Multiple Myeloma

Multiple myeloma is a form of bone marrow cancer

Bone marrow is the spongy tissue in the center of bones responsible for producing blood cells. Cancer affects plasma cells (a type of blood cell) in the bone marrow, which is an important part of the immune system. Typically, myeloma does not take the form of a tumor; the myeloma cells divide and spread within the bone marrow.

Myeloma often spreads to various parts of the body where bone marrow is present, hence its name. Areas of spread may include:

• Spinal bones;
• Skull;
• Pelvic bone;
• Ribs;
• Areas around the shoulders and thighs;
• Sometimes upper and lower extremities.

In the early stages, multiple myeloma may be asymptomatic and/or masked by symptoms resembling various other diseases. 

Main Symptoms of Multiple Myeloma

Bone Pain

Pain can be a symptom of bone disease, which often occurs in multiple myeloma. The lower back, ribs, and thighs are most commonly affected. The pain is often persistent and described as dull, intensifying with movement.

Bone Fractures

Spontaneous fractures of the spine and ribs often develop, which is a characteristic feature of myeloma. Fractures can occur with minimal stress, trauma, or strain. Vertebral fractures are characterized by the collapse of spinal segments, accompanied by pain, and sometimes spinal cord compression.

Fatigue

Patients with multiple myeloma often experience chronic, debilitating fatigue, which may be a consequence of the underlying disease or its complications.

Anemia

Anemia is a deficiency of red blood cells. Anemia can be caused by myeloma itself or as a side effect of its treatment.

Reduced Immunity

People with myeloma are particularly susceptible to infections. This is because the disease affects the immune system, the body’s natural defense against infections and diseases.

Decreased Platelet Count (Blood Clotting Cells):

Patients with myeloma often experience bruising and bleeding as plasma cells in the bone marrow (myeloma tumor cells) proliferate and interfere with the normal functioning of the bone marrow.

Hypercalcemia

Hypercalcemia is a condition where the calcium levels in the blood are too high. It can develop in patients with myeloma because bone disease leads to the release of large amounts of calcium from damaged bones.

Kidney Damage

Kidney damage can develop in people with myeloma for various reasons. The abnormal protein produced by myeloma cells can cause kidney damage and other complications, such as hypercalcemia and dehydration.

The reason why plasma cells in the bone marrow become malignant is unknown, but researches indicate that several factors may increase the likelihood of developing multiple myeloma. These factors include:

• Family history of myeloma;
• Weakening of the immune system due to immunosuppressants, AIDS, or HIV;
• Excess weight or obesity, etc.

When to apply for a doctor

Make sure to consult a doctor if you experience the following symptoms:

• Unexplained fatigue lasting more than 2 weeks;
• Changes in the results of a complete blood count;
• Prolonged unexplained bone pain, especially in the ribs or lower back, not relieved by symptomatic pain reliever;
• Unexplained weight loss;
• Difficulty walking and/or moving;
• Decreased urine output;
• Weakness, numbness, or tingling in the extremities;
• Incontinence of urine or stool, etc.

While these symptoms may not always be caused by multiple myeloma, they should be studied by a doctor.

Diagnosis of Multiple Myeloma

Blood Tests

Blood tests can aid in diagnosing multiple myeloma.

This includes an increase in the erythrocyte sedimentation rate (ESR), or the levels of total protein and creatinine.

Urine Analysis

Urine analysis helps check for the presence of proteins produced by abnormal tumor cells. These abnormal proteins are called monoclonal light chains and are referred to as Bence Jones proteins.

Intensive Treatment                          

Intensive treatment includes the use of high doses of chemotherapy to destroy a large number of myeloma cells, extending remission. Autologous stem cell transplantation reinforces the results. Following transplantation, patients receive specific medications as protective therapy.