Multiple myeloma
Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multipleMultiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bones in children and in the front chest bone (sternum) and the pelvis bones in adults. The bone marrow makes blood cells.
Plasma cells help your body fight infection by producing proteins called antibodies. In people with multiple myeloma, abnormal plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone. The growth of these bone tumors weakens the bones. It also makes it harder for the bone marrow to make healthy blood cells and platelets.
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...
Read Article Now Book Mark ArticleCauses
The cause of multiple myeloma is unknown. Past treatment with radiation therapy increases the risk for this type of cancer. Multiple myeloma mainly affects older adults.
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
Read Article Now Book Mark ArticleSymptoms
Multiple myeloma most commonly causes:
- Low red blood cell count (anemia), which can lead to fatigue and shortness of breath
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
Read Article Now Book Mark Article - Low white blood cell count, which makes you more likely to get infections
- Low platelet count, which can lead to abnormal bleeding
As the cancer cells grow in the bone marrow, you may have bone pain, most often in the ribs or back.
The cancer cells can weaken bones. As a result:
- You may develop broken bones (bone fractures) just from doing normal activities.
- If cancer grows in the spine bones, it can press on the nerves. This can lead to numbness or weakness of the arms or legs.
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
Read Article Now Book Mark Article - Frequent infections may occur.
Exams and Tests
The health care provider will perform a physical exam and ask about your symptoms.
Blood tests can help diagnose this disease. These tests include:
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Calcium level
Calcium level
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
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Total protein level
Total protein level
The total protein test measures the total amount of two classes of proteins found in the fluid portion of your blood. These are albumin and globulin...
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Kidney function
Kidney function
Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...
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Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Immunofixation
Immunofixation
The immunofixation blood test is used to identify proteins called immunoglobulins in blood. Immunoglobulins are proteins that function as antibodies...
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Quantitative nephelometry
Quantitative nephelometry
Quantitative nephelometry is a lab test to quickly and accurately measure levels of certain proteins called immunoglobulins in the blood. Immunoglob...
Read Article Now Book Mark Article - Serum protein electrophoresis
- Urine protein electrophoresis
Bone x-rays, CT scans, or MRI may show fractures or hollowed out areas of bone. If your provider suspects this type of cancer, a bone marrow biopsy will be performed.
Bone marrow biopsy
A bone marrow biopsy is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is foun...
Read Article Now Book Mark ArticleBone density testing may show bone loss.
Treatment
People who have mild disease or in whom the diagnosis is not certain are usually closely monitored without giving treatment. Some people have a form of multiple myeloma that grows slowly (smoldering myeloma), which takes years to cause symptoms.
Various types of medicines are used to treat multiple myeloma. They are most often given to prevent complications such as bone fractures and kidney damage.
Radiation therapy may be used to relieve bone pain or to shrink a tumor that is pushing on the spinal cord.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleA bone marrow transplant may be recommended:
Bone marrow transplant
A bone marrow transplant is a procedure to replace damaged or diseased bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatt...
Read Article Now Book Mark Article- An autologous bone marrow or stem cell transplantation is performed using a person's own stem cells.
- An allogeneic transplant uses someone else's stem cells. This treatment has additional risks, but may offer the chance of a cure.
You and your provider may need to manage other concerns during your treatment, including:
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Having chemotherapy at home
Having chemotherapy at home
You or your child will be going home from the hospital soon. The health care provider has prescribed medicines or other treatments that you or your ...
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Managing your pets
Managing your pets
If you have a weak immune system, having a pet can put you at risk for serious illness from diseases that can spread from animals to humans. Learn w...
Read Article Now Book Mark Article - Avoiding infections
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Bleeding problems
Bleeding problems
Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and...
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Dry mouth
Dry mouth
Some cancer treatments and medicines can cause dry mouth. Take good care of your mouth during your cancer treatment. Follow the measures outlined b...
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Eating enough calories
Eating enough calories
If you are sick or undergoing cancer treatment, you may not feel like eating. But it is important to get enough protein and calories so you do not l...
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Safe eating during cancer treatment
Safe eating
When you have cancer, you need good nutrition to help keep your body strong. To do this, you need to be aware of the foods you eat and how you prepa...
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Support Groups
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society -- www. cancer. orgAmerican Childhood Cancer Organiz...
Read Article Now Book Mark ArticleOutlook (Prognosis)
Outlook depends on the person's age and the stage of disease. In some cases, the disease progresses very rapidly. In other cases, it takes years for symptoms to appear.
In general, multiple myeloma is treatable, but only in rare cases can it be cured.
Possible Complications
Kidney damage that may lead to Kidney failure is a frequent complication. Others may include:
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Read Article Now Book Mark Article- Bone fractures
- High level of calcium in the blood (hypercalcemia), which can be very dangerous
- Increased chances for infection, especially in the lungs
- Anemia
When to Contact a Medical Professional
Contact your provider if you have multiple myeloma and you develop an infection, or numbness, loss of movement, or loss of sensation.
References
National Cancer Institute website. Plasma cell neoplasms (including multiple myeloma) treatment (PDQ) - health professional version. www.cancer.gov/types/myeloma/hp/myeloma-treatment-pdq. Updated April 14, 2023. Accessed May 30, 2023.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: multiple myeloma. Version 5.2022. www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf. Updated December 8, 2022. Accessed March 31, 2023.
Rajkumar SV, Dispenzieri A. Multiple myeloma and related disorders. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 101.
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Cryoglobulinemia of the fingers - illustration
Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark. The black areas are gangrene resulting from lack of blood flow.
Cryoglobulinemia of the fingers
illustration
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Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
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Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Cryoglobulinemia of the fingers - illustration
Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark. The black areas are gangrene resulting from lack of blood flow.
Cryoglobulinemia of the fingers
illustration
-
Immune system structures - illustration
The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.
Immune system structures
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 2/2/2023
Reviewed By: Mark Levin, MD, Hematologist and Oncologist, Monsey, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 05/30/2023.