About multiple myeloma
Multiple myeloma, sometimes known as just myeloma, cause normal plasma cells to turn into cancerous cells. Plasma cells secrete antibodies, also known as immunoglobulin, into the blood to help fight diseases and infections. Cancerous plasma cells secrete immunoglobulins as well, but they do not have any useful function and are named paraproteins. The type of paraproteins produced by the cancerous plasma cells determines the type of multiple myeloma the person has with the most common being immunoglobulin G (IgG) myeloma.
Multiple myeloma is often found in the spine, skull, shoulders, ribs and pelvis, where bone marrow is most active. It will rarely appear in the limbs.
There are two asymptomatic diseases which have a small chance of progressing into multiple myeloma. These include monoclonal gammopathy of undeterminate significance (MGUS) and smouldering myeloma. MGUS has about 1% chance of progressing into multiple myeloma every year and is non-cancerous. Smouldering myeloma is considered to be a very early phase of multiple myeloma that has about 10% chance of developing further per year. Both of these do not require treatment, but instead necessitate yearly check-ups.
- Diagnosis & Treatment
There is no known cause of multiple myeloma. It is not considered hereditary though in very rare cases it can appear more than once within a family. An increased risk may be attributed to high exposure to some chemicals, radiation, viruses and a weakened immune system.
The risk of developing multiple myeloma increases as age increases with the average age at diagnosis being 70 years old. Men are more likely to develop multiple myeloma than women.
There is some risk that those with MGUS or smouldering myeloma will progress to full multiple myeloma though it can take many years and may not progress at all.
Complications that can arise from multiple myeloma are summarised in “CRAB” - increased calcium levels in the blood, renal (kidney) problems due to paraprotein build up within the kidneys, anaemia due to lowered bone marrow productivity and bone changes such as osteoporosis. The lowered bone marrow productivity can also affect white blood cell production leading to a weakened immune system.
Symptoms of multiple myeloma are related to the decrease in healthy blood cells, the presence of paraproteins in the blood, and the corrosion of the healthy bone and bone marrow during the growth of the tumours. Some of the symptoms of multiple myeloma that can be seen are:
- Bone pain (most common symptom), easily fractured bones
- Frequent infections that may be hard to beat
- Fatigue, drowsiness, confusion, nausea
- Shortness of breath
- Kidney problems
- Easy to bruise, increased or heavy bleeding such as frequent nosebleeds
- Abnormal blood cell counts and/or proteins.
Diagnosis of multiple myeloma requires multiple tests and may sometimes be an incidental finding in a routine blood test. The tests can include:
- Blood tests: determines the full blood count (FBC) of white blood cells, red blood cells and platelets to see if the bone marrow is functioning properly. It will also be tested for paraproteins.
- Bone marrow biopsy: normally taken from the hip, the bone marrow contents are examined microscopically.
- Urine test: measures paraproteins in the urine
- Imaging tests and scans: x-rays and scans such as CT scans and MRI scans may be done to image the bone marrow and look for bone damage.
Treatment depends on how for the myeloma has progressed, age, and previous treatments taken. They aim to achieve remission or stabilise the disease and include:
- Plasma exchange
- Stem cell transplant
- Drugs for pain relief and to treat complications.
This content is provided for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. If you have any concerns or questions about your health, please consult a suitably qualified healthcare professional.