Patient: Hello Dr. Chong! My current tests are: globulin 57.5, immunoglobulin LGA 10,500, mature plasma cells 5.50 (3.5 two months ago) My current symptoms are chest and ribs, back pain, weakness, etc. But the doctor said that the immunoglobulin LGA must reach more than 20,000 and mature plasma cells must reach more than 10 before I can be treated. Do I really have to become a bone marrow cancer before I can start treatment? I don’t know what can be done to control the disease from becoming myeloma or later. I would like to ask Dr. Zhuang for an answer. I have not been treated before, or I can guide myself to physical therapy. Junling Zhuang: Is the diagnosis of multiple myeloma clear? Are you saying that the percentage of plasma cells in the bone marrow is 5.5%? The need to start treatment for myeloma does not depend entirely on the blood immunoglobulin and the percentage of plasma cells in the bone marrow. If anemia, impaired kidney function, hypercalcemia, bone disease or recurrent infections are already present, treatment should be started even if these two indicators are not high. This means that the disease is starting to threaten the function of your organs. Do you have any of these problems against it? Also if you can do blood immunoelectrophoresis it is best to do it, and 24 hour urine light chain quantification. Patient: Thank you Dr. Chong. The doctor said that my disease is definitely myeloma, but the index is not up to standard and no treatment is given. If the standard is reached, won’t it be a game? The percentage of plasma cells in the bone marrow is 5.5%, Dr. Zhuang, do you have any way to treat it? Is there no other way but chemotherapy? If there is no organ damage, and the ratio of immunoglobulin to myeloma cells is not high enough, it is possible to observe what we call gammaglobulinemia of undetermined significance (MGUS). Some MGUS will become myeloma, and some may be immune disorders or of unknown origin. Even if myeloma is diagnosed, it is not hopeless. Nowadays, myeloma treated intensively abroad can even survive for more than 10 years, and the vast majority of myeloma progresses slowly, so you should monitor these indicators regularly first.