CRAB Symptoms — Key Diagnostic Features
| Letter | Feature |
|---|---|
| C — Calcium | Elevated calcium (hypercalcaemia) — causes thirst, confusion, constipation |
| R — Renal | Kidney impairment from abnormal protein deposits |
| A — Anaemia | Fatigue, pallor — from bone marrow crowding |
| B — Bone | Bone pain, fractures, lytic lesions on X-ray — from bone destruction |
Diagnostic Blood Tests
| Test | Finding |
|---|---|
| Serum protein electrophoresis (SPEP) | Detects abnormal monoclonal protein (paraprotein/M-protein) |
| Serum free light chains | Sensitive marker, especially for early or light-chain-only myeloma |
| FBC | Anaemia common at diagnosis |
| Calcium | Often elevated |
| Kidney function (creatinine/eGFR) | Often impaired |
| Beta-2 microglobulin | Used for staging and prognosis |
| Bone marrow biopsy | Confirms plasma cell percentage — needed for diagnosis |
Treatment Overview
Modern myeloma treatment typically combines a proteasome inhibitor (bortezomib), an immunomodulatory drug (lenalidomide), and a steroid, often followed by autologous stem cell transplant in eligible patients. Newer immunotherapies (daratumumab, CAR-T cell therapy) have further improved outcomes.MGUS — A Precursor ConditionMonoclonal Gammopathy of Undetermined Significance (MGUS) is a common, usually harmless condition found incidentally on blood tests, where an abnormal protein is present without myeloma. It progresses to myeloma at about 1% per year and requires monitoring rather than treatment.
Is multiple myeloma the same as leukaemia?
No — myeloma affects plasma cells in the bone marrow (a type of white blood cell that makes antibodies), while leukaemia affects different blood cell lines. Both are blood cancers but behave and are treated differently.
Can multiple myeloma be cured?
Currently myeloma is considered a treatable but not curable cancer for most patients, though remission periods can last years, and new treatments continue to improve survival and quality of life.
What is a paraprotein and should I worry if it's found on a test?
A paraprotein is an abnormal antibody protein. If found incidentally, further testing (bone marrow biopsy, imaging, other blood tests) determines whether it represents MGUS (usually harmless, monitored) or myeloma (requiring treatment).
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.