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Eur J Haematol. 2015 Jul;95(1):57-64. doi: 10.1111/ejh.12478. Epub 2015 Jan 21.

Clinical course and prognosis of non-secretory multiple myeloma.

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Mayo Medical School, Mayo Clinic, Rochester, MN, USA.
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Division of Biostatistics, Mayo Clinic, Rochester, MN, USA.



To determine the prognosis of patients with non-secretory myeloma.


We studied 124 patients diagnosed with multiple myeloma who had no monoclonal protein detected on serum and urine immunofixation at diagnosis and on all subsequent follow-up testing (non-secretory myeloma). The overall survival (OS) of patients with non-secretory myeloma was compared with 6953 patients with typical myeloma seen during the same time period in whom a monoclonal protein was detected at the time of diagnosis.


One hundred and twenty-four patients met criteria for non-secretory multiple myeloma. The median follow-up was 102 months (range, 1-204 months). The median progression-free survival with initial therapy was 28.6 months, and the median OS was 49.3 months. There was a significant improvement in OS since 2001; median survival 43.8 months (prior to 2001) vs. 99.2 months (2001-2012), P < 0.001. OS was superior in patients with a normal baseline FLC ratio (n = 10) compared to patients with an abnormal ratio (n = 19), medians not reached in both groups. Prior to 2001, OS was similar in non-secretory myeloma (n = 86) and secretory myeloma (n = 4011), median 3.6 vs. 3.5 yr, respectively, P = 0.63. However, among patients diagnosed between 2001 and 2012, OS was superior in non-secretory myeloma (n = 36) compared to secretory myeloma (n = 2942), median 8.3 vs. 5.4 yr, respectively, P = 0.03.


Non-secretory myeloma is an uncommon subtype of multiple myeloma. In the last decade, there has been an improvement in the survival of non-secretory myeloma and appears superior to secretory myeloma.


myeloma; prognosis; therapy

[Indexed for MEDLINE]

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