Multiple Myeloma

Multiple myeloma (MM) is a malignant bone marrow disorder that involves plasma cells growing without control. The abnormally high number of plasma cells can “crowd” out other types of cells you need to be healthy, such as red blood cells or platelets. At the same time, too much of the same immunoglobulin is produced, such as too much IgG or IgA. This is referred to as the monoclonal protein (M-protein).

Myeloma is fairly rare before age 40; most people are in their 60s when they are diagnosed. Given that the population is aging and patients are living longer, the prevalence of myeloma is increasing.

Causes of multiple myeloma

The precise causes of MM has not yet been established. Roles have been suggested for a variety of factors, including genetic causes, environmental or occupational causes, radiation, chronic inflammation, and infection.

Symptoms of multiple myeloma

Bone aches
Fractures
Anemia (low RBC count)
Weakness and fatigue
High levels of calcium in the blood which makes the patient feels fatigue, constipation, abdominal pain and mental fogginess or confusion
Others such as spinal cord compression, renal failure, infections

Diagnosis of multiple myeloma

Bone marrow aspirate and biopsy To check the number of plasma cells and to do genetic studies
Blood tests such as a complete blood count (CBC) test, kidney function test, calcium level test, serum protein electrophoresis, beta 2microglubulin, LDH and free light chain assay
24 hour urine collection to detect the Bence Jones protein
X-rays of the skull, long bones and the spine to detect typical bone lesions
MRI for patients with back pain or weakness in their lower limbs due to compression on the spinal cord. Other imaging techniques may also be used, such as a CT or PET scan.

Treatment of multiple myeloma at KHCC

It is difficult to achieve a cure for multiple myeloma but with treatment, many people can return to a semi-normal life. Immunomodulating and biological therapies are the most common types of treatment for multiple myeloma. Patients who do not display any symptoms are usually observed until symptoms develop. For patients who experience symptoms, steroids and radiation therapy can effectively control these symptoms. Another class of medications called bisphosphonates are used to help in restoring bone structure.

Autologous (patient's own cells) stem cell transplantation is a standard treatment option for patients under the age of 65 years, taking into consideration many other factors and the related risks and benefits.