Multiple Myeloma
Multiple myeloma is a cancer of the blood that is under-recognised and currently has no known cure. In multiple myeloma, white blood cells called plasma cells, responsible for the production of antibodies (proteins which fight infection) are over produced in the bone marrow - the tissue inside the bone which manufactures all blood cells.
The abnormal plasma cells that cause myeloma are called myeloma cells and the over production of these defective cells causes:
- Increased production of an abnormal antibody, called M-protein (or paraprotein),
- Decreased production of normal red and white blood cells, and
- The growth of myeloma tumors that spread to 'multiple' sites.
This is why myeloma is often referred to as multiple myeloma.
What causes multiple myeloma?
The causes of multiple myeloma are not known for certain, but possible associations have been found between myeloma and exposure to certain chemicals found in herbicides and pesticides etc.
A weakened immune system, exposure to radiation and viruses are also thought to be important trigger factors.
What are the symptoms of multiple myeloma?
Some patients with multiple myeloma present with few (often non specific symptoms) or no symptoms at all in the early stages of disease, which makes early diagnosis very difficult. In other patients, it may cause vague symptoms that at first appear to be due to other diseases. Abnormalities caused by multiple myeloma may be accidentally identified by blood tests being carried out for other clinical reasons.
The most common symptoms at presentation are outlined below:
- Bone pain - the middle or lower back, the rib cage and the hips are most frequently affected places;
- Bone fracture - the bones that most commonly break are the spine and the ribs, and breaks can occur with only minor pressure or injury;
- Fatigue caused by the disease itself and the complications of the disease;
- Anaemia can occur as a result of the disease itself;
- Infections more common in people with multiple myeloma because the disease interferes with your immune system;
- Kidney problems - the abnormal protein produced by the myeloma cells, dehydration and the high level of calcium in the blood can damage the kidney;
- Hypercalcaemia due to high levels of calcium in the blood which is released from the affected bones. Symptoms of hypercalcaemia include thirst, nausea, vomiting, confusion and constipation.
Can multiple myeloma be treated?
Although there is no known cure for multiple myeloma, there are treatments available that may help reduce the symptoms and improve a patient's quality of life. Unfortunately, generally, survival has not improved significantly in the last 30 years. Following are the treatments most commonly used for patients with multiple myeloma.
- Conventional chemotherapy. Chemotherapy means treating the disease with potent medicines that are intended to kill the cancer cells. In myeloma, this is one of the best ways of reducing the amount of disease in the bone marrow. Some chemotherapy medicines can be taken by mouth (in tablet form) and others are given as an infusion into the vein.
- High-dose chemotherapy with stem cell transplantation. This involves giving high dose chemotherapy that destroys the myeloma cells as well as the patient's healthy bone marrow and then replacing this with a transfusion of stem cells from the patient's own blood or from a donor.
- Other medicine treatments. The rate of relapse is high, as small numbers of myeloma cells remain despite standard chemotherapeutic approaches. When the multiple myeloma recurs, the cancer is often more aggressive, and does not respond to standard first-line therapies.
- Medications may be used alone or in combination with standard chemotherapy as a further treatment option in multiple myeloma.
For more information see your Doctor or Healthcare Professional.
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