Multiple Myeloma

Overview

Multiple myeloma treatments have expanded significantly in the past decade, offering new options and a new sense of hope. Many people are able to manage this disease and lead healthy, active lives. With numerous treatments in the pipeline, the future is more hopeful for people who have multiple myeloma.

Dr. James O. Armitage, a leader in oncology/hematology, agrees. “The dramatic changes in therapy over the years have brought about equally dramatic improvements in making patients feel better by alleviating symptoms and side effects, along with helping people live longer. Today, it’s even more exciting because there are more advances on the horizon.”

What is Multiple Myeloma?

Multiple myeloma is a type of hematologic (blood) cancer. Also referred to as a plasma cell neoplasm, it is a plasma cell disorder that begins when the blood’s plasma cells multiply uncontrollably.

Normally, plasma cells are produced in the bone marrow and produce antibodies to help fight germs and viruses, and stop infection and disease. As a type of white blood cell, they are an important part of the immune system, which is a network of cells that work together to defend your body against infections. Plasma cells create different types of antibodies, which are proteins created as a reaction to foreign substances, such as bacteria, in the body.

When abnormal plasma cells grow out of control, they can weaken the immune system by preventing healthy plasma cells from producing antibodies. These 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 anti-bodies are called M-proteins. They 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 1).

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.

How is it Discovered?

Diagnosing multiple myeloma can be difficult because the symptoms may also be attributed to another condition. In some cases, you may not have symptoms at all. As a result, the multiple myeloma may be at an advanced stage when it is diagnosed.

If your doctor suspects you have multiple myeloma, you may have blood and urine tests as well as a bone marrow biopsy and imaging tests, which may include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and X-rays (See Testing & Diagnosis).

Special testing called cytogenetics may also be done to check for chromosomal abnormalities. Additionally, your doctor may order a biopsy of fat from around your stomach to check for amyloidosis, which is a buildup of an abnormal protein called amyloid.

The only two known precursors to multiple myeloma are monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma. MGUS occurs when abnormal plasma cells produce many copies of an identical antibody. Most cases of multiple myeloma are preceded by MGUS, but it is unknown whether MGUS is always present before diagnosis. Smoldering myeloma, also called asymptomatic multiple myeloma, is an early stage of myeloma. Preventive treatments to delay smoldering myeloma from progressing to multiple myeloma are being studied in clinical trials.

Although the exact cause of multiple myeloma is unknown, scientists continue to learn more about the development of the disease. 

 


[CRAB]
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

 

 

Key Takeaways

  • Advances in research are providing new treatment options for people with multiple myeloma.
  • Multiple myeloma is a cancer of plasma cells, which are produced in the bone marrow.
  • Many people with multiple myeloma lead healthy, active lives and manage the disease similar to a chronic condition.

Additional Resources

 

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