What is multiple myeloma?
Multiple myeloma is a form of cancer that occurs due to abnormal and uncontrolled growth of plasma cells in the bone marrow. Some people with multiple myeloma, especially those with early stages of the condition, have no concerning signs or symptoms. When present, the most common symptom is anemia, which can be associated with fatigue and shortness of breath. Other features of the condition may include; multiple infections, abnormal bleeding, bone pain, weak and/or easily broken bones, and numbness and/or weakness of the arms and legs.[1][2][3]The exact underlying cause of multiple myeloma is currently unknown. Factors that are associated with an increased risk of developing multiple myeloma include increasing age, male sex, African American race, radiation exposure, a family history of the condition, obesity, and/or a personal history of monoclonal gammopathy of undetermined significance (MGUS).[1][2][4]Treatment varies based on many factors, but may include one or more of the following interventions: chemotherapy, corticosteroid medications, targeted therapy, stem cell transplant, biological therapy, radiation therapy, surgery and/or watchful waiting.[2][1][3]
What are the signs and symptoms of multiple myeloma?
In some cases, multiple myeloma is not associated with any signs and symptoms. When present, the most common symptom is anemia (low red blood cell count), which can be associated with fatigue, shortness of breath, and dizziness. Other features of the condition may include:[5][2][6]
- Bone pain
- Nausea
- Constipation
- Loss of appetite
- Frequent infections
- Weight loss
- Excessive thirst
- Weakness and/or numbness in the arms and legs
- Confusion
- Abnormal bleeding
- Weak bones that may break easily
- Difficulty breathing
What causes multiple myeloma?
Although the exact underlying cause of multiple myeloma is poorly understood, the specific symptoms of the condition result from abnormal and excessive growth of plasma cells in the bone marrow. Plasma cells help the body fight infection by producing proteins called antibodies. In people with multiple myeloma, excess plasma cells form tumors in the bone, causing bones to become weak and easily broken. The abnormal growth of plasma cells also makes it more difficult for the bone marrow to make healthy blood cells and platelets. The plasma cells produced in multiple myeloma produce abnormal antibodies that the immune system is unable to use. These abnormal antibodies build up in the body and cause a variety of problems.[5][2][4]
Factors that are associated with an increased risk of developing multiple myeloma include increasing age, male sex, African American race, radiation exposure, a family history of the condition, obesity, and/or a personal history of monoclonal gammopathy of undetermined significance (MGUS).[1][2][4]
How is multiple myeloma diagnosed?
A diagnosis of multiple myeloma may be suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This may include:[1][3][2]
- Specialized blood tests including immunoglobulin studies,complete blood count with differential, and blood chemistry studies
- Urine tests such as immunoglobulin studies and a twenty-four-hour urine test
- Bone marrow aspiration and biopsy
- Imaging studies such as an X-ray of the bones (skeletal bone survey), MRI, CT scan, and/or PET scan
The American Cancer Society offers more information regarding the diagnosis of multiple myeloma, including a summary of the many tests that may be recommended.
Some affected people may have no suspicious signs or symptoms of multiple myeloma, especially in the early stages of the condition. In these cases, multiple myeloma is sometimes diagnosed by chance when a blood test or urine test is ordered to investigate another condition.[3]
How might multiple myeloma be treated?
The treatment of multiple myeloma varies based on many factors including the age and general health of the affected person the associated signs and symptoms and the severity of the condition. In general, one or more of the following interventions may be used to treat multiple myeloma:[2][1][3]
- Chemotherapy
- Corticosteroid medications
- Targeted therapy
- Stem cell transplant
- Biological therapy
- Radiation therapy
- Surgery
- Watchful waiting
The National Cancer Institute offers information regarding the management of multiple myeloma, including more specific information regarding the treatments outlined above.
What is the long-term outlook for people with multiple myeloma?
The long-term outlook (prognosis) for people with multiple myeloma can be difficult to predict as some cases progress rapidly despite treatment, while others remain stable without therapy for a number of years. However, some general patterns have been observed. For example, prognosis appears to vary based on the affected person’s age and the stage of the condition at the time of diagnosis. In general, survival is higher in younger people and lower in the elderly. Other factors that can be associated with a poor prognosis include a high tumor burden and kidney damage.[5][1][7]
Infections are an important cause of early death among people with multiple myeloma. In fact, studies show that the risk of both bacterial infections and viral infections is approximately seven times higher in people affected by the condition.[1]
References
- Dhaval Shah, MD. Multiple Myeloma.Medscape Reference. February 2016; http://emedicine.medscape.com/article/204369-overview.
- Multiple Myeloma.American Cancer Society. January 2016; http://www.cancer.org/Cancer/MultipleMyeloma/DetailedGuide/index.
- Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment.National Cancer Institute. October 2015; http://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq.
- Multiple Myeloma.Mayo Clinic. December 2015; http://www.mayoclinic.org/diseases-conditions/multiple-myeloma/basics/de….
- Multiple Myeloma.MedlinePlus. February 2015; http://www.nlm.nih.gov/medlineplus/ency/article/000583.htm.
- S Vincent Rajkumar, MD. Clinical features, laboratory manifestations, and diagnosis of multiple myeloma. UpToDate. January 2016
- S Vincent Rajkumar, MD. Staging and prognostic studies in multiple myeloma. UpToDate. January 2016
Source:
https://rarediseases.info.nih.gov/diseases/7108/multiple-myeloma/cases/3…
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