Multiple Myeloma

Summary about Disease


Multiple myeloma is a cancer that forms in plasma cells, a type of white blood cell. Healthy plasma cells help you fight infections by making antibodies that recognize and attack germs. In multiple myeloma, cancerous plasma cells accumulate in the bone marrow and crowd out healthy blood cells. Instead of producing helpful antibodies, the cancerous cells produce abnormal proteins that can cause complications.

Symptoms


Signs and symptoms of multiple myeloma can vary and, in the early stages, there may be none. When signs and symptoms do occur, they can include:

Bone pain, especially in your back or ribs

Bone fractures

Fatigue

Frequent infections

Weight loss

Weakness or numbness in your legs

Excessive thirst

Frequent urination

Nausea

Constipation

Mental fogginess or confusion

Causes


The exact cause of multiple myeloma is not known. However, it begins with an abnormal plasma cell in your bone marrow. This abnormal cell multiplies rapidly.

Monoclonal proteins (M proteins): Cancerous plasma cells produce an abnormal protein, the M protein, which accumulates in the body and causes problems such as kidney damage.

Crowding out healthy cells: Cancer cells crowd out healthy cells, leading to a decrease in red blood cells (anemia) and white blood cells, which impairs the body's ability to fight infections. They can also interfere with bone formation, increasing the risk of fractures. Factors that may increase the risk of multiple myeloma include:

Increasing age

Male sex

Black race

Family history of multiple myeloma

Obesity

Exposure to radiation

Medicine Used


Treatment for multiple myeloma aims to control the cancer and manage the symptoms. Treatment options can include:

Targeted therapy: Drugs that target specific vulnerabilities in cancer cells. Examples include proteasome inhibitors (e.g., bortezomib, carfilzomib, ixazomib) and immunomodulatory drugs (e.g., thalidomide, lenalidomide, pomalidomide).

Immunotherapy: Drugs that help your immune system fight cancer. Examples include monoclonal antibodies (e.g., daratumumab, elotuzumab).

Chemotherapy: Drugs that kill cancer cells. Often used in combination with other treatments. Examples include melphalan, cyclophosphamide, doxorubicin.

Corticosteroids: Drugs that help control inflammation and also kill myeloma cells. Examples include prednisone, dexamethasone.

Stem cell transplant: Replaces diseased bone marrow with healthy bone marrow. Often preceded by high-dose chemotherapy.

Radiation therapy: Uses high-energy beams to kill cancer cells. Can be used to treat localized bone pain or to shrink tumors that are pressing on nerves.

Bisphosphonates: Used to strengthen bones and reduce the risk of fractures.

Is Communicable


Multiple myeloma is not communicable. It is not contagious and cannot be spread from person to person through any means.

Precautions


While you cannot prevent multiple myeloma, you can take steps to manage your health and potentially reduce risk:

Maintain a healthy weight.

Eat a healthy diet.

Exercise regularly.

Avoid exposure to radiation and certain chemicals when possible.

If you have a family history of multiple myeloma, discuss this with your doctor.

If you have MGUS (monoclonal gammopathy of undetermined significance), a condition that can sometimes lead to multiple myeloma, follow your doctor's recommendations for monitoring.

How long does an outbreak last?


Multiple myeloma is not an outbreak. It's a chronic disease. People live with it for years. The course of the disease and the duration of treatment vary greatly from person to person depending on the stage of the disease, response to treatment, and other factors.

How is it diagnosed?


Multiple myeloma is diagnosed through a combination of tests:

Blood and urine tests: These can detect M proteins, abnormal antibody levels, and other markers of myeloma.

Bone marrow biopsy: A sample of bone marrow is taken and examined under a microscope to look for myeloma cells.

Imaging tests: X-rays, MRI, CT scans, or PET scans can be used to look for bone damage or other signs of myeloma.

Free light chain assay: Measures the amount of kappa and lambda light chains in the blood. Elevated levels or an abnormal ratio can indicate myeloma.

Timeline of Symptoms


The timeline of symptoms varies greatly among individuals.

Early Stages: Many people have no symptoms in the early stages of multiple myeloma.

Gradual Onset: Symptoms often develop gradually over time.

Fluctuating Symptoms: Some people experience periods of remission (when symptoms improve) followed by periods of relapse (when symptoms worsen).

Late Stages: As the disease progresses, symptoms can become more severe and frequent.

Important Considerations


Multiple myeloma is a complex disease that requires specialized care.

Treatment options are constantly evolving.

It's important to have a strong support system.

Clinical trials may be an option for some people.

Early diagnosis and treatment can improve outcomes.

Quality of life is an important consideration in treatment decisions.

Regular follow-up with your doctor is essential.