd out healthy blood cells. The word “multiple” means that cancer cells are found in more than one area of the body. Smoldering myeloma and monoclonal gammopathy of undetermined significance (MGUS) are conditions that can happen before multiple myeloma, but these conditions don’t usually need treatment.

Confirming Your Multiple Myeloma Diagnosis

The first step in creating a treatment plan is checking your diagnosis of multiple myeloma or another plasma cell disorder.

Your physicians will use blood tests and a bone marrow biopsy to learn more about your myeloma, find out the stage of your cancer, get other information that can help predict what will happen with your disease and find out which organs in your body are affected.

Staging Multiple Myeloma

Staging means finding out how far your multiple myeloma has spread. Knowing the stage of your cancer helps your physicians predict which treatments are most likely to control your disease or put it into remission.


Physicians use the Revised International Staging System (R-ISS) to stage multiple myeloma. It measures several different things in your body — albumin levels, Beta-2 microglobulin (B2M), lactate dehydrogenase (LDH) and genetic changes — to place you in one of three stages:

  • Stage I: Levels of albumin, B2M and LDH are normal or close to normal, and the genetic makeup of your cancer cells isn’t aggressive. 
  • Stage II: Your albumin level is low and B2M is either normal or slightly high. 
  • Stage III: B2M levels are high. LDH levels are high, or cell DNA may show changes. 

Staging Evaluation

To find out how far your multiple myeloma has spread, your Physician will use blood tests and a bone marrow biopsy. 

Most patients with myeloma have a protein that can be measured in their blood. This protein is called a monoclonal protein, or sometimes an M-spike or M-protein. The levels of this protein help your doctor understand the state of your disease. 

Bone marrow biopsy and aspiration is another type of test that is often used. It is the best way to check the percentage of plasma cells in the bone marrow. For people who don’t have multiple myeloma, blood plasma cells make up less than 5% of their cells. For people who have multiple myeloma, bone marrow plasma cell levels usually make up 10% or more of their cells. 

If your disease is advanced, your physician may do imaging to see if there is any bone damage or large tumors. This imaging may be a whole-body low-dose CT scan, PET/CT scan, bone marrow MRI or skeletal survey. 

Types of Treatment for Multiple Myeloma

There are more treatment options for multiple myeloma than ever before. No matter what type of treatment you need, multiple myeloma specialists at Fred Hutch will work closely with you, your family and each other to get you back to health. 


Learn About Subtypes and Other Plasma Cell Disorders

Each subtype of multiple myeloma acts differently. Fred Hutch physicians who specialize in multiple myeloma have a deep knowledge of these subtypes. They know which therapies to use and when to use them.

Active Multiple Myeloma

Most patients who get treatment for multiple myeloma have this standard subtype, which means that the buildup of cancerous plasma cells is causing symptoms. This is also called having symptomatic multiple myeloma.  

Smoldering Myeloma

Smoldering myeloma, also known as asymptomatic myeloma, often happens before active multiple myeloma. Patients with smoldering myeloma don’t usually get treatment unless they are considered high-risk. Most people with smoldering myeloma will eventually develop active multiple myeloma. 


MGUS stands for monoclonal gammopathy of undetermined significance. Usually, MGUS is diagnosed when a physician finds abnormal plasma cells during a routine blood test. It’s rare that patients have symptoms from MGUS, and most cases don’t turn into cancer. However, regular monitoring is important in case it turns into smoldering myeloma, which could later turn into active multiple myeloma. 

Fred Hutch has researched and treated Multiple Myeloma for decades.


There are many resources online for learning about your disease. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.

Whether you are newly diagnosed, going through treatment or know someone with cancer, our staff are available to tailor personalized resources and answer questions about support options in the community. 

Cancer Research Organizations

American Cancer Society

American Cancer Society (ACS): Overview of Multiple Myeloma

If you have multiple myeloma or are a caregiver for someone who does, knowing what to expect can be helpful. Here you can find out all about multiple myeloma in adults, including risk factors, symptoms and how they are found and treated.

American Society of Clinical Oncology

American Society of Clinical Oncology (ASCO): Guide to Multiple Myeloma

This is ASCO's guide to multiple myeloma. Here you can learn more about multiple myeloma cancer, treatment, the latest research and clinical trials.

American Society of Clinical Oncology

ASCO Answers: Multiple Myeloma

ASCO Answers is a collection of oncologist-approved patient education materials developed by ASCO for people with cancer and their caregivers. Here you can find illustrations and information on multiple myeloma.

Leukemia & Lymphoma Society

Leukemia & Lymphoma Society (LLS): Overview of Myeloma

If you have multiple myeloma, LLS is a good place to start to better understand your diagnosis, treatment and support options.

National Cancer Institute

National Cancer Institute (NCI): Plasma Cell Neoplasms (Including Multiple Myeloma)-Patient Version

The NCI is the federal government's principal agency for cancer research and training. Here you can find more information about multiple myeloma cancer treatment, research and coping with cancer.

National Comprehensive Cancer Network

National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Multiple Myeloma

This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms.

Cancer Support Organizations


CancerCare: Multiple Myeloma General Information and Support

CancerCare provides free, professional support services for people affected by multiple myeloma, as well as myeloma cancer treatment information and additional resources, including financial and co-pay assistance.

International Myeloma Foundation

International Myeloma Foundation (IMF)

The oldest and largest foundation focusing specifically on multiple myeloma. IMF funds research, provides education, lends support and promotes advocacy initiatives that allow collective voices to be heard.

Multiple Myeloma Research Foundation

Multiple Myeloma Research Foundation (MMRF)

A nonprofit organization that works to accelerate the development of new multiple myeloma treatments.

Myeloma Crowd by Healthtree

Myeloma Crowd

A division of The CrowdCare Foundation, a patient-driven, 501(c)3 non-profit organization that empowers patients with rare diseases at each step of their disease – from diagnosis, through education, care and on to a cure.

Northwest Multiple Myeloma Fighters

Northwest Multiple Myeloma Fighters

A support organization for multiple myeloma patients and family in the Greater Puget Sound area.