Multiple Myeloma

Multiple myeloma, also known as myeloma, is a cancer that begins in the bone marrow that affects plasma cells. Healthy plasma cells are a type of white blood cell responsible for creating antibodies, which help protect the body from disease and infection. A multiple myeloma diagnosis indicates that at some point a group of these plasma cells began abnormally reproducing, which increases the level of abnormal proteins in circulating blood and reduces the space available in the bone marrow for healthy plasma cell production. As this process continues, multiple myeloma can negatively affect your bones, immune system, kidneys and red blood cell count. About 24,050 people in the United States are expected to be diagnosed with multiple myeloma in 20141.

Credit: Cancer Council Victoria

What are the different types of multiple myeloma?

The abnormal reproduction of plasma cells leads to abnormally high levels of certain abnormal proteins circulating in the blood. Read more about these proteins at:

What are some symptoms of multiple myeloma?

There are no specific symptoms that indicate multiple myeloma in its early stages. While symptoms may be present, they often overlap with other conditions. Some possible symptoms of multiple myeloma include:

  • Bone pain
  • Fatigue
  • Loss of appetite
  • Increased thirst
  • Increased urination
  • Restlessness
  • Difficulty thinking or confusion
  • Nausea
  • Vomiting
  • Infection (pneumonia, urinary tract infection, shingles)
  • Shortness of breath
  • Chest pain
  • Pain and numbness in the fingers and toes in cold weather
  • Neuropathy
  • Low blood counts
  • High blood calcium
  • Kidney problems

How is multiple myeloma diagnosed?

Bone marrow biopsies are the removal of a portion of bone marrow, and examination of the sample it under a microscope to detect if there are myeloma cells present and how many. The presence, type and count of multiple myeloma cells are determined by immunochemistry, flow cytometry, cytogenetics, fluorescent in situ hybridization tests.

Laboratory tests for multiple myeloma include complete blood counts, quantitative immunoglobins, electrophoresis, free light chains, Beta-2 microglobuin, and blood chemistry tests.

Imaging tests use x-rays, magnetic fields, or sound waves to create pictures of the inside of your body. For multiple myeloma, these tests include chest x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, positron emissions tomography (PET) scans, and echocardiograms.

What are the different stages of multiple myeloma?

Multiple Myeloma is staged using the Durie-Salmon staging system

What are the treatments for multiple myeloma?

This multiple myeloma treatment information does not outline the particular therapies a patient will receive. Rather, it provides general information about the typical multiple myeloma.

Primary treatment options:

  • Chemotherapy Stem Cell Transplants are often used together to treat multiple myeloma. Chemotherapy is used in high doses to kill a great amount of myeloma cells, but, in the process, it also kills healthy, blood producing bone marrow cells. Stem cell transplants counteract this damaging side effect of chemotherapy by regenerating damaged bone marrow and creating healthy blood cells.
  • Radiation therapy uses high-energy rays to kill cancer cells. Radiation may be used to treat damaged bone areas that have not responded to chemotherapy and are causing pain.

Secondary treatment options:

  • Biophosphonates help maintain bones strength by slowing down the bone weakening processes of multiple myeloma.
  • Biologic therapy uses proteins in the body to fight multiple myeloma cell production. It is often used to extend remission times after chemotherapy.

What are the risk factors of multiple myeloma?

There have been a few risk factors that researchers have identified, they are:

  • Age: The majority of cases of multiple myeloma are diagnosed in people over 50.
  • Gender: Men are at higher risk of developing MM than women.
  • African Ancestry: People of African descent are two times more likely to develop MM.
  • Plasma cell diseases: History of a monoclonal gammopathy of undetermined significance (MGUS) is correlated to an increased chance of developing multiple myeloma.
  • Obesity: is linked to higher incidence of Multiple Myeloma.
  • Chemical Exposure: Some studies are showing a link between the development of myeloma and smoking, radiation, or exposure to certain kinds of chemicals such as pesticides, fertilizers and Agent Orange

How is multiple myeloma prevented?

There are no known behavioral risk factors that are fully linked developing multiple myeloma. Therefore, preventative measures remain unknown.

Mikayla D. Williams , BS student, Nursing , The University of Arizona
Michael Principe, MA, Information Resources and Library Science , The University of Arizona
Works Cited: 
Leukemia and Lymphoma Society (2014). Multiple Myeloma.
Works Consulted: 
American Cancer Society (2014). Multiple Myeloma.
American Society of Clinical Oncology (2014). Multiple Myeloma.
International Myeloma Foundation (2014). About Myeloma.