Multiple Myeloma: The Basics
Multiple myeloma (also called myeloma) is a cancer that affects the plasma cells, which are found in the blood. In myeloma, the plasma cells grow out of control and overcrowd the bone marrow where blood cells are made. This prevents normal production of other blood cells and keeps the immune system from working well.
Risk factors for developing multiple myeloma include: extensive exposure to radiation, chemical resins, organic solvents, pesticides, or herbicides, presence of Human Herpes virus 8, or a family history of myeloma.
There are no routine screening tests to find myeloma.
Signs and Symptoms of Multiple Myeloma
Sings and symptoms of multiple myeloma include:
- Bone pain and bone damage
- High calcium level in the blood, which causes increased urination and thirst, kidney stones, decreased appetite, restlessness and confusion
- Abnormal blood counts and increased blood thickness (detected with blood tests)
- Infections that don’t go away
- Plasmacytoma, which is a buildup of myeloma cells, forming a mass, that can occur in the skin, bones and brain
- Kidney failure
These can also be signs of other health issues. If you experience any of these symptoms, you should be evaluated promptly by a healthcare provider.
Diagnosis of Multiple Myeloma
When your healthcare provider suspects multiple myeloma, they will order further tests which may include: a series of blood tests, a 24-hour urine collection, bone marrow biopsy, and radiology tests, including a skeletal survey, X-rays, MRI, CT scan, and PET scan.
Staging Multiple Myeloma
Staging is a way to describe how much the myeloma has affected the body and to help guide treatment. There are two staging systems used in myeloma: The Durie-Salmon Criteria and The International Staging System. The Durie-Salmon Criteria is based on:
- Amount of abnormal monoclonal immunoglobulin in the blood/urine
- Blood calcium levels
- Bone damage as shown on x-ray
- Blood hemoglobin
It uses stages I-III and A or B, which represents kidney function.
The International Staging System also divides multiple myeloma into three stages, in this case, based on serum beta-2 microglobulin and serum albumin levels.
Treatments depends on how the disease is affecting the body, the patient’s age and current health. Common treatments include:
- Chemotherapy: Chemotherapy can be used at diagnosis, in high doses to prepare for a bone marrow or stem cell transplant, as maintenance after transplant, and to treat relapse.
- Stem Cell Transplant: For patients younger than 65, and in good health, a stem cell transplant is a typical treatment option.
- Targeted Therapy: These medications can be used with chemotherapy to treat patients over the age of 65 or who have other medical problems.
- Radiation Therapy: Radiation can be used to treat a plasmacytoma (a mass of myeloma cells) or areas of bone damage.
This article is a basic guide to multiple myeloma. You can learn more about multiple myeloma and treatment by using the links below.