Multiple Myeloma


Multiple myeloma is a plasma cell disorder that begins when the blood’s plasma cells multiply uncontrollably. Plasma cells are produced in the bone marrow. As a type of white blood cell that produces antibodies to fight infection, they are a part of the immune system, a network of cells, organs and tissues that work together to defend your body against germs and infection. Plasma cells play an important part in the immune system because when they identify a threat to the body, they create different types of antibodies.

Although few patients with multiple myeloma are currently cured, many treatments are available. With today’s treatment options, many people are able to manage this disease and lead healthy, active lives. Treatments for multiple myeloma differ from person to person. Factors that will guide your treatment include the stage of the disease as well as your age, overall health and symptoms.

Understanding Bone Marrow and Cells

To better understand multiple myeloma, it’s important to have a general knowledge of bone marrow and blood cells.

Antibodies are proteins created from plasma cells as a reaction to foreign substances, such as bacteria, in the body.

Bone marrow is the soft, spongy center of some bones that contains immature blood stem cells, more mature blood-forming cells, fat cells and tissues that support cell growth. The immature blood stem cells, known as hematopoietic stem cells, develop into several types of blood cells, including white blood cells, red blood cells and platelets (see Figure 1).

Lymphocytes are the primary cells in lymphoid tissue, which is a major part of the immune system. These cells develop from lymphoblasts (immature cells found in bone marrow) into mature, infection-fighting cells. Subtypes of these cells include B-lymphocytes and T-lymphocytes.

Plasma cells develop from B-lymphocytes and produce antibodies to help fight germs and viruses, and stop infection and disease. Plasma cells are primarily found in the bone marrow.

                                                         Figure 1.

How Multiple Myeloma Develops

When abnormal plasma cells (myeloma cells) grow out of control, they can weaken the immune system by preventing healthy plasma cells from producing antibodies. Abnormal, cancerous plasma cells are called myeloma cells, and, like normal plasma cells, myeloma cells make antibodies. But, myeloma cells are all the same and produce too much of the same antibody. These antibodies are called monoclonal antibody proteins, or M-proteins. M-proteins accumulate in the blood and urine and can lead to damage of the kidneys or other organs.

In people with multiple myeloma, the myeloma cells multiply uncontrollably and accumulate in bone marrow, solid parts of bone and, occasionally, in other organs. This accumulation of myeloma cells usually occurs in multiple areas of the bones in the body, giving the disease its name, “multiple myeloma” (see Figure 2). When the cells collect in bone marrow, they slow down the growth of healthy white blood cells, red blood cells and platelets. These cells collect in solid bone, causing holes called lytic lesions. The majority of people with multiple myeloma have these lesions when their disease is diagnosed.

                   Figure 2.


The Common Signs of Multiple Myeloma


The most common signs of multiple myeloma, which are attributed to the same factors used to stage multiple myeloma (see Staging), can be described with the CRAB acronym:

Calcium level – the disease may cause elevated calcium levels in the blood

Renal (kidney) function – kidney failure may result from damage to the kidneys caused by the multiple myeloma protein

Anemia – low red blood cell counts may be caused by cancer cells slowing the growth of healthy bone marrow cells

Bone lesions – multiple myeloma cells can cause bone damage (lytic lesions), thinning of the bones (osteoporosis) or a compression fracture of the spine



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