[Music] what are the different types of myeloma so people who have active myeloma we can see a number of ways in at least 95 percent of patients who have myeloma we can actually find some protein in their in their blood or in their urine that doesn't belong there and so it requires some very specific tests things that are called a protein electrophoresis test or an immune of fixation test the majority patients have what we call heavy chain myeloma where we can see a specific type of immunoglobulin or antibody being secreted in very large amounts and what's unique about multiple myeloma is every one of the cells every cancer cell is making the exact same protein and so we can actually with a certain laboratory methods identify that protein and quantify it so the heavy chain part of the myeloma can is most commonly IgG but it can also be iga rarely there are other types IgM and IgD associated with the heavy chain most patients also have a light chain component so the antibody that we normally make is both a heavy chain and a light chain and so we can identify people's myeloma based on their heavy chain and light chain there are a percentage of people who have what we call light chain myeloma we don't see the heavy chain we just see light chains in their blood or their urine at high levels and that's either what we call Kappa or lambda light chain myeloma and then there's about 5% of people who we can't identify either a heavy chain or a light chain and we call that non secretory we don't know why that is these cells that become myeloma cells are not normal genetically and so the the proteins they make sometimes aren't made the right way and don't get secreted and so in patients who have non secretory disease it actually just becomes a little harder to follow their disease because in people who have light chain or heavy chain myeloma we can do a blood or urine collection and know exactly how their disease is behaving in patients with non secretory disease we have to rely on things like fruit more frequent bone marrow biopsies as well as doing imaging of the bones or or PET scans [Music]