What is multiple myeloma?
Multiple myeloma is a cancer of the plasma cells. The plasma cells are a type of white blood cell present in the bone marrow. Plasma cells are part of the immune system and help fight against infections by producing antibodies that recognize and attack microorganisms. In multiple myeloma, cancer cells accumulate in the bone marrow and replace healthy blood cells. The cancerous plasma cells multiply rapidly and have definite bodily functions. Instead of producing beneficial antibodies, the cancer cells produce abnormal proteins called monoclonal protein or M protein, which cause complications. Multiple myeloma can eventually damage the bones, immune system, kidneys, and red blood cells. Initially, the symptoms may be generalized and nonspecific, such as loss of appetite, bone pain, and fever. Sometimes, a fracture of a bone on a minor fall or a spine fracture without any history of trauma may lead to the diagnosis of multiple myeloma. Multiple myeloma is the second most common type of blood cancer after leukemia. Multiple myeloma is considered treatable but is generally incurable and hence may be called chronic.
What causes multiple myeloma?
The exact cause of multiple myeloma is not known, but certain factors can increase the risk of multiple myeloma:
- Increasing age: The risk of multiple myeloma increases after the age of 60 years.
- Male sex
- Black race
- Family history of multiple myeloma
- Personal history of a monoclonal gammopathy of undetermined significance (MGUS): Multiple myeloma can have a relatively benign condition called MGUS that is characterized by elevated levels of an abnormal protein called M protein, same as in multiple myeloma.
What are the stages of multiple myeloma?
It’s important to remember that the outlook for everyone with multiple myeloma is different. Your treatment options and the general state depend on various factors. Most doctors divide multiple myeloma into four stages:
Smoldering stage: Myeloma that doesn’t present with active symptoms is called the “smoldering stage.” It may be undetectable in the blood in this stage.
Stage 2: A moderate number of myeloma cells are present. Hemoglobin levels drop further. Monoclonal immunoglobulin and blood calcium levels may increase. X-rays may show several areas of bone damage.
Stage 3: This is the final stage of multiple myeloma. A high number of myeloma cells are present. The hemoglobin level drops below 8.5 grams per deciliter. Blood calcium levels are high. There are multiple areas of bone destruction due to cancer on the X-ray.
What are the signs and symptoms of multiple myeloma?
Common signs and symptoms include:
How is multiple myeloma treated?
In the absence of symptoms (smoldering multiple myeloma):
No treatment is required at this stage. Regular follow-up is advised to monitor the progress of the disease.
In the presence of symptoms:
Treatment options for multiple myeloma depend on the stage and severity of the disease. A combination of more than one treatment modality may be advised. Treatment options include:
- Targeted therapy: Targeted drug treatment focuses on specific abnormal proteins within cancer cells. These drugs bind to these proteins and kill the cancer cells. They may be administered intravenously or orally.
- Biological therapy: They stimulate the immune system cells to identify and attack cancer cells. These medications are usually taken orally.
- Chemotherapy: Chemotherapy drugs kill fast-growing cells, including myeloma cells. They may be administered intravenously or orally.
- Corticosteroids: They suppress the immune system and reduce inflammation in the body. A corticosteroid may be administered orally or intravenously.
- Bone marrow transplant: A bone marrow transplant, also known as a stem cell transplant, is a minimally invasive procedure to replace the diseased bone marrow with healthy bone marrow.
- Radiation therapy: This treatment uses beams of radiation energy, such as X-rays, to target and kill myeloma cells.
What is the prognosis of multiple myeloma?
The prognosis of multiple myeloma depends on age. Younger patients usually do better than older patients. Other underlying medical conditions may also affect the prognosis. Some may be asymptomatic for a long time, with a slow progression of cancer. Patients who respond well to initial treatment and experience complete remission (symptom-free periods) have a better prognosis. After treatment, regular follow-up testing and disease management care is required. Multiple myeloma is considered treatable cancer but is generally incurable and hence may be referred to as chronic.
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Blood Cancer TypesTypes of blood cancers include leukemia, lymphomas, multiple myelomas, and others discussed in this slideshow. Symptoms may include fever, night sweats, fatigue, and other symptoms. Blood cancer treatment depends on the type of cancer and other factors. Blood tests for cancer as well as imaging tests and needle biopsy may help diagnose the condition.
Darzalex Faspro (daratumumab and hyaluronidase-fihj)Darzalex Faspro (daratumumab and hyaluronidase-fihj) is a prescription medicine used to treat adults with multiple myeloma, which may be used alone or in combination with other medications. Serious side effects of Darzalex Faspro serious allergic reactions include serious allergic reactions, injection site reactions, decreases in blood cell counts, and changes in blood tests.
Hemady (dexamethasone)Hemady (dexamethasone) tablets is a corticosteroid indicated in combination with other anti-myeloma products for the treatment of adults with multiple myeloma. Common side effects of Hemady include allergic reactions, vision changes, heart problems, acne, thin fragile skin, thinning scalp hair, hives, menstrual irregularities, fluid retention, weight gain, bloating, and others.
How Long a Person Can Live With Multiple Myeloma?Since 2000, the percentage of patients living five years after diagnosis has been on the rise. With improved treatment, survival results are likely to be better. The median survival rates of multiple myeloma are 62 months for Stage I, 42 months for Stage II, and 29 months for Stage III, according to the American Cancer Society.
ibrutinibIbrutinib is a novel targeted therapy for certain cancers of white blood cells (Mantle cell lymphoma [MCL], chronic lymphocytic leukemia [CLL]/small lymphocytic lymphoma [SLL], Waldenstrom’s macroglobulinemia [WM], marginal zone lymphoma [MZL]) in adults and is also used for the treatment of chronic graft versus host disease in adult and pediatric patients. Ibrutinib can cause fetal harm. Do not take if pregnant or breastfeeding. Common side effects of ibrutinib include major hemorrhage, gastrointestinal hemorrhage, postprocedural hemorrhage, blood in urine (hematuria), bruising, round pin-point spots on skin from bleeding (petechiae), blood disorders, and others.
Is Multiple Myeloma Genetic or Hereditary?Multiple myeloma is a cancer of the white blood cells, also called plasma cells. Multiple myeloma is linked to specific gene mutations.
Multiple MyelomaMultiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
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pembrolizumabPembrolizumab is a medication used to treat many cancers as a targeted therapy that does not directly kill cancer cells but alters a specific cell mechanism that promotes cancer growth and spread. Common side effects of pembrolizumab include fatigue, fever, pain, headache, peripheral nerve damage (neuropathy), musculoskeletal pain, joint pain (arthralgia), muscle pain (myalgia), back pain, weakness (asthenia), neck pain, muscle inflammation (myositis), joint inflammation (arthritis), decreased appetite, diarrhea, constipation, abdominal pain, nausea, vomiting, swallowing difficulties (dysphagia), colon inflammation (colitis), and others. Do not take if pregnant or breastfeeding.
Pepaxto (melphalan flufenamide)Pepaxto is a prescription medicine used in combination with the medicine dexamethasone to treat adults with multiple myeloma who did not respond to or stopped responding to at least four prior medicines including at least one proteasome inhibitor, one immunomodulatory agent and one CD38-directed antibody. Serious side effects of Pepaxto include low blood cell counts, infections, and secondary cancers.
Pomalyst (pomalidomide)Pomalyst is a prescription medicine used to treat adults with multiple myeloma, AIDS-related Kaposi sarcoma (KS), and non-AIDS-related Kaposi sarcoma (KS). Serious side effects include severe birth defects and miscarriage when taken in pregnancy, venous and arterial thromboembolism, low white blood cells (neutropenia), low platelets (thrombocytopenia), low red blood cells (anemia), severe liver problems, and Severe allergic reactions and severe skin reactions.
Xpovio (selinexor)Xpovio is a prescription medicine used in combination with dexamethasone to treat adults with multiple myeloma (MM), and to treat adults with certain types of diffuse large B-cell lymphoma (DLBCL). Xpovio can cause serious side effects, including nausea and vomiting, diarrhea, loss of appetite and weight loss, decreased sodium levels in your blood, serious infections, and neurologic side effects.