Multiple myeloma almost always starts out as a relatively benign condition called monoclonal gammopathy of undetermined significance (MGUS). In the United States, about 3 percent of people older than age 50 have MGUS. Each year, about 1 percent of people with MGUS develop multiple myeloma or a related cancer.
MGUS, like multiple myeloma, is marked by the presence of M proteins produced by abnormal plasma cells in your blood. However, in MGUS, the levels of M proteins are lower and no damage to the body occursirst.
When present, the symptoms of multiple myeloma may be vague or similar to those of the other conditions. Certain multiple myeloma symptoms may also be associated with complications of the disease. Remember that not all individuals with myeloma will have symptoms and that it is unusual for any one individual to have all of these symptoms.
Myeloma cells result in the production of abnormal antibodies, or M proteins. A high level of M protein in the blood is the hallmark characteristic of multiple myeloma. Additionally, all myeloma cells are identical to each other and produce large quantities of the same specific M protein (for example, IgG or IgA). The M proteins offer no benefit to the body, and as the amount of M protein increases, it crowds out normally functioning immunoglobulins.
The risk factors for multiple myeloma are not conclusive, because the cause of multiple myeloma is not known. Researchers believe that multiple myeloma is most likely the result of many risk factors acting together. There are, however, some factors that may be associated with an increased risk of developing multiple myeloma. These multiple myeloma risk factors include genetic factors, prevalence of MGUS, occupational exposure, age, race, and gender kidney problems. In addition, advances in treatment options allow for multiple myeloma symptoms to be managed or prevented.
What is Multiple Myeloma Cancer?
Multiple myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. Multiple myeloma is a hematological (blood) cancer that develops in the plasma cells found in the soft, spongy tissue at the center of your bones, called bone marrow. Plasma cells are a type of white blood cell responsible for producing antibodies (immunoglobulins) which are critical for maintaining the body’s immune system. Through a complex, multi-step process, healthy plasma cells transform into malignant myeloma cells
Multiple Myeloma Symptoms
Multiple myeloma symptoms may vary by patient, with the early stages of myeloma often presenting no visible symptoms or signs. The most common multiple myeloma symptoms may include:
- Bone pain or bone fractures
- Increased vulnerability to infections
- Increased or decreased urination
- Restlessness eventually followed by extreme weakness and fatigue
- Increased thirst
- Nausea and vomiting
- Loss of appetite and weight loss
- Impaired kidney function
Multiple Myeloma Stages
The international staging system (ISS) is the most commonly used myeloma staging system. It is based on two blood test results, beta 2-microglobulin (ß2-M) and albumin. ß2-M is a protein that indicates the extent of disease and albumin in an indicator of overall general health. The Durie-Salmon Staging System is an older staging system that is sometimes still used. With the Durie-Salmon Staging System, the stage of myeloma is determined by four measurements: the amount of hemoglobin and the level of calcium in the blood, the number of bone lesions, and the production rate of M protein. Stages are then further divided according to kidney function.
- A relatively small number of myeloma cells are found. All of the following features must be present:
- Hemoglobin level is only slightly below normal (but still above 10 g/dL)
- Bone x-rays appear normal or show only 1 area of bone damage
- Calcium levels in the blood are normal (less than 12 mg/dL)
- Only a relatively small amount of monoclonal immunoglobulin is in blood or urine
- A moderate number of myeloma cells are present. Features are between stage I and stage III.
- A large number of myeloma cells are found. One or more of the following must be present:
- Low hemoglobin level (below 8.5 g/dL)
- High blood calcium level (above 12 mg/dL)
- 3 or more areas of bone destroyed by the cancer
- Large amount of monoclonal immunoglobulin in blood or urine
Multiple Myeloma Prognosis and Life expectancy
The prognosis of multiple myeloma is usually based on the existence of different signs, symptoms, and circumstances. Multiple myeloma prognosis as well as survival rates have improved due to myeloma research. The prognosis of myeloma is also dependent on the stage of the disease as determined by the results of diagnostic testing. Survival rates are sometimes used by doctors to explain a patient’s prognosis; however, many patients prefer to avoid knowing about myeloma survival rates when learning of their prognosis.
Multiple Myeloma Treatment
The following medicines are approved by the U.S. Food and Drug Administration for the initial treatment of multiple myeloma: These medicines are typically used in combinations to attain the best results.
Steroids (e.g., dexamethasone and prednisone)
IMiDs (immunomodulatory drugs)
- Thalomid (thalidomide)
- Revlimid (Lenalidomide)
- Proteasome inhibitors.
- Velcade (bortezomib)
- Alkylating agents
- Alkeran (melphalan)
- Oncovin (vincristine)
- Cytoxan (cyclophosphamide)
High-dose Therapy and Stem Cell Transplant