In many cases, treatment can control the myeloma and put the disease into remission. As disruption of normal blood cell production increases, signs and symptoms may include: Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. Blood in the urine (hematuria) sometimes is a sign of bladder cancer. unexplained weight loss. Some blood cancer treatments have significant side effects. In many cases where there is remission or partial remission, at some point in the future the disease returns (relapses). Breast cancer doesn't always come with the signature lump or bump. It can also be a sign of precancerous changes in the mouth or mouth cancer. Primary myelofibrosis. If you do need treatment, it will be aimed at lowering the amount of red blood cells your body makes and preventing blood clots and other complications. Bone marrow scarring can also cause you to have a low number of blood-clotting cells called platelets, which increases the risk of bleeding. Frequent infections. But it can also cause you to have too many white blood cells and platelets. When DNA gives your cells new instructions, your body develops abnormal blood cells that grow and multiply faster than normal and sometimes live longer than normal. Most salivary gland tumors are noncancerous (benign). Other (Uncommon) Signs of Prostate Cancer. How common is myeloma and who is affected by it? Find out when you should see a doctor and how cancer When your endometrium thickens, it can lead to unusual bleeding. Why? In people with myelofibrosis, the normally spongy bone marrow becomes scarred. For more detailed information on polycythemia vera, the National Cancer Instituteprovides patient information on its Chronic Myeloproliferative Neoplasms page. Coughing or chest pain. Early signs can include sores or lumps on the lips or in the mouth. Knowing whether these gene mutations are associated with your myelofibrosis helps determine your prognosis and your treatment. Myelofibrosis occurs when bone marrow stem cells develop changes (mutations) in their DNA. Cancer patients should be aware of the risk of blood clots and take steps to prevent them. National Comprehensive Cancer Network. The condition is therefore not hereditary. Eventually, your bone marrow produces fewer normal cells. WebBlood Cancer Symptoms. Myelofibrosis is a condition in which your bone marrow fills with scar tissue. But blood cancer is a serious illness, and learning you have a form of blood cancer is serious business. How common is myeloma and who is affected by it? Make an appointment with your doctor if you experience any signs or symptoms that Stage II : The nodular melanoma is thicker than 2 millimeters. The veteran reporter, diagnosed with multiple myeloma in 2014 and retired after 55 years in 2021, told his former Today show co-anchor Jane Pauley in an upcoming interview that his fight against blood cancer has been an overwhelming cross to bear. Once considered a blood disorder only, polycythemia vera is now defined as a rare, chronic blood disorder that is a type of cancer. MH spoke with Professor Roger Kirby, one of the UKs best known and most Our team includes expert hematologists and oncologists. Bone marrow cancer happens when cells in the marrow begin to grow abnormally or at an accelerated rate. WebImmunoglobulin M (IgM) proteins are large molecules. Some symptoms will ease, like headaches or dizziness. If these tests don't show another cause and the swollen nodes don't go away in 3-4 weeks, your doctor will probably do a biopsy. All rights reserved. Your doctor will keep a close watch on you. You can also find patient information on polycythemia vera on the National Center for Advancing Translational Sciences website. Other symptoms include bone pain, breaks (fractures) due to bone damage, and kidney damage. The sample gets sent to a lab so a specialist can check it with a microscope for cancer. Myeloma is more common in men than in women. Itchy skin. Myelofibrosis can happen on its own (primary myelofibrosis) or it can develop from another bone marrow disorder (secondary myelofibrosis). Your DNA tells cells what to do. AmyloidosisThis is an uncommon complication of myeloma. WebEndometrial hyperplasia is a condition where the lining of your uterus is abnormally thick. It may happen because you have too many red blood cells, white blood cells or blood proteins. If youre in remission, youre probably relieved youve finished treatment, but worried your cancer will come back. ongoing chest infections. It's an outpatient procedure, which means you don't have to stay overnight in a hospital. Myelofibrosis usually develops slowly. 2005 - 2023 WebMD LLC, an Internet Brands company. Then, your doctor uses a needle to take out a small amount of bone marrow. These are called IgM, IgG, IgA, IgD and IgE. Cancer mainly changes the blood, then So, after the high-dose treatment, some stem cells are given to you via a drip into a vein (like having a blood transfusion). In its very early stages, many people don't experience signs or symptoms. WebIts small less than 2 millimeters thick. Based on the source of the cancer cells and how far away that is from the swollen nodes, your doctor will recommend a treatment plan. This is because it is not as toxic as other medications used as chemotherapy. They're much more likely to be caused by infections or a disease that affects your immune system, and they will often clear up as your body heals. The change was understandably difficult, as Brokaw who served as NBCs White House correspondent for three years beginning in 1973, co-anchored the Today show from 1976 to 1981 and briefly helmed Meet the Press in 2008 spent his entire career at NBC. You'll often have a good idea why a lymph node is swollen -- you've got a cold, your tooth is infected, or you have a cut that isn't healing well. WebWhen diabetes affects the skin, its often a sign that your blood sugar (glucose) levels are too high. After it's done, your blood will be thinner, and itll flow more easily. The exact combination of medicines used, and the length of the course of chemotherapy, depend on various factors. There are three blood cancer types, each with several subtypes. Extra blood cells increase your likelihood of bleeding, bruising and clotting. ", MPN Research Foundation: "Polycythemia Vera. This can lead to anaemia, bleeding problems and infections. This disease gets worse slowly, usually over many years. Kidney cancer usually doesn't have signs or symptoms in its early stages. It is thought that as B lymphocytes develop into plasma cells, mistakes occur in the process which copies genetic material, leading to the cell becoming cancerous. Before your appointment, it's a good idea to make a list of things to ask your doctor, such as: If you don't have many symptoms, you might not need treatment for PV right away. mucus draining into the back of your nose and throat. WebLearn about the signs and symptoms of blood cancer, including unexplained weight loss, bruising or bleeding, lumps or swellings, shortness of breath, drenching night sweats, Receive automatic alerts about NHLBI related news and highlights from across the Institute. WebLearn about the signs and symptoms of blood cancer, including unexplained weight loss, bruising or bleeding, lumps or swellings, shortness of breath, drenching night sweats, infections, fever, rash or itchy skin, pain in bones, joints, or abdomen, and tiredness. Blood may be thicker than water, but that's not necessarily a good thing. WebThere are a few symptoms that may point to endometrial cancer. If you have blood cancer, ask your healthcare provider to explain how blood cancer will affect you, your treatment options and what to expect. The term multiple myeloma is sometimes used which means there are lots of (multiple) areas in bones throughout the body which are affected. This content does not have an English version. Forappointments, contact your preferred doctor or location directly. Men get it more often than women. certain chest infections, like bronchitis. Can you do biomarker or molecular testing for my type of blood cancer? Pinkish-red spot or growth. Policy. I just wasnt the same person.. Severe constipation, Abdominal (belly) Unusual vaginal bleeding, spotting, or other discharge. Polycythemia vera (PV) is a blood cancer that begins in the marrow of your bones, the soft center where new blood Develop a lack of fluid in the body (dehydration). Fever or chills. Mayo Clinic; 2019. Thick While hemoptysis is a tell-tale sign of lung cancer, it is more often due to a benign (non-cancerous) cause. Brokaw reported on former President Ronald Reagans first run for office, Robert F. Kennedys campaign and assassination and the fall of the Berlin Wall. Sometimes, it can indicate pregnancy or perimenopause, but it can also signify an underlying health condition. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. Stem cells are the immature cells that develop into mature blood cells in the bone marrow. Recent developments in medicines to combat myeloma have improved the outlook (prognosis). A mass or tumor in your lower abdomen (belly) that you can feel. ", UpToDate: "Evaluation of peripheral lymphadenopathy in adults. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.cancer.org/cancer/lymphoma.html), (https://www.cancer.org/cancer/multiple-myeloma/about/what-is-multiple-myeloma.html), (https://www.cancer.net/navigating-cancer-care/cancer-basics/what-cancer), (https://www.lls.org/facts-and-statistics/facts-and-statistics-overview#General%252520Blood%252520Cancers), (https://www.cancer.gov/about-cancer/causes-prevention/genetics?msclkid=1c51bfc6b51511ec863ab275ee1551f4). Protect yourself from infection. But you should contact your healthcare provider when you notice symptoms or changes in your body that last more than a few weeks. The full interview airs Sunday at 9 a.m. EST on CBS and will be available on Paramount+. Bathe or shower in cool water if warm water makes you itch. Cancerous plasma cells dangerously overtake healthy ones in the bone marrow. Myelofibrosis is considered to be a chronic leukemia a cancer that affects the blood-forming tissues in the body. If the endometrium looks too thick, the doctor can do a biopsy. WebThe thickening can be in the skin (which is a sign of Inflammatory Breast Cancer) or deeper in the breast. Swollen nodes that are close to your collarbone or the lower part of your neck when you're over 40 are more likely to be cancer. 2005 - 2023 WebMD LLC, an Internet Brands company. For example, the severity of the myeloma, the exact type of myeloma, if you have kidney damage, your age and general health. And even if it is cancer, you should still be able to treat it effectively. This keeps platelets from sticking together. High cholesterol For 30 years, UPMC Hillman Cancer Center, is committed to excellence in all aspects of cancer care. Your doctor or a physical therapist can show you how. Other less common mutations include CALR and MPL. WebIf you have polycythemia vera, it means you have a slow-growing blood cancer that can sometimes turn into another, more serious blood cancer. "Polycythemia Vera., National Center for Advancing Translational Sciences: Polycythemia Vera.. 7th ed. About 6,000 people are diagnosed with myeloma in the UK each year. Those cancer types and subtypes are: Researchers know blood cancer happens when blood cell DNA changes or mutates, but they arent sure why this happens. Don't miss a beat. It is part of a group of myeloproliferative neoplasms, or diseases that affect the bone marrow and cause the body to make too many red blood cells, white blood cells, or platelets. It lets each member of your care team know the exact type, location, and spread of the cancer. Blood cancers are serious illnesses, but other cancer types are more deadly. Upgrade to Patient Pro Medical Professional? As a result, various symptoms develop. Blood in urine that can be seen with the naked eye may be a sign of advanced kidney, bladder or prostate cancer. Understanding Stem Cell Transplants for Blood Cancers, Slideshow: Understanding Stem Cell Transplants for Blood Cancers, New Treatments for Non-Hodgkin's Lymphoma, Advanced Phases of Chronic Myelogenous Leukemia, Remission for Chronic Myelogenous Leukemia. Some common nail changes include: Changes in thickness and strength of nails causing nails to become weaker. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Kidney problems and even kidney failure. Treatments may be used to treat and to control the myeloma itself; also, to ease symptoms and complications of the myeloma. WebAside from looking like a changing mole, a melanoma on the foot can appear as a: Brown or black vertical line under a toenail. WebTo diagnose metastatic breast cancer, your doctor may recommend one or more tests: Blood Tests. mucus running from your nose this can be bloody. Cleveland Clinic is a non-profit academic medical center. Fatigue is a common symptom and treatment side effect. Tefferi A. UPMC Hillman Cancer Center has more than 70 locations in Pa., Ohio, Maryland, and western New York. I had to walk away from them as they were walking away from me. Treatment for myelofibrosis, which focuses on relieving symptoms, can involve a variety of options. Pittsburgh, PA 15232. WebSwollen lymph nodes are much more likely to be caused by infections or a disease that affects your immune system. It can also help you find support groups. WebLong-term use of powerful antibiotics or anticoagulants, which is medication that thins the blood. A stem cell transplant may be an option. Researchers dont know why this happens, which makes it hard to single out specific steps someone could take to reduce their risk. Webthickening of the womb lining (endometrial hyperplasia) growths (polyps) in the womb lining. You may have some blood tests, including: You may also need a bone marrow biopsy. You might take busulfan (Busulfex, Myleran) or ruxolitinib (Jakafi) if hydroxyurea isnt helpful or if it causes severe side effects. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. High blood pressure is a known risk factor in the onset and/or progression of glaucoma, diabetic retinopathy, macular degeneration and other diseases. WebPolicy Are blood cancers serious? Learn the facts about this condition, including symptoms, stages, how it's diagnosed, treatments, and more. An accurate diagnosis is important so you can get the proper treatment. Hypercalcaemia. Inherited illnesses. It can even be streaked with blood that over time may turn dark brown or black as it exits the body. Egton Medical Information Systems Limited. The stem cells have the ability to replicate and divide into the multiple specialized cells that make up your blood red blood cells, white blood cells and platelets. ", National Heart, Lung, and Blood Institute: "How Is Polycythemia Vera Diagnosed? Myelofibrosis belongs to a group of diseases called myeloproliferative disorders. Liver disease and medication side effects can also cause dark vomit. These include five distinct disease types: What these diseases have in common is that most start in the bone marrow. Thats great news, of course. Removal of your spleen. Your bone marrow makes stem cells that mature and become red blood cells, white blood cells and platelets. It causes heavy menstrual bleeding. Causes of blood cancer. It could be something like chickenpox, HIV, or a cancer such as leukemia or lymphoma. Share sensitive information only on official, secure websites. Some remissions are partial which means there is some improvement, often a great improvement, but some myeloma cells remain. As more and more of these mutated cells are created, they begin to have serious effects on blood production. HyperviscosityThis means that the blood may become too thick due to a very high level of paraprotein. See Further Reading and References below. Night sweats. Treatment for myeloma may include one or more of the following: Chemotherapy is a treatment which uses anticancer medicines to kill cancer (myeloma) cells, or to stop them from multiplying. Some people with blood cancer may not have any symptoms until the disease has advanced. The color may give you some clues about the cause. Cancer thickens the blood, releasing substances that make it sticky so clots form more easily, and treatment can exacerbate the risk. Diagnosis and staging often happen at the same time. Accessed Dec. 16, 2020. ", University of Iowa Hospitals and Clinics: "Polycythemia Vera. Investigators at the Dana-Farber/Harvard Cancer Center in Boston became intrigued with the thick, slimy stuff when they learned that breast, lung, colon, and other tumor cells make more than 50 times more of a certain type of it than normal cells. They also make a chemical that can damage bone. In some cases the disease does not respond to treatment very well, or life-threatening complications develop such as kidney failure. Swollen, painless lymph nodes in the neck, armpits, or groin. Endometrial cancer is highly curable. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. If you notice unusual pain or irregular vaginal bleeding, talk to your healthcare provider. Other bladder cancer symptoms include: If youre having trouble eating, ask to speak with a nutritionist. WebInner cheek cancer (also called buccal mucosa cancer) is a type of head and neck cancer that begins when the cells that make up the inner cheek grow out of control and form lesions or tumors. Plasma cells develop from small white cells called B lymphocytes. Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. Briefly, a stem cell transplant involves high-dose treatment with chemotherapy (and sometimes radiotherapy) to kill all the abnormal plasma cells. Signs of uterine cancer can resemble those of many conditions. But blood cancers are different. Often, swollen lymph nodes will be close to where the problem is. Most blood cancers start in your bone marrow, the soft, sponge-like material in the center of your bones. In time, small parts of bone are destroyed and are called lytic lesions. WebPossible symptoms of lung cancer are: a new cough or a cough most of the time. This may also include lung cancer or cancer from another organ, such as the kidneys, that has spread to the lung or airways. Several specific gene mutations have been identified in people with myelofibrosis. The famed reporter told Pauley his doctors didnt think he would live much longer when they diagnosed him with the disease. Here are some questions from the American Cancer Society you might want to ask your doctor: To reach the Mario Lemieux Center for Blood Cancersat UPMC Hillman Cancer Center, call 412-864-6600. If you develop these symptoms then you need to seek medical advice without delay. They'll take either a sample of cells from a node, typically using a needle, or remove a whole node. As with other cancers, what seems to happen is that the cancer starts with one abnormal cell. You may notice rectal bleeding on your toilet paper when you wipe or when you see blood in your stool. Depending on what is causing changes in your nails, you might notice changes in how they look, feel, and work. Surgeries immobilize patients, chemotherapy inflames the blood vessels and veins, and the blood becomes clogged with bits of dead cancer cells. High levels of calcium in the blood (called hypercalcemia) can cause: Extreme thirst, leading to drinking a lot. In time, signs and symptoms may develop, including: Blood in your urine, which may appear pink, red or cola colored; Pain in your back or side that doesn't go away; Loss of appetite; Unexplained weight loss; Tiredness; Fever; When to see a doctor Having too many red blood cells might cause stomach ulcers, gout, or kidney stones. What causes myeloma? Mayo Clinic. Polycythemia vera (PV) is a blood cancer that begins in the marrow of your bones, the soft center where new blood cells grow. The pain tends to be persistent and made worse by movement. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the treatment options for myeloma. Although the cause of myelofibrosis often isn't known, certain factors are known to increase your risk: Complications that may result from myelofibrosis include: Mayo Clinic does not endorse companies or products. Vaginal discharge in early cancer may be white or clear, watery, or foul smelling. And what you try to do is control it as much as you can.. Accessed Dec. 20, 2021. Your blood cancer care team will conduct tests to classify the type and stage of your blood cancer. The levels of these proteins are affected by myeloma and give an indication as to the severity of the disease. If youre receiving chemotherapy or radiation therapy, ask your healthcare provider about side effects. Or call 1-800-533-8762 to make an appointment between 8 a.m. and 5 p.m. Monday through Friday. Various medicines are used and myeloma may be treated with chemotherapy medicines given as tablets or injections. These store immune cells and act as filters to remove germs, dead and damaged cells, and other waste from your body. Depending on the effects of the myeloma, one or more of the following may be advised: People with myeloma will also usually be advised to drink plenty of fluids (at least three litres a day). Most people who have PV dont get diagnosed until theyre 60 or older, usually after a routine blood test. Intermediate grade: moderate growth rate. WebThick blood is not directly linked to cancer, but cancer can increase the risk of blood clots, which can cause thickening of the blood. Learn about other bladder cancer signs and symptoms and explore treatment options. Inherited bleeding disorders. Hemolytic anemia a type of anemia in which your body destroys red blood cells faster than it produces them, often due to certain blood diseases or autoimmune disorders. Contact our Development Office at 412-623-4700. For example, tailoring treatment to the genetic make-up of the patient seems to be a promising way forward. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. But you should contact a healthcare provider whenever you spot blood in your pee. When that happens, normal blood cells become lost in an ever-growing horde of abnormal cells that crowd your normal cells and monopolize space in your bone marrow. Coughing up blood; Fevers, night sweats; Weight loss; Fatigue; Cough; Chest pain; Shortness of breath; Cancers involving the airway or lungs can bleed. Phlebotomy. The first symptom of bladder cancer is often blood in the urine, but Dr. Tyson says it isn't always Cancer is not just one disease, but many different diseases that affect the body differently. Induction treatment before stem cell transplantIf you are offered a stem cell transplant, your doctor will usually advise that before this you have a combination of treatments, including chemotherapy. Mild anemia often causes no symptoms. It could include surgery, radiation, or chemotherapy, or a combination of treatments. When signs and symptoms do appear, they may include: Losing weight without trying; Loss of appetite; Upper abdominal pain; Nausea and vomiting; General weakness and fatigue; Abdominal swelling; Yellow discoloration of your skin and the When you pass blood clots during your periods occasionally, it is normal. You should have a full discussion with a specialist who knows your case. Blood cell counts, including the number of healthy cells. Advertising revenue supports our not-for-profit mission. The symptoms and problems which develop are mainly due to the uncontrolled production of plasma cells in the bone marrow, and the excess amount of antibody (paraprotein) that the plasma cells make. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. This can cause a variety of symptoms such as weakness in muscles of the legs, numbness of areas of the body or legs, bladder or bowel problems, and pain. Ive had a bad experience, the 83-year-old told Pauly on CBS Sunday Morning, per ET. Generally for people with myeloma in England: The treatment of cancer and myeloma is a developing area of medicine. Because of this, it is difficult for normal cells in the bone marrow to survive and to develop into normal mature blood cells. It's a lot like donating blood. See the separate leaflet called Stem Cell Transplant for more details. Grading helps understand the cancer's growth patterns and aggressiveness. Some people with myelofibrosis have no symptoms and might not need treatment right away. These include causes like bronchitis, pneumonia, and the use of blood thinners. Cancer that starts in the bone marrow is called bone marrow cancer or blood cancer. In particular, a successful stem cell transplant gives a good chance of a complete remission. Myeloproliferative disorders involve too many blood cells getting made in your bone marrow where blood cells get made. But your doctor would much rather see you promptly to make that diagnosis. However, in time, the relapses become more difficult to treat. National Cancer Institute: "Polycythemia Vera. By entering your email and clicking Sign Up, you're agreeing to let us send you customized marketing messages about us and our advertising partners. Some evidence suggests that Some are more common as the cancer becomes advanced (grows and spreads). WebTiny red dots on your skin from broken blood vessels. Search for a UPMC Hillman Cancer Center doctor or location. Extra blood cells increase your likelihood of bleeding, bruising and clotting. Imaging tests CT scan, PET scan, and X-ray. WebThis is thickening of the uterine lining and it is not always a sign of cancer, even though, as Dr. Schink points out, it can eventually lead to malignancy. Early signs of throat cancer include vocal changes and difficulty swallowing. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information. Mucus consists of mucins and other proteins. The tests theyll use may be different for each suspected blood cancer type. The presence of cancer cells in other organs. shortness of breath. It makes sense if you feel depressed about your situation. He became managing editor and anchor of NBC Nightly News in 1982 and helmed it for 22 years. Myelofibrosis biology and contemporary management. The most common is the Janus kinase 2 (JAK2) gene mutation. Weba cough that is either dry or productive (it produces mucus) a cough that interferes with sleep. This abnormal cell then multiplies to produce many identical abnormal plasma cells (a clone of cells). Primary myelofibrosis: 2019 update on diagnosis, risk-stratification and management. Daratumumab in combination for untreated multiple myeloma when a stem cell transplant is suitable; NICE Technology appraisal guidance, February 2022, Daratumumab monotherapy for treating relapsed and refractory multiple myeloma; NICE Technology appraisal guidance, April 2022, Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma; NICE Technology appraisal guidance, February 2023, Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation; National Cancer Institute (US), Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma; NICE Technology appraisal guidance, June 2023. This is, in effect, low-level chemotherapy which aims to keep you in remission for as long as possible. Talking to a therapist or finding a support group may help you navigate the challenges. But in people with leukemia, the bone marrow produces an excessive amount of abnormal white blood cells, which don't function properly. A bump or lump, which could be red, pink, or white and could have a wart-like or raw surface or feel rough or From nausea and vomiting to abdominal pain and discomfort, learn the most common signs and symptoms of stomach cancer from the cancer experts at the University of Kansas Cancer Center. If you receive a cancer diagnosis, you will likely have many questions. Hoffman R, et al. WebThe most common symptoms of esophageal cancer are: Trouble swallowing; Chest pain; Weight loss; Hoarseness; Chronic cough; Vomiting; Bone pain (if cancer has spread to the bone) Bleeding into the esophagus. This is a type of cancer that infects plasma cells. Any bleeding from the vagina after menopause. And they would put a rope around my dads legs and drop him down headfirst into the well.. Reviewed by QualityHealth's Medical Advisory Board. Symptoms Causes Diagnosis Treatment Having thick blood (known as hypercoagulability) means you are at increased risk for developing blood clots. In general, blood cancer staging looks at: Doctors also assign a grade to non-Hodgkin lymphomas. They'll do a physical exam and ask about things that have happened, like if you've: They'll want to know what medications you're taking and other symptoms you have. A genetic condition that affects red blood cells, called sickle cell anemia, can cause blood in urine. Rapidly growing mass on your foot, especially where you once injured your foot. Therefore, problems which can develop include: Kidney damageThe kidneys may be damaged by an increased calcium level in the bloodstream, and/or by the high level of the abnormal antibody (paraprotein).
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