Multiple Myeloma

Overview

Multiple myeloma, also known as simply myeloma, is cancer that begins in the plasma cells. Plasma cells make proteins (antibodies) that help our bodies fight disease. They are located in the soft part of the bones, called the bone marrow.

Multiple myeloma starts when plasma cells become abnormal. These cancerous plasma cells (called myeloma cells) produce large amounts of abnormal proteins called M proteins, which crowd out normal bone marrow and affect the bone structure. This can make the bones weak and more likely to fracture. Because the myeloma cells crowd out the normal cells, the bone marrow also cannot produce enough healthy cells. This causes low red blood cell counts (anemia) and low white cell counts (neutropenia), which weaken the body's defenses against infection. Low platelet counts (thrombocytopenia), which may lead to bleeding, may also occur.

Because they destroy bone, myeloma cells can also cause the release of stored calcium from the bone into the bloodstream. This can lead to a potentially dangerous condition called hypercalcemia of malignancy (elevated calcium levels in the blood). Hypercalcemia of malignancy can affect the functioning of many organs, including the heart, nerves, and kidneys.

Myeloma cells also produce large amounts of abnormal proteins called M proteins, which can cause the blood to become thick and also damage the kidneys. Symptoms of hypercalcemia of malignancy include nausea and vomiting, constipation, frequent urinating, and frequent thirst, fatigue, and muscle weakness.

 

Multiple Myeloma Staging

The clinical stage of myeloma is determined based on the results of blood tests, X-rays, and bone marrow tests. There are 3 different stages of multiple myeloma:

• Stage I (low tumor burden). People with stage I disease usually do not have symptoms, and do not have elevated M proteins.
• Stage II (intermediate tumor burden). Stage II multiple myeloma has spread through the body a little bit.
• Stage III (high tumor burden). In stage III multiple myeloma, many cancer cells are present in the body. The patient has high levels of M protein and calcium in the blood, and many bones are affected.

After being staged, patients are further classified based on kidney function. Group A patients have normal kidney function, while Group B patients have some kidney problems.

 

Who Is More At Risk

According to the American Cancer Society, more than 21,700 new cases of multiple myeloma will be diagnosed in 2012. Multiple myeloma accounts for 1% of all hematologic cancers (cancers of the blood).

Most people who get multiple myeloma are over 65 years old. It is rarely seen in people younger than age 40. Slightly more men get multiple myeloma than do women, and more African American people get the disease than do white people.

Possible risk factors for multiple myeloma include:

• Family medical history. People are more likely to get multiple myeloma if their brothers or sisters have the disease.
• Radiation. People who are around radiation have a higher risk of getting multiple myeloma.
• Chemical exposure. Occupational exposure to certain chemicals, such as herbicides, rubber, textiles, petroleum products, or heavy metals, may raise a person's risk of getting multiple myeloma.
• Chronic infections. People suffering from certain chronic infections who have a higher risk of getting multiple myeloma than the general population.

However, most people with multiple myeloma have no known risk factors for the disease.

For additional information on symptoms and diagnosis, please visit the Compass Support Program.