Understanding multiple myeloma
There are many paths forward from a multiple myeloma diagnosis. Multiple myeloma can be a highly manageable disease. The MMRF champions advancement of multiple myeloma therapies, funding the most promising treatments for this rare form of blood cancer.
What is multiple myeloma?
Multiple myeloma is a type of blood cancer that affects plasma cells. In multiple myeloma, malignant plasma cells accumulate in bone marrow — the soft, spongy tissue at the center of your bones — crowding out the normal plasma cells that help fight infection. These malignant plasma cells then produce an abnormal antibody called M protein, which offers no benefit to the body and may cause tumors, kidney damage, bone destruction and impaired immune function. The hallmark characteristic of multiple myeloma is a high level of M protein in the blood.
How does multiple myeloma start?
Multiple myeloma is a blood cancer that develops in the bone marrow, the soft spongy tissue found in the center of many bones. This is where normal blood cells grow. In healthy bone marrow, there are normal plasma cells that make antibodies to protect your body from infection. In multiple myeloma, plasma cells are transformed into cancerous multiple myeloma cells, which grow out of control and produce large amounts of a single abnormal antibody called M protein. As the cancerous cells multiply, there is less space in the bone marrow for normal blood cells, resulting in decreased numbers of red blood cells, white blood cells and platelets. The myeloma cells may activate other cells in the marrow that can damage your bones.
How does this affect the body?
Decreased blood cell numbers can cause anemia, excessive bleeding and decreased ability to fight infection. The buildup of M protein in the blood and urine can damage the kidneys and other organs. Bone damage can cause bone pain and osteolytic lesions, which are weakened spots on bones. This bone destruction increases the risk of fractures, and can also lead to a serious condition called hypercalcemia (increased levels of calcium in the blood).
Causes and increased risk factors
Researchers have made advancements in understanding how multiple myeloma develops, but the exact cause has not yet been identified. Like all cancers, multiple myeloma is heterogeneous, meaning each case is unique. The genetic mutations that cause multiple myeloma are different from person to person. There are some specific mutations that have been identified as genetic risk factors, but multiple myeloma is not thought to be a hereditary disease. Increased incidence of multiple myeloma has been found in males, African Americans and people over the age of 45. Keep in mind these factors have not been proven to cause multiple myeloma, and new studies regularly demonstrate new findings that help us identify risk factors and work towards a cure.
Multiple myeloma in Black patients
Multiple myeloma is twice as common in the Black community compared to other ethnicities, and is twice as deadly in Black patients compared to white patients. Additionally, the conditions associated with the development of myeloma (including monoclonal gammopathy of undetermined significance, or MGUS) are seen frequently in Black patients.
Adapted with permission from DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 1997
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Each case is unique
It can be difficult to diagnose multiple myeloma. Symptoms may be vague or appear similar to other conditions, and symptoms often vary from person to person. There are a number of tests that help your doctor form an accurate diagnosis — blood and urine tests, bone marrow biopsy, imaging, scans, X-rays and genome sequencing can provide critical information in determining the extent of your disease.
The prognosis of multiple myeloma is determined by many factors — symptoms, age, your overall health, staging and other circumstances and prognostic indicators are all significant in predicting the course of your disease. Prognostic indicators may include blood tests, bone marrow tests, urine tests, chromosome analysis and more, which indicate bodily values that aid in prognosis. These factors help doctors develop the most effective treatment plan for your disease.
There is no cure for multiple myeloma; however, there are many treatment options to manage the disease that can potentially lead to a symptom-free life. You and your doctor will determine a personalized treatment plan that may include drug therapies, stem cell transplants, clinical trials, experimental therapies and supportive care. Treatment will be designed around the specifics of your disease and the effects it has on your body. Treatments are constantly advancing — there are many promising new therapies under investigation right now.
Symptoms and side effects
There are many ways to manage symptoms and side effects resulting from multiple myeloma. It’s important to discuss the details of your experience with your doctor to determine what additional support is needed. Learn about some common changes and issues that can arise in people with multiple myeloma and how they might be mitigated.