Multiple myeloma is a plasma cell cancer. Here, we presented an article which includes its types, signs, and symptoms, risk factor, treatment, and complication.
A type of cancer that affects the plasma cell, which are a type of white blood cell, is called multiple myeloma. Plasma cells originate in the bone marrow, which is the soft tissue that forms the center of hollow bones. Apart from plasma cells, the bone marrow also produces other healthy blood cells.
If the patient has no signs or symptoms, then treatment is not usually necessary. And for symptomatic patients, various treatment options are available to control the disease.
There are two main subtypes of multiple myeloma:
Hyperdiploid (HMM) - Here, the abnormal plasma cells have more chromosomes than normal. Almost 45 % of cases are of this type, and it is generally less aggressive.
Non-hyperdiploid or hypodiploid - The abnormal plasma cells have fewer chromosomes than usual. It is a more aggressive type, and 40 % of the cases are this type.
The other common kinds of multiple myeloma and precancerous conditions that can result in multiple myeloma are:
Light Chain Myeloma - This is when the myeloma cells make incomplete immunoglobulins (antibodies) called light chain antibody. 20 % of patients have this type.
Non-secretory Myeloma - Here, patients do not make enough light chain antibodies to get detected in any test.
Solitary Plasmacytoma - Here, the plasma cells become cancerous and grow abnormally, resulting in plasmacytoma, which is a tumor that usually affects the bone.
Monoclonal Gammopathy of Undetermined Significance (MGUS) - This condition results in the body producing an abnormal protein or M protein, which can be found in the blood and urine. 1 in 5 MGUS patients develops multiple myeloma.
Smoldering Multiple Myeloma (SMM) - It is a precancerous condition, and this condition does not result in symptoms. As these patients have more M proteins in the blood or more myeloma plasma cells in the bone marrow, they are more likely to get the active kind of myeloma.
Immunoglobulin E (IgE) Myeloma - This is the rarest form of multiple myeloma. It is aggressive and progresses rapidly to plasma cell leukemia.
Immunoglobulin D (IgD) Myeloma - This is a rare condition, and men younger than 60 years are most susceptible.
Most patients do not have any signs or symptoms during the early stages of this condition. As cancer progresses, symptoms appear, which vary from person to another. The common symptoms include:
Bone pain and weakness.
Bone fractures easily.
Kidney disease or failure.
Anemia (low red blood cells).
Leukopenia (low white blood cells).
In multiple myeloma, abnormal plasma cells keep multiplying and accumulating in the bone marrow. This outnumbers the healthy blood cells in the bone marrow, which leads to anemia, tiredness, and other multiple myeloma symptoms.
And instead of producing antibodies that fight off infection, cancer cells produce abnormal antibodies monoclonal proteins or M proteins. These proteins build up in the patient’s body, which damages the kidneys.
Some of the common factors that can increase the risk of a person developing multiple myeloma are:
People who are 60 years and older.
African-Americans are more likely to develop this than Caucasians.
Men are susceptible.
Sometimes, multiple myeloma is accidentally diagnosed during a routine blood test. Or if your doctor suspects that you might have multiple myeloma, then you might have to get the following tests done:
Blood tests - To detect M proteins in the blood. And to detect how aggressive the condition is, beta-2-microglobulin level in the blood is checked. Apart from these, total blood count, kidney function test, calcium and uric acid levels are also tested.
Urinalysis - Bence Jones proteins, that is M proteins in the urine is detected.
Bone marrow examination - A sample of the bone marrow is collected and tested. The sample is examined for myeloma cells using fluorescence in situ hybridization (FISH). It also gives an idea of how fast the cancer cells are multiplying.
Imaging - To check for bone problems, an X-ray, MRI, or CT scan is done.
Treatment helps relieve pain, prevent complications, and slows the progression of the disease in patients with symptoms. If you do not have any symptoms, then treatment is usually not needed, and the doctor just monitors your condition regularly.
The treatment options for multiple myeloma include:
1) Targeted drug treatment - (Bortezomib, Carfilzomib, Ixazomib) - These drugs attack and block the action of a specific substance in the cancer cells and break down the protein.
2) Biological therapy - (Thalidomide, Lenalidomide, Pomalidomide) - These drugs enhance the immune system and fight off the cancer cells.
3) Chemotherapy - Chemotherapy drugs are used to kill cells that multiply and grow fast, which includes myeloma cells.
4) Corticosteroids - (Prednisone, Dexamethasone) - These drugs control inflammation by regulating the immune system.
5) Bone marrow transplant - Otherwise called a stem cell transplant is done to replace the diseased bone marrow.
6) Radiation therapy - Here, X-rays and protons are used to destroy myeloma cells.
Painkillers - To reduce pain and discomfort.
Dialysis - In case of kidney failure.
Vaccinations - To prevent infections.
Bisphosphonates (Pamidronate, Zoledronic acid) - To prevent bone loss.
Iron tablets - To treat anemia.
The possible complications include:
Possible kidney failure.
Some patients have to alter their lifestyles to cope with pain and other symptoms of multiple myeloma. If you feel that your symptoms are getting worse, then it is best to consult a doctor. You can consult experienced and professionally trained doctors easily and comfortably from your home by posting a query now!
Multiple myeloma is a cancer of the plasma cells (type of white blood cell) of the bone marrow. Like every other cancer, these cells become abnormal and cancerous on their own due to genetic mutations and begin to multiply at a faster rate than the healthy plasma cells. They accumulate within the bone marrow outnumbering healthy cells.
Multiple myeloma does not show any early signs or symptoms. Symptoms over time include,
- Excessive thirst.
- Bone pain (frequently in the spine, skull, and long bones).
- Appetite loss.
- Unintentional weight loss.
- Leg and arm weakness.
- Nerve damage.
- Skin lesions.
Multiple myeloma starts from within the bone in the bone marrow’s plasma cells. They replicate and accumulate within the bone marrow. Over time they spread to other parts of the body through the harmful antibodies (M protein) that these abnormal plasma cells release.
The newer revised international staging system (RISS) stages multiple myeloma into three stages based on the albumin, beta-2 microglobulin (B2M), and lactate dehydrogenase (LDH) levels, and genetic changes.
Stage 1- Albumin, B2M, and LDH levels are normal and genetic changes are not aggressive.
Stage 2- Albumin is low, B2M is normal to high.
Stage 3- B2M and LDH levels are high and have highly abnormal genetic changes.
In the advanced stages, the symptoms get worse. Frequent infections, bone pain, fatigue, fractures, abdominal pain, anemia, sick feeling, etc., are experienced. The life expectancy during this stage is expected to be another three to four years.
- People having a family member with multiple myeloma.
- African American race.
- People above 65 years of age.
- Obese or overweight people.
- People with radiation exposure.
- People working in rubber factories are exposed to chemicals.
- Farmers exposed to herbicides.
Multiple myeloma does not exhibit any symptoms in the initial stage. If and when someone experiences any symptom, the disease would be in the advanced stage. Smoldering Myeloma, a type of multiple myeloma, is an asymptomatic and inactive variant.
Though there is no cure for multiple myeloma, prompt identification and treatment of the symptoms caused by myeloma can sustain and improve the quality of life. People under symptomatic management of myelomas were found to live for more than five years. Average survival rates range from three to ten years.
Multiple myelomas are found to spread through the bloodstream, making it easy and quick for them to spread throughout the body.
Multiple myeloma does not cause any symptoms in the early stages. However, abnormally high levels of M protein in the blood and urine tests done for other purposes can raise suspicion for multiple myeloma. It can be suspected in older people above 50 years of age with persistent back pain for more than a month.
The immunoglobulin E and hypodiploid types of multiple myeloma are more aggressive forms of multiple myelomas.
Multiple myeloma and myeloma are the same. It is just that both terms are used interchangeably.
While some multiple myeloma survivors do not have any symptoms and feel alright, some feel fatigued and weak with persistent pain in their back. Numbness, recurrent infections, and itchiness accompany. Generally, they tend to feel sick.
Multiple myeloma is not curable. Treatments are aimed to ease the symptoms, reduce complications, prolong life, and slow down the disease progression.
Usually, treatment is not advised if there are no prevailing symptoms. Careful monitoring of the health condition will be done. Upon the presence of symptoms, symptomatic treatment is recommended. If the symptoms are not treated, the disease progression will be fast, and it may lead to complications like anemia, bone loss, infections, kidney failure, back pain, fractures, etc.
Last reviewed at:
10 Jan 2020 - 4 min read
Query: Hello doctor, RA patient for 13 years and on treatment with Methotrexate, Leflunomide. Then suffered from aplastic anemia and ATG treatment done with partial recovery. Presently on Cyclosporine on the advice of hematologist and HCQS on advice of Rheumatologist. Reti iman chemotherapy was done since... Read Full »
Query: Hello doctor, My relative aged 82 years is suffering from prostate cancer. It was discovered one year ago. Surgery was done eight months ago, and it is still spreading. He is not diabetic. Will chemo might be fatal? Read Full »
Query: Hi doctor, I am suffering from an infection on my penis. I am using Clotrimazole cream over the infection. Once I miss applying cream a day, the penis gets infected with red patches, pus-filled boils and there is severe itching. My partner is not affected by any problem though we are sexually activ... Read Full »
Most Popular Articles
Do you have a question on Chemotherapy or Radiation Therapy?Ask a Doctor Online