Paraprotein in the blood: is it a sign of cancer?

Written in association with: Dr Jonathan Sive
Published: | Updated: 14/11/2024
Edited by: Laura Burgess

Some people make an abnormal amount of protein called a paraprotein or 'M protein' that can be found in their urine or blood. There are different conditions that can cause a paraprotein, with the most common being monoclonal gammopathy of unknown significance (MGUS). In most cases, this is a non-cancerous condition but another, more serious, blood abnormality linked to a paraprotein is myeloma.

One of our top haematologists Dr Jonathan Sive explains how a paraprotein is detected, what the possible causes are and what happens following diagnosis.

What is a paraprotein?

A paraprotein is an abnormal protein that is produced by plasma cells in the bone marrow. Plasma cells are specialised blood cells that usually produce a range of different proteins called immunoglobulins as part of the body’s immune system. If a group of plasma cells start to produce just one type of abnormal protein this is called a paraprotein and can be an indicator of an abnormality. It may also be referred to as an “M-band” or “M-protein”.
 

Are there paraprotein blood tests for detection?

Paraprotein levels can be detected in the blood using tests called Serum Protein Electrophoresis and Serum Free Light Chains. These will detect slightly different kinds of paraproteins (“Intact Paraprotein” or “Light Chain”), but they are both produced by the same process and are usually managed the same way. When a paraprotein is detected in the urine it is sometimes referred to as “Bence-Jones protein”.
 

What causes a paraprotein?

There are a number of different conditions that can cause a paraprotein. Commonly, they are produced by a condition called MGUS. This is a benign condition. Although it can occasionally turn into more serious conditions, this happens rarely and MGUS can usually be safely monitored.

Occasionally, paraproteins may be a sign of a serious blood abnormality called myeloma. This is usually accompanied by signs of damage to the body such as fatigue from low red blood cells (anaemia), kidney problems, high calcium or bone damage.

More rarely, paraproteins can be caused by other blood conditions such as lymphomas, and sometimes they can occur with infections, liver problems or inflammatory conditions.
 

Read more: on treatment for myeloma

 

What should I do if a paraprotein is detected?

Your doctor may refer you to a haematologist (blood specialist) for further tests, which may include blood and urine tests, scans and sometimes a bone marrow biopsy test. If a serious abnormality such as myeloma is detected, they may recommend starting some treatment. If it is found to be MGUS or another benign condition, then this could be safely monitored either by the specialist or your GP.


Book an appointment with Dr Sive today.

By Dr Jonathan Sive
Haematology

Dr Jonathan Sive is an expert haematologist based in London. He specialises in the diagnosis and management of blood cancers, with particular expertise in the treatment of myeloma and other related disorders. He is the Clinical Service Lead for the UCLH myeloma service - the largest in the UK, and has a specialist interest in POEMS Syndrome.He is also highly experienced in the investigation of abnormal blood counts and paraproteins.

After qualifying, he completed specialist training in haematology at University College London Hospital and carried out a PhD at Cambridge University, where he investigated the use of genomic technologies to study the mechanisms of leukaemia development. He currently practises as a consultant haematologist at University College London Hospital, where he also has a private practice

Dr Sive is committed to research which improves treatment outcomes for all patients. In this respect, he is actively engaged in a variety of clinical research projects and takes a leading role in the development of national guidelines.

He is the lead author of the new UK national guidelines for the diagnosis and initial treatment of myeloma. These are published by the British Society for Haematology and the UK Myeloma Forum, and provide the standard for practice throughout the UK. https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.17410

His work has been widely published in numerous peer-reviewed journals and book chapters. He is also a member of the British Society for Haematology (BSH) and the UK Myeloma Research Alliance, and is member of the executive committee of the UK Myeloma Forum.

A skilled clinician, Dr Sive combines his academic expertise in blood disorders with dedication to delivering an excellent standard of care to every patient. He is known for his clear and empathetic communication style and will explore all treatment options relevant to the patient’s circumstances in an honest and sensitive manner.

To reduce infection risk during the Covid19 outbreak, he is able to offer consultations by telephone or videocall.

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