All you Need to Know About Multiple Myeloma

By Dr. Balkrishna Padate in Nanavati Max Institute of Cancer Care , Centre for Haematology & Bone Marrow Transplant

Apr 24 , 2023 | 2 min read

Multiple myeloma is a cancer of bone marrow that originates from a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than producing helpful antibodies, the cancer cells produce abnormal proteins that can cause kidney problems.

Signs and Symptoms of Multiple Myeloma

Myeloma patients can present with symptoms like bone pain, especially in spine or chest, generalised fatigue, nausea, constipation, loss of appetite, frequent infections, weight loss, weakness or numbness in legs. Persistent and recurrent low haemoglobin of no known cause as well as kidney failure of no known cause must be investigated for underlying multiple myeloma.

Diagnosis of Multiple Myeloma

Blood Tests

Laboratory analysis of blood may reveal abnormal M proteins produced by myeloma cells.

Additional, blood tests to examine kidney function, blood cell counts, calcium levels and uric acid levels are used for diagnosis of myeloma.

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Urine Tests

Analysis of urine may show presence of abnormal proteins, which are referred to as Bence Jones proteins produced detected in the urine.

Examination of Bone Marrow

Bone Marrow sample is collected with a long needle under local anaesthesia and is helpful in assessment of staging and also identification of type of disease.

Mention Imaging Tests

Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include X-rays, MRI, CT or positron emission tomography (PET) scan.

Complications of Multiple Myeloma

Frequent Infections: Myeloma cells inhibit the body's ability to fight infections.
Bone Problems: multiple myeloma can affect bones, leading to bone pain and fracture of bones and lytic lesions in the bones.
Reduced Kidney Function: Multiple myeloma can cause problems with kidney function, including kidney failure.
Low Red Blood Cell Count (Anaemia): As myeloma cells crowd out normal blood cells, multiple myeloma can cause anaemia and other blood problems.

Treatment of Multiple Myeloma

Targeted Therapy

Targeted drug treatment focuses specifically on the cancer cells and does not allow them to survive. Bortezomib (Velcade) is one of the targeted drugs. It is administered through a vein in the arm.

Biological Therapy

Biological therapy drugs use your body's immune system to fight myeloma cells. The drugs thalidomide, lenalidomide and pomalidomide enhance the immune system cells to identify and attack cancer cells.

Chemotherapy

Chemotherapy drugs kill fast growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a stem cell transplant / bone marrow transplant.

Corticosteroids

Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. Corticosteroids are used in combination with other medicines for treatment of Multiple Myeloma. Steroids can be taken in pill form or administered through a vein in the arm.

Stem Cell Transplantation

A Stem cell transplant / Bone marrow transplant is a procedure to replace the diseased bone marrow with healthy bone marrow. Before a stem cell transplant, stem cells are collected from the patient's own blood. A high dose of chemotherapy is given to destroy the diseased bone marrow, followed by infusion of collected stem cells which re-populates the bone marrow.

Radiation Therapy

This treatment uses beams of energy, such as X-rays, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that's causing pain or destroying a bone or putting pressure on vital structures.