Key Information

Appropriate Tests


Full blood count, Blood film, Protein (total) and Protein electrophoresis with paraprotein quantitation and typing, Immunoglobulins G, A, M , Beta-2-microglobulin, Free light chains.

Protein urine, Bence Jones protein urine.

Bone marrow aspiration and trephine biopsy is usually not required in elderly, asymptomatic patients with small paraproteins (<10 g/L), no bone lesions, or evidence of bone marrow or other organ failure.

See Table 2.



Waldenström's macroglobulinaemia


Lymphoma (non-Hodgkin)


Heavy chain disease


Primary Amyloidosis


Monoclonal gammopathy of undetermined significance (MGUS)


Smouldering plasma cell myeloma

See Plasma cell myeloma

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