Multiple Myeloma
What Is Multiple Myeloma
Multiple myeloma is a form of cancer resulting from the overproduction of a single clone of plasma cells, a type of white blood cell produced in the bone marrow. Plasma cells proliferate in the marrow, infiltrate adjacent bone tissue, and may spread throughout the skeleton, resulting in bone pain and fractures of fragile, brittle bones. (Some patients develop a single plasma cell tumor, known as a plasmacytoma, in a bone or elsewhere.) Proliferation of plasma cells interferes with the formation of red cells (causing anemia), platelets (increasing the risk of bleeding), and white cells (increasing susceptibility to infection). Myeloma also involves the production of large amounts of a type of immunoglobulin (antibody) termed myeloma protein. Multiple myeloma most often affects those over age 60 and without treatment is usually fatal within two years of diagnosis. Although there usually is no cure, treatment can prolong life and improve the patient's quality of life.
Symptoms of Multiple Myeloma
- Bone pain, especially along the spine, that
worsens with movement.
- Unexplained bone fractures. The collapse of
affected vertebrae may cause loss of height
and compression of the spinal cord, which
may result in the inability to urinate and pain
or paralysis of the legs.
- Fatigue, paleness (pallor), and shortness of
breath, due to associated anemia.
- Frequent bacterial infections, due to a weakened
immune system.
- Increased bruising and bleeding (for example,
from the nose or gums).
- Headache and visual disturbances.
- Symptoms of hypercalcemia (high blood levels
of calcium), which include generalized discomfort;
muscle aches or weakness; arthritic
joint pain; heartbeat irregularities; constipation,
nausea, vomiting, and loss of appetite;
and fatigue, lethargy, confusion, depression,
psychosis, or other mental changes. Untreated,
the hypercalcemia may result in coma and
death.
- Symptoms of kidney failure (see Renal Failure,
Acute).
What Causes Multiple Myeloma
- The cause of multiple myeloma is unknown, although genetic factors may play a role.
- Risk increases with age and exposure to radiation.
Prevention of Multiple Myeloma
- Try to minimize exposure to radiation.
Diagnosis of Multiple Myeloma
- Patient history and physical examination.
- Blood tests for myeloma protein, calcium levels, and measurement of the number of red cells, platelets, and white cells.
- Urine examination for myeloma protein.
- Bone marrow aspiration or biopsy, usually taken from the hip.
- X- rays of the skull, chest, spine, or other pain sites.
How To Treat Multiple Myeloma
- Stay as active as possible to maintain bone strength. Because bones may be brittle, your doctor or physical therapist should supervise any program of activity.
- A combination of chemotherapeutic agents, often including corticosteroids (usually prednisone), is used to destroy cancerous cells.
- Radiation therapy is effective for plasmacytomas.
- Radiation is also used to relieve bone pain and spinal cord compression.
- Surgery may be necessary to repair bone fractures.
- Plasmapheresis, a procedure that filters excess waste products out of the blood artificially, may be performed in the event of an increase in the blood viscosity due to excess protein, produced by myeloma cells (hyperviscosity syndrome).
- Analgesics are administered to reduce pain.
- Antibiotics may be prescribed to treat associated bacterial infections.
When To Call A Doctor
- Call a doctor for bone pain or for the emergency symptoms of hypercalcemia or kidney failure.
For more information on Multiple Myeloma and related conditions, click on this link -- Johns Hopkins Health Alerts: Healthy Living
