Multiple myeloma is a cancer that develops in a type of white blood cell called a plasma cell. Healthy plasma cells help fight infection by making proteins called antibodies. Antibodies find and attack germs.
In multiple myeloma, cancerous plasma cells form in the bone marrow. Bone marrow is the soft substance inside bones where blood cells are made. In the bone marrow, cancer cells crowd out healthy blood cells. Instead of making helpful antibodies, cancer cells make proteins that don’t work properly. This leads to complications of multiple myeloma.
Treatment for multiple myeloma is not always needed right away. If multiple myeloma is growing slowly and not causing symptoms, a closer look may be the first step. For people with multiple myeloma who need treatment, there are several ways to help control the disease.
Symptoms
Early in multiple myeloma, there may be no symptoms. When signs and symptoms appear, they may include:
- Bone pain, especially in the spine, chest or hips.
- Nausea
- Constipation.
- Loss of appetite.
- Mental fog or confusion.
- Fatigue
- Infections.
- Weight loss.
- weakness
- Thirst
- Frequent need to urinate.
Reasons/Causes
It is not clear what causes myeloma.
Multiple myeloma begins in a plasma cell in the bone marrow. Bone marrow is the soft substance inside bones where blood cells are made. Something happens that turns a plasma cell into a cancerous myeloma cell. The myeloma cell rapidly begins to make many more myeloma cells.
Healthy cells grow at a fixed rate and die at a fixed time. Cancer cells do not follow these rules. They make many extra cells. Cells survive when healthy cells die. In myeloma, cancer cells form in the bone marrow and crowd out healthy blood cells. This leads to fatigue and an inability to fight infection.
Myeloma cells continue to try to make antibodies, just as healthy plasma cells do. However, the body cannot use these antibodies, called monoclonal proteins or M proteins. Instead, M proteins build up in the body and cause problems, such as kidney damage. Myeloma cells can damage bones and increase the risk of bone fractures.
A connection with MGUS
Multiple myeloma begins as a condition called monoclonal gammopathy of undetermined significance, also known as MGUS. In MGUS, the level of M protein in the blood is low. M proteins do not harm the body.
Risk factors
Components that increment the hazard of different myeloma incorporate:
Getting old; most people are diagnosed in their late 60s.
Being a man Men are more likely to develop this disease than women.
To be black; Black people are more likely to develop multiple myeloma than people of other races.
Having a family history of different myeloma; having a kin or parent with different myeloma increases the chance of the disease. Different myeloma begins as MGUS, so having these condition increments the hazard.
There is no way to prevent multiple myeloma. If you get multiple myeloma, nothing you did caused it.
Complications
Complications of multiple myeloma include:
Infections Having multiple myelomas reduces the body’s ability to fight infection.
Bone problems Multiple myeloma can cause bone pain, thinning of the bones, and broken bones.
Kidney problems Multiple myeloma can cause problems with the kidneys. It can lead to kidney failure.
Sometimes a healthcare professional discovers multiple myeloma during a blood test for another condition. Other times your symptoms may lead your healthcare professional to test for multiple myeloma.
Tests and procedures for diagnosing multiple myeloma include:
Blood tests M proteins made by myeloma cells may show up in a blood sample. Blood tests may also detect another protein in myeloma cells, called beta-2-microglobulin.
Other blood tests give your healthcare team clues about your diagnosis. These tests may include tests that look at kidney function, blood cell counts, calcium levels, and uric acid levels.
Urine tests M proteins can be detected in urine samples. The protein in urine is called Bence-Jones protein.
Bone marrow test Bone marrow biopsy and bone marrow aspiration are used to collect bone marrow samples for testing. Bone marrow consists of a solid and a liquid part. In a bone marrow biopsy, a needle is used to collect a small amount of solid tissue. In a bone marrow aspiration, a needle is used to draw a sample of fluid. Samples are usually taken from the hip bone.
The samples go to the laboratory for testing. In the laboratory, tests look for myeloma cells. Other special tests give your healthcare team more information about your myeloma cells. For example, a fluorescence in situ hybridization test looks for changes in cells’ genetic material, called DNA.
Imaging tests imaging tests can show bone problems associated with multiple myeloma. Tests may include X-rays, MRI scans, CT scans, or positron emission tomography scans, also known as PET scans.
Treatments for myeloma
Treatment may include:
Targeted therapy Targeted therapy uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, targeted therapies can cause cancer cells to die.
Immunotherapy is a treatment with drugs that help the body’s immune system kill cancer cells. The immune system fights diseases by attacking germs and other cells that shouldn’t be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps immune system cells find and kill cancer cells.
CAR-T cell therapy chimeric antigen receptor T cell therapy, also called CAR-T cell therapy, trains your immune system cells to fight multiple myeloma. This treatment starts by removing some white blood cells, including T cells, from your blood. The cells are sent to a laboratory. In the laboratory, cells are treated to make special receptors. The receptors help cells recognize markers on the surface of myeloma cells.
The cells are then put back into your body. They can now find and destroy multiple myeloma cells.
Chemotherapy uses strong drugs to kill cancer cells. The drugs kill rapidly growing cells, including myeloma cells.
Corticosteroids Corticosteroid medications help control swelling and inflammation in the body, called inflammation. They also work against myeloma cells.
Bone marrow transplant a bone marrow transplant, also called a stem cell transplant, replaces diseased bone marrow with healthy bone marrow.