Medically Reviewed by Dr. K on 20 May 2022
Table of Contents:
- Multiple Myeloma
- Causes And Risk Factors
- Stem Cell Transplant
- Related Health Issues
- Questions to Ask Your Doctor
When plasma cells, which are white blood cells that fight pathogens, grow out of control, blood cancer develops. They're found in the spongy tissue within some of the larger bones, called marrow. Myeloma cells, which are abnormal plasma cells, may often form a single tumour. This is referred to as a solitary plasmacytoma. Multiple myeloma is when you have more than one of these tumours.
Causes And Risk Factors
Multiple myeloma, like many cancers, has no clear cause. However, there are a few factors that can increase your risks. The majority of those who have it are over the age of 65. It affects twice as many African-Americans as it does Caucasians, and men are more likely to be affected than women. You're more likely to have it if there is a family history of the disease as well.
You may be wondering if there was something you could have done differently to prevent this cancer. It is not caused by lifestyle factors, and it is not detectable by early screening tests. Multiple myeloma is notoriously difficult to detect early on in its growth. Symptoms do not normally appear until you have had it for a while. An abnormal blood test count may raise suspicion, but further testing is needed. Every year, scientists learn more about what triggers it, and new drugs are being developed to combat this cancer.
Low Blood Counts
IYour bone marrow is the location in which many cells are formed, including plasma cells, white blood cells, red blood cells, and platelets. Multiple myeloma cells, on the other hand, crowd out these other normal cells. This may result in:
- Anaemia: This results from low red blood cells. Anaemia is a condition that can make you tired.
- Thrombocytopenia: This results from low platelets. Thrombocytopenia is a condition that can result in bruising or bleeding.
- Leukopenia: This results from low white blood cell count. Leukopenia which increases the risk of infection
Bones are particularly vulnerable to myeloma cells. Your “old” bone is continually being dissolved by cells called osteoclasts. Meanwhile, osteoblasts are responsible for the formation of new bones. These things almost all happen at the same time. Myeloma cells speed up the process of bone deterioration, and tumour cells take over the bone. As a result, the bones become brittle and vulnerable to fracturing.
Antibodies are generated by plasma cells and are used to fight germs. They will enable an antibody to fight the virus that makes you ill whenever you have a cold. Monoclonal antibodies made by abnormal plasma are not directed against a specific virus or bacteria, so they cannot fight infections. Myeloma cells replicate rapidly, crowding out the healthy plasma cells and other white blood cells that fight infection.
Other Things to Watch For
Multiple myeloma can cause a variety of health issues, including:
- Dizziness and confusion
- Numbness or muscle fatigue, especially in your legs
- Kidney injury
You could have an elevated amount of calcium in your blood as your bone dissolves quicker than normal. You may also experience severe thirst and dehydration.
Some warning signs, such as low blood cell counts and elevated calcium levels, may be detected by blood samples. After that, immunofixation is used to do a SPEP and UPEP. They are serum tests that detect the presence of a monoclonal antibody. If a monoclonal antibody is found, a bone marrow biopsy is performed. A bone marrow biopsy, though, is the most significant test for this disease. A specialist will use a specific needle to extract a little fragment of tissue from the bone. They'll examine it under a microscope to see whether there are any myeloma cells.
If you don't have symptoms yet — a stage known as smouldering myeloma — your doctor may advise you not to get treatment. Often patients put off starting therapy for months or even years.
If you ever need treatment, you can choose from a variety of options. You might try chemotherapy and corticosteroids, which are traditional cancer treatments. Alternatively, the doctor might consider one of the following new approaches:
- Immunomodulating agents: These have an effect on the immune system.
- Proteasome inhibitors: These stop the breakdown of proteins in cells.
- Monoclonal antibodies: These are antibodies that attack cells that pose a threat.
Stem Cell Transplant
Your doctor may recommend a stem cell transplant if you're under 65 or over 65 and otherwise healthy. You'll get a heavy dose of chemo or radiation beforehand to destroy cells in your bone marrow. After that, you'll get a transplant of healthy stem cells, which are the cells that produce new blood. It's possible that you'll have your own cells. This would be referred to as an autologous transplant by the doctor. They may also have come from a generous donor. An allogeneic transplant is what this is called.
Related Health Issues
Symptoms of anaemia (low red blood cell counts) like extreme fatigue can be improved with medications and blood transfusions. A specific procedure is used to thin the thickened blood, which may trigger dizziness and confusion.
Intravenous immunoglobulin (IVIG) is another medication that can aid the body fight infections.
Bisphosphonate medications can also be used to reduce the likelihood of bone fractures.
Questions to Ask Your Doctor
Be sure to bring up concerns and ask questions at your next appointment. Make a note of the following questions:
- How do I maintain my health?
- Is there something I can do to make my pain subside?
- What is the stage of my diagnosis, and what does it mean to me?
- Are there any side effects of my treatment?
- Is it essential for me to get a second opinion?
- Is it a good idea for me to participate in a clinical trial?
Referenced on 2/5/2021
- American Cancer Society: “Bisphosphonates for multiple myeloma,”“Can multiple myeloma be found early?” “Chemotherapy and other drugs for multiple myeloma,” “Radiation therapy for multiple myeloma,” “Signs and symptoms of multiple myeloma,” “Stem cell transplant for multiple myeloma,” “Supportive treatments for patients with multiple myeloma,” “Tests to find multiple myeloma.” “What’s new in multiple myeloma research and treatment?” “What are the risk factors for multiple myeloma?” “What is multiple myeloma?” “What should you ask your doctor about multiple myeloma?”
- American Academy of Family Physicians: “Multiple Myeloma: Diagnosis & Tests,” “Multiple Myeloma: Diagnosis & Treatment,” “Multiple Myeloma: Questions to Ask Your Doctor.”
- PubMed Health: “Multiple Myeloma.”
- UpToDate: “Patient education: Multiple myeloma treatment (Beyond the Basics).”