Multiple Myeloma: Stages, Symptoms, Diagnosis, Treatment

Multiple myeloma is a type of blood cancer, which includes leukemia, lymphoma, etc.. In order to understand this condition, you have to know the following facts: your bone marrow is the site for producing blood cells. The bone marrow is like a factory that produces various of blood cells. After they have been produced, they would be released into the peripheral blood to fulfill their functions.

The multiple myeloma is caused by mutation of a kind of cell called plasma cell. However, the exact cause of the cell mutation is unknown. The mutated cells would proliferate and migrate to various body sites (especially bones) to produce various symptoms. In normal healthy individuals, the plasma cells function to produce antibodies that fight against infections. In patients with multiple myeloma, the aberrant plasma cells secrete aberrant antibodies.

Symptom

Symptoms of multiple myeloma are related to bone problems and the aberrant antibodies it produces.

A main symptom of multiple myeloma is bone pain. The bones frequently involved include spinal bones (back pain), ribs (chest pain), etc..

The aberrant antibodies it produces are highly toxic to your kidneys. Therefore elevated creatinine is commonly seen in patients with multiple myeloma. Also, the aberrant antibodies can not fight against infections, so you might get frequent infections.

Patients with multiple myeloma may also have some non-specific symptoms, such as mental fogginess, constipation, lack of appetite, etc..

Diagnosis

Bone marrow aspiration/biopsy: This procedure is almost done in every patient with or suspected with multiple myeloma. This would involve taking a small piece of your bone marrow for pathological examination.

Blood tests: Monoclonal protein (M protein) strongly suggests the presence of multiple myeloma.

Urine tests: The M protein could also be detected in the urine.

Imaging scans: X-ray or CT scans of the bones with pain are frequently done.

Stage

There are several staging system used. The International Staging System is a simple and widely used one. The stage of multiple myeloma depends on the 2 blood test parameters: β-2 microglobulin and albumin. The more advanced the stage is, the shorter the life expectancy of the patient.

Stage Serum β-2 microglobulin Albumin
I <3.5mg/L ≥3.5g/dL
II Neither stage I OR III
III ≥5.5mg/L  

Treatment

The stage of multiple myeoloma varies, but the treatment for it is all the same. It commonly includes medications and bone marrow transplant.

Medications

Certain medications could kill the aberrant plasma cells, such as bortezomib, carfilzomib and ixazomib. And some other drugs could boost your immune system to kill the aberrant plasma cells, including thalidomide and lenalidomide.

Corticosteroids, such as prednisone and dexamethasone, are also frequently used for treating multiple myeloma. In fact, the BD regimen (bortezomib+dexamethasone) is the classic treatment for multiple myeloma.

It is now considered that autologous stem cell transplant could cure some multiple myeloma. In this procedure, your doctor would harvest your stem cells from the bone marrow or peripheral blood before the transplantation. The cells are stored properly. Then your doctor would treat you with multiple rounds of high-dose chemotherapy, or total radiation to kill the cancer cells. It’s then followed by fusion of the previously harvested stem cells to rebuild your hematologic system.

An autologous transplant can make the myeloma go away for a time (even years), yet it doesn’t cure the cancer, and often the myeloma returns.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.