Published on Dec 09, 2019 and last reviewed on Jan 10, 2020 - 4 min read
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!
Query: Hello doctor, I am asking this question on behalf of my dad, who is 60 years old, 5 feet 9 inches, and 173 lbs. He was recently diagnosed with stage three chronic kidney disease. He also recently received an abnormal result on a serum immunofixation test, which I know can be an indicator of multiple... Read Full »
Query: Hi doctor, I recently had a serum PEL IFE with a free light chain analysis. PEL and IFE were normal, but elevated kappa 39.86 mg/L and lambda 19 mg/L with the ratio of 2:1. The test was done due to persistent and worsening polyneuropathy. Currently, I am having confusion and significant short-term m... Read Full »
Query: Hello doctor, I am writing this letter for my mother-in-law. She is 65 years old and seems to be healthy. Recently she was suffering ill (fever, sleepless at night, body pain, etc.) thus visited a doctor (physician). After a physical examination and studying certain blood tests (that he was suggest... Read Full »
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