All you Need to Know About Multiple Myeloma

By Dr. Balkrishna Padate in Centre for Haematology & Bone Marrow Transplant

Apr 24 , 2023 | 2 min read

What Is Multiple Myeloma?

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 an 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 producing 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 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 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 Myeloma. Steroids can be taken in pill form or administered through a vein in arm.

Stem Cell Transplantation: A stem cell 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. 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.

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