Multiple myeloma is a cancer of the plasma cells (a type of white blood cells) of the bone marrow. Plasma cells are protein-producing cells that normally produce a variety of antibodies for our immune system. In multiple myeloma, the plasma cells become malignant and cancerous. These myeloma cells stop making different forms of the protein in response to the needs of the immune system and instead begin to produce an abnormal type of protein sometimes called a monoclonal or M protein. Multiple myeloma plasma cell populations accumulate in the bone marrow, and these collections of cells called plasmacytomas can destroy the hard outer covering of bone or the cortex that normally surrounds the marrow. These weakened bones show thinning of the bone, as seen in non-contagious osteoporosis or in perforated or lytic bone lesions. People often refer to multiple myeloma simply as myeloma. This disease usually occurs in middle-aged people.
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However, it can rarely occur in a child.
One type of myeloma-associated plasma cell neoplasm is called monoclonal gammopathy of undetermined significance (MGUS). In MGUS, medical professionals only find low levels of the M protein and people have no symptoms; MGUS often develops into multiple myeloma.
Plasma cell neoplasm is another name for multiple myeloma.
cause of Multiple myeloma
What triggers plasma cells in malignant multiple myeloma is unknown. cancerous
Myeloma plasma cells proliferate and crowd out normal plasma cells and can scar areas of bone. Proteins produced in large amounts can cause many of the symptoms of the disease by making the blood more viscous and depositing proteins in organs that can interfere with kidney, nerve, and immune system functions.
The exact cause of multiple myeloma is not known. But patients are more likely to be affected
• Over 65 years of age
• People of African-American descent
• Overweight or obese people
• family member with
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stages of multiple myeloma
There are four stages of multiple myeloma. While many health care professionals use different staging, these are the different stages cited by many physicians:
• Smoldering: Multiple myeloma without any symptoms
• Stage I: early disease with anemia, relatively low amounts of M protein and no
• Bone damage
• Stage II: Bone loss along with excess anemia and M protein
• Stage III: still high M protein, anemia, as well as signs of kidney damage
Because staging criteria vary according to different groups, some clinicians simply define an individual’s multiple myeloma without specifying a stage and simply estimate the prognosis for their patient.
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Symptoms of Multiple Myeloma
Myeloma patients may be asymptomatic with unexplained increase in protein
blood. With more advanced disease, some myeloma patients may have weakness due to anemia due to insufficient production of red blood cells, bone pain due to bone damage, and abnormal M proteins can accumulate and damage the kidneys. which can result in unexplained kidney damage of the patient. and reduced kidney function. Multiple myeloma cancer cells can occur inside or outside the bone marrow.
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Symptoms and signs of multiple myeloma
• Anemia
• is bleeding
• nerve damage
• bone tenderness or pain, including back pain
• Enlarged tongue
• Skin lesions
• Infection weakness, tiredness or fatigue
• Kidney failure and/or other end-organ damage • Compression of the spinal cord •
• Loss of appetite and weight loss
• Swelling of the feet
• Hypocalcemia
• Diagnosis of Multiple Myeloma
• The first sign of multiple myeloma is when a routine blood test shows abnormal amounts of protein in the bloodstream or abnormal stickiness of red blood cells, causing them to coagulate almost like coins, an abnormal formation for red blood cells. The health care professional will do a history and physical exam to look for signs and symptoms of multiple myeloma. If multiple myeloma is suspected, several studies help confirm the diagnosis.
These include bone marrow aspiration and biopsy, usually from the large bones of the pelvis. Cells obtained from the marrow are studied by a pathologist to determine whether there is one (plasmacytoma) or more (multiple myeloma) abnormal type or a number of cells.
• Medical professionals also study the bone marrow aspirate sample for more detailed information
• Characteristics such as the presence or absence of abnormal numbers or types of chromosomes (DNA) called cytogenetic testing.
Bone marrow biopsy can assess the concentration of cells in the marrow and the presence of abnormal invasive growth of cellular elements.
• Blood tests and urine tests can determine the levels and types of
The National Comprehensive Cancer Network (NCCN) recommends that health care professionals use the serum-free light chain assay and fluorescence in situ hybridization (FISH) test to further advance the diagnosis.
• Monoclonal protein is produced and if kidney damage occurs.
Identify multiple myeloma in patients
X-ray studies to identify skeletal lesions and MRI for spinal cord lesions in multiple myeloma.
Medical treatment for multiple myeloma
The therapy is decided based on the patient’s condition and the cancer management team,
Created with patient input. Treatment options often include a combination of drugs, some of which are given by medical professionals as pills and others by intravenous injection.
These include drugs that affect or control the immune system, steroids, and some oral or injectable chemotherapy drugs. These are usually used in combinations.
There may be a role for high-dose chemotherapy followed by the administration of bone marrow called stem cell transplantation. Several factors come into play in determining whether to perform this type of transplant. Other medical treatments may include steroids, bisphosphonate therapy, blood or platelet transfusions, plasmapheresis, and other combination therapies.
The stage of illness of the individual patient.
Radiation therapy can treat painful areas of bone loss. Surgeons can surgically repair broken bones in many cases.
Several drugs are used to treat multiple myeloma. Medical professionals often use
The following medicines in combination with dexamethasone,
• Bortezomib Velcade — protease inhibitor
• Lenalidomide (Revlimid) — immune cell modulator
• Melphalan (Alkeran) — alkylating agent that is toxic to myeloma cells
• Carfilzomib (Kyprolis) — a protease inhibitor commonly approved by the FDA for patients
• Those who have failed in previous treatments
• Daratumumab (Darzalex) — monoclonal antibody that can harm or kill many
• Myeloma cells (and others) that have the CD38 protein on their surface
• Elotuzumab (Amplicity) – a compound that activates the body’s natural killer cells
• Destroy multiple myeloma cells, usually in combination with Revlimid and Decadrone
• Ninlaro (ixazomib) — this proteasome inhibitor, Revlimid and . in combination
• Dexamethasone improves survival in some patients with multiple myeloma.
Hospitals provide the best multiple myeloma treatment in India, the fee for autologous stem cell transplant ranges between USD 15000 to USD 21000 depending on the disease condition and per person response to the treatment provided in the hospitals.