Navigating IgG Kappa Multiple Myeloma

Welcome to this interactive guide. Multiple Myeloma is a complex cancer of the plasma cells. This resource aims to provide comprehensive information about the "Free Chain kappa IgG" type, especially for a 69-year-old individual, potentially with pre-existing mood considerations. It covers understanding the disease, diagnosis, modern treatments, managing complications, prognosis, and living with myeloma, with a special focus on mental well-being.

This application is based on a detailed report summarizing medical information primarily from the last five years. Its goal is to help you explore, understand, and synthesize key information in an accessible way. It now includes AI-powered features (marked with ✨) to help summarize information and generate personalized questions for your doctor, alongside detailed tables and statistics from the source report.

How to Use This Guide:

Use the navigation tabs at the top to explore different sections. Within each section, you'll find detailed information, including comprehensive tables and expandable sections (accordions) – just click on a heading to reveal more. Look for the ✨ icon for AI-assisted features. This guide is for informational purposes and should not replace advice from your healthcare professionals. AI-generated content is not medical advice.

Understanding Multiple Myeloma

This section provides foundational knowledge about Multiple Myeloma, specifically the IgG Kappa type. It covers what the disease is, how it affects the body, common symptoms (including the CRAB criteria and a detailed symptom table), and how it is diagnosed and staged, incorporating key statistics from recent medical literature.

Multiple myeloma is a cancer originating in plasma cells, a type of white blood cell in the bone marrow. Healthy plasma cells produce antibodies (immunoglobulins) to fight infections. In myeloma, these cells become cancerous, multiply uncontrollably, and produce abnormal proteins. This can crowd out healthy blood cells, leading to anemia, increased infection risk, and bleeding issues.

The specific diagnosis "Multiple Myeloma Free Chain kappa IgG" means the myeloma cells produce an abnormal immunoglobulin where the heavy chain is IgG type and the light chain is kappa type. IgG kappa myeloma is the most common subtype. Often, an excess of "free" kappa light chains is also produced, which are small enough to be filtered by the kidneys and can cause kidney damage (light chain cast nephropathy or "myeloma kidney").

It's distinct from "light chain only" myeloma (approx. 15-20% of cases), where only light chains are produced. While the patient's diagnosis indicates intact IgG, the "free chain kappa" part highlights the risk from excess unbound kappa light chains.

Common Symptoms & CRAB Criteria

Multiple myeloma symptoms can vary. The "CRAB" criteria highlight key signs of organ damage:

Increased bone breakdown releases calcium. Symptoms: thirst, frequent urination, nausea, confusion.

Caused by M-proteins and free light chains. Symptoms: leg swelling, foamy urine, fatigue.

Myeloma cells crowd out red blood cell production. Affects approx. 73-75% of patients at diagnosis. Symptoms: fatigue, weakness, pale skin.

Weakened bones, lytic lesions, pain (reported by ~58% at diagnosis), fracture risk. Commonly affects back, ribs, hips.

Other common symptoms include severe fatigue, frequent infections, peripheral neuropathy (numbness/tingling), and unexplained weight loss.

Chart illustrates approximate prevalence of some common symptoms at diagnosis based on report data.

Table 1: Common Symptoms of Multiple Myeloma

Symptom Category	Specific Symptom	Brief Explanation/Common Manifestations
CRAB Criteria
Calcium Elevation	Hypercalcemia	Increased thirst, frequent urination, nausea, constipation, confusion, weakness
Renal Dysfunction	Kidney damage/failure	Leg swelling, foamy urine, fatigue, decreased urine output
Anemia	Low red blood cell count	Persistent fatigue, weakness, shortness of breath, pale skin
Bone Abnormalities	Bone pain, lytic lesions, fractures, osteoporosis	Pain (especially in back, ribs, hips), bones that break easily, spinal cord compression (rare but serious)
Other Common Symptoms
	Fatigue	Overwhelming and persistent tiredness not relieved by rest
	Infections	Frequent or recurrent infections (e.g., pneumonia, urinary tract infections, sinusitis)
	Peripheral Neuropathy	Numbness, tingling, burning pain, or weakness, usually in hands and/or feet
	Weight Loss	Unexplained loss of body weight
	Gastrointestinal Issues	Nausea, constipation, loss of appetite
	Mental Fogginess/Confusion	Difficulty concentrating, memory problems (can be due to hypercalcemia or hyperviscosity)
	Bleeding/Bruising	Easy bruising or bleeding from minor injuries (if platelets are low)

Key Diagnostic Tests:

Blood/Urine Tests (SPEP, UPEP, Immunofixation): Detect and type M-protein.
Serum Free Light Chain (sFLC) Assay: Measures kappa and lambda free light chains. Normal kappa/lambda ratio is typically 0.26-1.65. An involved:uninvolved sFLC ratio $\ge$100 is a myeloma-defining event (MDE).
Complete Blood Count (CBC): Checks for anemia, low white cells/platelets.
Blood Chemistry: Assesses kidney function, calcium, albumin, LDH, Beta-2 Microglobulin ($\beta$2M).

Bone Marrow Biopsy & Imaging:

Bone Marrow Biopsy: Confirms $\ge$10% clonal plasma cells (or $\ge$60% as an MDE). Allows for cytogenetic (FISH) testing for risk stratification.
Imaging (Low-dose Whole-Body CT, MRI, PET-CT): Detect bone lesions. More than one focal lesion ($\ge$5mm) on MRI is an MDE.

Staging (R-ISS):

The Revised International Staging System (R-ISS) combines ISS ($\beta$2M, Albumin) with LDH and high-risk cytogenetics to predict prognosis (Stage I, II, III). Higher stages indicate poorer prognosis.

Precursor Conditions:

MGUS (Monoclonal Gammopathy of Undetermined Significance): Small M-protein, <10% plasma cells, no organ damage. Occurs in ~3% of healthy individuals >50 years. Risk of progression to myeloma ~1% per year.

SMM (Smoldering Multiple Myeloma): Higher M-protein and/or 10-59% plasma cells, no organ damage/MDEs. Average progression risk ~10% per year for first 5 years.

Treatment Approaches

This section outlines the goals of Multiple Myeloma treatment, the main classes of drugs used (detailed in Table 2), significant advancements in therapy over the last five years, and considerations for treatments like stem cell transplantation, especially for older patients. Treatment is highly individualized and aims to control the disease while maintaining quality of life. The median age at diagnosis is around 69 years.

Primary goals include: disease control, achieving deep and durable remission, symptom relief, improving quality of life, preventing organ damage, and prolonging survival. While generally incurable, myeloma is often manageable as a chronic condition with modern therapies.

Treatment typically involves combination regimens (triplets or quadruplets) using drugs from different classes to target myeloma cells effectively.

Table 2: Overview of Key Drug Classes and Recent Agents for Multiple Myeloma

Drug Class / Specific Agent	Examples	General Mechanism of Action	Common Use (Newly Diagnosed or RRMM)	Key Considerations for Elderly	Notable Advancements (Last 5 Years)
Proteasome Inhibitors (PIs)	Bortezomib, Carfilzomib, Ixazomib	Block proteasome activity, leading to protein accumulation and myeloma cell death	Both	Dose adjustments may be needed. Bortezomib: neuropathy risk. Carfilzomib: cardiac monitoring, renal caution. Ixazomib: oral, generally better tolerated but neuropathy still possible.	Continued use in combinations.
Immunomodulatory Drugs (IMiDs)	Lenalidomide, Pomalidomide, Thalidomide	Multiple: direct anti-myeloma, immune modulation, anti-angiogenesis	Both	Dose adjustments common, especially for lenalidomide in renal impairment. Risk of blood clots (prophylaxis needed). Fatigue, neuropathy (thalidomide > lenalidomide).	Pomalidomide established for RRMM. Lenalidomide is a backbone of therapy.
Anti-CD38 Monoclonal Antibodies	Daratumumab, Isatuximab	Target CD38 on myeloma cells, leading to cell death via multiple immune mechanisms; immunomodulatory	Both	Infusion reactions (especially first dose, premedication crucial). Generally well-tolerated but can increase infection risk. Subcutaneous formulations improve convenience.	Expanded use in frontline and RRMM, often in quadruplet/triplet regimens. Subcutaneous daratumumab.
Anti-SLAMF7 Monoclonal Antibody	Elotuzumab	Targets SLAMF7 on myeloma cells and NK cells, enhances NK cell activity against myeloma	Both (often in combination)	Generally well-tolerated. Infusion reactions possible.	Used in combination regimens.
Corticosteroids	Dexamethasone, Prednisone	Direct anti-myeloma effects, anti-inflammatory	Both	Numerous side effects: mood changes, insomnia, hyperglycemia, fluid retention, increased infection risk. Dose reduction/sparing strategies important for elderly/frail. (See Section Mental Wellness)	Ongoing research into optimal dosing and duration, steroid-sparing regimens.
BCMA-Targeted CAR-T Cell Therapy	Idecabtagene vicleucel (Ide-cel/Abecma®), Ciltacabtagene autoleucel (Cilta-cel/Carvykti®)	Genetically engineered patient T-cells target BCMA on myeloma cells	RRMM	Complex procedure, requires specialized centers. Risks: cytokine release syndrome (CRS), neurotoxicity (ICANS). Eligibility based on fitness, prior therapies.	Major breakthrough for heavily pretreated RRMM, offering deep and durable responses. Research ongoing for earlier lines of therapy.
BCMA or GPRC5D-Targeted Bispecific Antibodies (BsAbs)	Teclistamab (BCMAxCD3/Tecvayli®), Talquetamab (GPRC5DxCD3/Talvey®), Elranatamab (BCMAxCD3/Elrexfio™)	Engage patient's T-cells to kill myeloma cells expressing BCMA or GPRC5D	RRMM	"Off-the-shelf" immunotherapy. Risks: CRS, neurotoxicity (ICANS), infections. Requires monitoring. Step-up dosing often used.	Another major breakthrough for heavily pretreated RRMM (approvals ~2022-2023). Different targets offer options.
Antibody-Drug Conjugate (ADC)	Belantamab mafodotin (Anti-BCMA ADC/Blenrep®)	Targets BCMA, delivers toxic payload into myeloma cell	RRMM	Ocular toxicity (keratopathy) is a significant concern requiring eye exams. Thrombocytopenia.	Efficacy in RRMM, but ocular toxicity management is key. Market status may vary.
XPO1 Inhibitor	Selinexor (Xpovio®)	Blocks nuclear export of tumor suppressor proteins	RRMM	Oral. Side effects: nausea, fatigue, low platelets, low sodium. Requires supportive care for GI toxicity. Dose adjustments common.	Provides a novel mechanism for patients with refractory disease.
BCL-2 Inhibitor	Venetoclax (Venclexta®)	Inhibits BCL-2, an anti-apoptotic protein	RRMM (primarily for t(11;14) subgroup)	Oral. Most effective in patients with t(11;14) translocation. Risk of tumor lysis syndrome.	Targeted therapy for a specific genetic subtype of myeloma.

RRMM: Relapsed/Refractory Multiple Myeloma. BCMA: B-cell maturation antigen. GPRC5D: G protein-coupled receptor class C group 5 member D.

Autologous Stem Cell Transplant (ASCT) involves high-dose chemotherapy (usually melphalan) followed by reinfusion of patient's own stem cells. Standard for eligible, newly diagnosed patients to deepen remission and prolong progression-free survival.

Eligibility for a 69-year-old: Chronological age is not the sole factor; physiological fitness, organ function, comorbidities, and frailty assessment are key. A 69-year-old can be a candidate if fit. The decision is personalized, weighing benefits against risks (toxicity, recovery time). Pre-existing mood disorders are an important consideration due to the stress of transplant; psychological support is crucial.

Treatment requires balancing efficacy and tolerability:

Frailty Assessment: Comprehensive geriatric assessment (CGA) or tools like IMWG frailty index guide therapy intensity.
Dose Adjustments: "Start low, go slow" principle, especially for lenalidomide and dexamethasone. Regimens like "VRd-lite" may be used.
Regimen Choice: Less intensive doublet or modified triplet regimens for frail patients.
Steroid Sparing: Strategies to reduce long-term dexamethasone due to side effects (e.g., discontinuing after 9 months in some Rd regimens).
Supportive Care: Essential for managing bone health, pain, infections, nutrition.
Patient Preferences: Central to decision-making.

Managing the Journey: Complications, Side Effects & Daily Life

Living with Multiple Myeloma involves managing potential complications of the disease itself and side effects from treatments. This section covers these aspects (detailed in Table 3), along with strategies for maintaining quality of life, including the risk of light chain amyloidosis. Proactive management and strong supportive care are key.

Table 3: Managing Common Complications and Treatment Side Effects in Multiple Myeloma

Complication/Side Effect	Common Causes/Triggers	Key Management Strategies
Bone Lesions/Pain	Myeloma activity, osteoclast activation	Bisphosphonates (e.g., zoledronic acid) or denosumab, pain medications (analgesics), radiotherapy, kyphoplasty/vertebroplasty
Kidney Dysfunction	Free light chains, M-protein, hypercalcemia, dehydration, nephrotoxic drugs	Hydration, treatment of myeloma (esp. bortezomib-based), avoidance of nephrotoxic drugs, management of hypercalcemia, dialysis if severe
Anemia	Bone marrow infiltration by myeloma cells, chemotherapy, kidney disease	Treatment of myeloma, iron supplements, erythropoiesis-stimulating agents (ESAs) in select cases, blood transfusions
Infections	Immunosuppression from myeloma and treatments	Vaccinations, hygiene, prophylactic antibiotics/antivirals/antifungals, prompt treatment of active infections, IVIG in some cases
Hypercalcemia	Increased bone resorption	Hydration, bisphosphonates, corticosteroids, treatment of myeloma, calcitonin (acute)
Peripheral Neuropathy	Bortezomib, thalidomide, myeloma proteins	Dose adjustment/discontinuation of offending drug, pain medications (e.g., gabapentin, pregabalin, duloxetine), physical therapy, acupuncture
Steroid-Induced Mood Changes (Anxiety, Depression, Insomnia, Irritability)	Dexamethasone, prednisone	Dose reduction/schedule adjustment, morning dosing, mood diary, sleep hygiene, psychological support (counseling, psychiatry), anxiolytics/antidepressants if needed, open communication with healthcare team
Nausea/Vomiting	Chemotherapy, some novel agents	Antiemetic medications (preventative and as needed), dietary adjustments, hydration
Fatigue	Anemia, myeloma activity, treatment side effects, pain, depression	Treat underlying causes (anemia, pain), energy conservation techniques, gentle exercise, good nutrition, psychological support
Blood Clots (VTE)	IMiDs (lenalidomide, pomalidomide, thalidomide), especially with dexamethasone or chemotherapy	Prophylactic anticoagulation (e.g., aspirin, LMWH, DOACs)
Hyperviscosity Syndrome (Rare)	Very high M-protein levels	Emergency: Plasmapheresis, treatment of myeloma

Myeloma impacts daily life through physical limitations, treatment burden, and emotional distress. Long-term management involves regular follow-ups, monitoring tests, and potentially maintenance therapy.

Supportive Care Pillars:

Nutrition: Balanced diet, hydration. Dietitian for managing appetite loss/side effects.
Exercise: Gentle, regular activity (walking, yoga) to reduce fatigue, improve mood and strength. Physical therapist guidance. Avoid high-impact activities.
Pain Management: Multimodal approach (medications, radiotherapy, non-pharmacological methods). Pain specialist/palliative care if needed.
Fall Prevention: Important for older adults. Home safety, assistive devices.
Emotional & Psychological Well-being: Acknowledge feelings, seek support. Open communication.
Building a Support System: Family, friends, healthcare team, support groups, professional counseling. Palliative care can be involved early for symptom control and quality of life. Caregiver support is also vital.

With "Free Chain kappa IgG," there's a risk of AL amyloidosis, where misfolded free light chains deposit in organs (kidneys, heart, liver, nerves), causing damage. This is distinct from direct light chain toxicity in myeloma kidney. If suspected, tissue biopsy confirms. It occurs in about 5-15% of multiple myeloma cases and significantly impacts prognosis and management.

Prognosis & Outlook

Prognosis in Multiple Myeloma is individualized, influenced by disease characteristics, patient factors (detailed in Table 4), and treatment response. This section explains these factors, how to understand survival statistics, potential best and worst-case scenarios, and the importance of the rapidly evolving treatment landscape.

Table 4: Key Prognostic Factors in IgG Kappa Multiple Myeloma

Prognostic Factor	Favorable Indicator (Generally Associated with Better Outcome)	Unfavorable Indicator (Generally Associated with Poorer Outcome)	Relevance/How it's Measured
Patient Factors
Age/Frailty	Younger physiological age, "Fit" status	Advanced chronological age (>75), "Frail" status	Assessed by age, comorbidities, performance status, geriatric assessment tools (e.g., IMWG frailty score)
Performance Status	Good (e.g., ECOG 0-1)	Poor (e.g., ECOG 2-4)	Clinical assessment of ability to perform daily activities
Disease Staging
R-ISS Stage	Stage I	Stage III	Combines $\beta$2M, albumin, LDH, and cytogenetics
Disease Biology
Cytogenetics (FISH)	Standard risk (e.g., hyperdiploidy, t(11;14))	High risk (e.g., del17p, t(4;14), t(14;16), gain 1q)	Analysis of chromosomal abnormalities in myeloma cells from bone marrow biopsy
Serum Beta-2 Microglobulin ($\beta$2M)	Low (<3.5 mg/L)	High ($\ge$5.5 mg/L)	Blood test, reflects tumor burden and kidney function
Serum Albumin	Normal/High ($\ge$3.5 g/dL)	Low (<3.5 g/dL)	Blood test, reflects nutritional status and inflammation
Serum LDH	Normal	High	Blood test, reflects tumor burden and cell turnover
Serum Free Light Chain (sFLC) Ratio	Normal or mildly abnormal, significant reduction with therapy	Markedly abnormal (e.g., involved:uninvolved ratio $\ge$100) at diagnosis or relapse	Blood test measuring kappa and lambda free light chains
Organ Function
Kidney Function	Normal (e.g., normal creatinine/eGFR)	Impaired (e.g., elevated creatinine, low eGFR, need for dialysis)	Blood tests (creatinine, BUN, eGFR), urine tests
Response to Treatment
Depth of Response	MRD negativity, Complete Response (CR)	No response (refractory), Partial Response (PR), Stable Disease	Assessed by M-protein levels, sFLC, bone marrow biopsy, imaging
Durability of Response / Time to Relapse	Long first remission (>12-24 months)	Early relapse (<12 months from ASCT or <8 months from initial therapy)	Clinical follow-up and monitoring
Extramedullary Disease	Absent	Present	Imaging (PET-CT, MRI)

Statistics like "5-year survival rate" (approx. 57% overall for myeloma in the US; for patients aged 65-74, often cited as 50-57%) and "median overall survival" are averages from large groups and don't predict individual outcomes. Outcomes are constantly improving. Specific subgroups (e.g., "good risk" IgG kappa myeloma, based on cytogenetics) can have much better median survival, potentially exceeding 10-12 years.

Best Case: Deep, durable remission (CR, MRD negativity) with modern therapy (potentially ASCT), good quality of life, and long-term survival (many years, sometimes a decade+), managing myeloma as a chronic condition.

Worst Case: Primary refractory disease, early relapse, high-risk biology, severe complications (kidney failure, debilitating bone issues, life-threatening infections), intolerable treatment toxicities, progression through multiple therapies.

The Evolving Landscape: It's crucial to remember that myeloma treatment is rapidly advancing. Outcomes for patients diagnosed today are generally better than in the past, and this trend is expected to continue. Hope lies in ongoing research.

Focus on Mental Wellness

For a patient with a pre-existing history of depression, anxiety, and mood swings, managing mental health alongside Multiple Myeloma is paramount. This section discusses the interplay between the disease, treatments (especially steroids), and mental well-being, offering strategies for psychological support (detailed in Table 5).

A cancer diagnosis itself is a major stressor. For this patient, existing vulnerabilities make her more susceptible to worsened anxiety/depression. Physical symptoms (pain, fatigue) can also impact mood.

Corticosteroids (Dexamethasone) are a major concern:

High probability of exacerbating pre-existing conditions or triggering new episodes of insomnia, mood swings, anxiety, depression, personality changes.
This can create a cycle: myeloma stress lowers mood, steroids destabilize it further, worsened mental health impacts coping and quality of life.

Table 5: Managing Steroid-Related Psychological Side Effects in a Patient with Pre-existing Mood Disorders

Potential Steroid-Induced Psychological Effect	Specific Manifestations to Watch For	Proactive Management Strategies	Who to Involve
Insomnia	Difficulty falling asleep, frequent awakenings, non-restorative sleep	Strict sleep hygiene, morning steroid dosing, avoid caffeine late in day, relaxation techniques before bed. Discuss short-term sleep aid with MD/psychiatrist if severe.	Patient, Caregiver, Oncologist, Psychiatrist, Primary Care Physician
Increased Anxiety / Agitation	Restlessness, excessive worry, panic attacks, feeling "on edge," irritability	Mindfulness, deep breathing, limit stimulants. Discuss current anti-anxiety medication efficacy with psychiatrist; consider short-term anxiolytic if acute and severe, under psychiatric guidance. Communicate with oncology about steroid dose.	Patient, Caregiver, Psychiatrist, Psychologist, Oncologist
Mood Swings / Irritability	Rapid shifts in emotion (e.g., from happy to tearful or angry), uncharacteristic outbursts, heightened sensitivity	Mood diary to track patterns. Family education about steroid effects. Plan low-stress activities on steroid days. Discuss steroid dose/schedule with oncologist. Psychological counseling for coping strategies.	Patient, Caregiver, Psychologist, Oncologist, Psychiatrist
Worsening/New Onset Depression	Persistent sadness, loss of interest/pleasure, fatigue, feelings of hopelessness/worthlessness, changes in appetite, suicidal thoughts (emergency)	Early and regular psychiatric consultation. Ensure current antidepressant (if any) is optimal; consider adjustment or new medication. Psychotherapy. Strong social support. Report any suicidal ideation immediately.	Patient, Caregiver, Psychiatrist, Psychologist, Oncologist, Social Worker
Euphoria / Hypomania	Abnormally elevated mood, racing thoughts, decreased need for sleep, impulsivity, pressured speech	Monitor for these signs as they can be distressing or lead to poor judgment. Report to psychiatrist/oncologist. May require steroid dose adjustment or temporary mood stabilizer.	Patient, Caregiver, Psychiatrist, Oncologist

A collaborative team (oncologist, psychiatrist, psychologist, PCP, nurses, social worker, dietitian, physical therapist, palliative care) is vital for holistic care.

Psychoneuroimmunology: Chronic psychological distress (depression, anxiety) can negatively impact the immune system and increase inflammation, potentially affecting disease course and treatment response. Managing mental health is not just for emotional well-being but may also be part of optimizing the physiological response to cancer.

Resources: Key Questions & AI Tools

This section provides a list of key questions to discuss with the healthcare team and an AI-powered tool to help you generate personalized questions. It also includes a glossary of common medical terms related to Multiple Myeloma.

✨ AI Personalized Question Generator

Describe your specific situation, concerns, or aspects of your diagnosis/treatment you'd like to understand better. The AI will help generate relevant questions to ask your doctor.

Your personalized questions will appear here. Remember, these are suggestions and not medical advice. Always discuss fully with your doctor.

Regarding Diagnosis & Prognosis:

Can you explain bone marrow biopsy results (plasma cell %, cytogenetics) and their influence?
What is the official R-ISS stage and its meaning?
What were the serum free kappa light chain levels and kappa/lambda ratio? How will they be monitored?
Is there kidney damage? How severe? Plan to protect kidneys?
Were lytic bone lesions found? Plan for bone health management?

Regarding Treatment Options:

What is the recommended initial treatment regimen and why?
Is ASCT a candidate option given age (69) and health? Benefits/risks?
What recent advancements (last 5 years) are relevant?
How will pre-existing mood history be factored into treatment, especially dexamethasone use?
Anticipated duration of initial treatment? Maintenance therapy afterwards?

Regarding Side Effect Management & Supportive Care:

Most common/serious side effects to expect?
Plan to manage potential neuropsychiatric side effects of dexamethasone?
Available support services (counseling, social work, nutrition, PT, palliative care)? Referrals?
Signs/symptoms requiring immediate medical attention?
Specific dietary/exercise guidelines?

Regarding Living with Myeloma:

How will quality of life be monitored/supported?
Resources for caregivers?
Frequency of appointments/tests during and after treatment?

AL Amyloidosis: Disorder where abnormal light chains form amyloid deposits in organs.
Anemia: Deficiency of red blood cells or hemoglobin.
Antibody (Immunoglobulin): Protein by plasma cells to fight antigens; has heavy/light chains.
ASCT (Autologous Stem Cell Transplantation): Patient's own stem cells reinfused after high-dose chemo.
Beta-2 Microglobulin ($\beta$2M): Protein elevated in myeloma, used for staging.
Bence Jones Protein: Free light chains in urine.
Bisphosphonates: Drugs to slow bone loss.
Bone Marrow Biopsy: Procedure to sample bone marrow.
CAR-T Cell Therapy: Immunotherapy using genetically modified T-cells.
CRAB Criteria: Calcium elevation, Renal dysfunction, Anemia, Bone lesions.
Corticosteroids (e.g., Dexamethasone): Anti-myeloma and anti-inflammatory drugs.
Cytogenetics (FISH): Study of chromosomes to find abnormalities.
Free Light Chains (FLCs): Unbound kappa or lambda light chains in blood.
IgG (Immunoglobulin G): Common antibody class; the heavy chain type in "IgG kappa" myeloma.
M-protein (Monoclonal Protein): Abnormal antibody produced by myeloma cells.
Minimal Residual Disease (MRD): Tiny number of cancer cells left after treatment, found by sensitive tests.
Multiple Myeloma: Cancer of plasma cells.
Myeloma-Defining Event (MDE): Biomarkers indicating active myeloma needing treatment, even without CRAB.
Peripheral Neuropathy: Nerve damage causing numbness, tingling, pain.
Plasma Cell: White blood cell that produces antibodies; origin of myeloma.
Proteasome Inhibitors (PIs): Drugs blocking proteasomes, killing myeloma cells.
RRMM (Relapsed/Refractory Multiple Myeloma): Myeloma returned or not responding to treatment.
sFLC Assay (Serum Free Light Chain Assay): Blood test for free kappa/lambda light chains.