What is Multiple Myeloma? Symptoms and Causes

Multiple Myeloma: Symptoms, Causes, Risks and Treatments

Multiple myeloma is an uncommon form of cancer which impacts plasma cells in the bone marrow. It restricts one’s body’s potential to create healthy blood cells and antibodies. As per studies, the prevalence of multiple myeloma in India is 2.2 per 1,00,000.

However, affected individuals stand at a higher risk of developing complications like leukopenia, anemia, bone lesions, or hyperviscosity. So, if you or your loved ones are dealing with this medical condition, knowing the risk factors, diagnostic criteria, treatment options, and other relevant details is crucial.

Keep reading for detailed insight!

What is Myeloma?

Myeloma, often referred to as multiple myeloma or myeloma cancer, is a type of cancer that affects plasma cells—those important white blood cells that produce antibodies to help fight off infections.

Here is an overview of how the disease occurs:

• In multiple myeloma, the unchecked proliferation of abnormal plasma cells in the bone marrow overshadows healthy cells, triggering various health issues.
• This disease typically arises from a precancerous condition known as monoclonal gammopathy of undetermined significance (MGUS).
• It may progress through a phase called smoldering myeloma before it becomes an active disease.

What are the Multiple Myeloma Symptoms?

Multiple myeloma can be tricky to spot in its early stages, often flying under the radar until it really takes hold. As the disease progresses, the affected person witnesses several symptoms:

1. Bone Pain: This is among the most prominent symptoms, particularly occurring in areas like the back, ribs, and hips. It happens because the abnormal plasma cells are breaking down bone tissue.
2. Fatigue and Weakness: These feelings often stem from anemia, as the cancerous cells interfere with the production of healthy red blood cells.
3. Frequent Infections: With the immune system taking a hit, patients may find themselves more prone to recurring infections.
4. Kidney Issues: The unusual proteins produced by myeloma cells can harm the kidneys, and in some cases, this can lead to kidney failure.
5. High Calcium Levels (hypercalcemia): When bones break down, they release calcium into the bloodstream, which can lead to symptoms like nausea, constipation, excessive thirst, confusion, and abdominal pain.
6. Unintentional Weight Loss: This can occur alongside other symptoms and often indicates that the disease is progressing.
    

Other potential symptoms of myeloma include numbness or weakness in the legs (especially if spinal nerves are compressed) and easy bruising or bleeding due to low platelet counts.

What are the Causes and Risk Factors of Multiple Myeloma?

The exact cause of multiple myeloma is still a bit of a mystery, but researchers have pinpointed several risk factors that can increase the likelihood of developing this condition:

• Age: Most who are diagnosed with the disease are over 60 years old.
• Gender and Ethnicity: Men and individuals belonging to the African-American community tend to be at a higher risk.
• Family History: If you have a close relative who has had myeloma or related blood disorders, your risk may be elevated.
• Obesity: A higher body mass index is linked to a greater chance of developing myeloma.
• Exposure to Radiation or Certain Chemicals: Working with aromatic hydrocarbon solvents and exposure to radiation may increase the risk.

What are the Multiple Myeloma Diagnostic Criteria?

Diagnosing multiple myeloma is a multifaceted process that includes various lab tests, imaging studies, and tissue examinations. The International Myeloma Working Group (IMWG) has laid out specific criteria for diagnosing this condition:

• CRAB Features: This refers to signs of end-organ damage, which can manifest as elevated calcium levels, kidney issues, anemia, and bone lesions.
• Bone Marrow Biopsy: A diagnosis of active disease occurs if the hormone tests show that more than 60% of plasma cells in the bone marrow have the same genetic features.
• Biomarkers: Treatment starts when the serum free light chain ratio is greater than 100 and at least one involved light chain measures 100 mg/L, together with at least two MRI lesions sized over 5 mm.
• Identification of Abnormal Antibody Proteins: Myeloma is readily detected when blood or urine examinations show the presence of an abnormal M-protein.
   

Those patients with a high chance of developing serious illness, despite being asymptomatic, could start treatment early to prevent future organ damage.

What are the Multiple Myeloma Treatment Options?

Multiple myeloma treatments have developed extensively, resulting in improved patient well-being. Treatment plans are adapted to the patient’s existing health, the stage of the disease, and the characteristics of that patient’s condition.

The following are the major treatment options:

• Chemotherapy: Some medications, such as alkylating agents, are chosen for chemotherapy because they target and get rid of myeloma cells that divide rapidly.
• Immunomodulatory Drugs: Lenalidomide and Thalidomide medications are used to improve the immune system so it can recognize cancer cells and attack them more easily.
• Proteasome Inhibitors: Drugs in this group, such as Bortezomib, interfere with how proteins are recycled in cancerous cells and play a crucial role in their destruction.
• Monoclonal Antibodies: Targeted therapies, including Daratumumab and Isatuximab, are designed to bind to specific proteins on myeloma cells, marking them for destruction.
• Corticosteroids: Together with other medications, corticosteroids are typically used to decrease inflammation and destroy myeloma cells.
• Stem Cell Transplantation: Giving healthy blood stem cells back to a patient through an Autologous Stem Cell Transplant (ASCT) can restore good bone marrow function and keep the disease away for a longer period.
• CAR-T Cell Therapy: In CAR-T cell therapy, the patient’s own immune cells are changed to find and destroy myeloma cells. Ciltacabtagene autoleucel is among the recent drugs that have brought hope to people with relapsed or refractory disease.
• Radiation Therapy: This is done to reduce bone pain or treat localized problems with the bones.
• Supportive Care: This encompasses medications aimed at maintaining bone health, preventing infections, and addressing complications such as anemia or kidney issues.
   

The choice and sequence of these therapies depend on whether the disease is newly diagnosed, relapsed, or refractory, along with individual patient factors.

What are the Tips for Living with Myeloma Cancer?

While there is no cure for multiple myeloma just yet, many patients manage to live for years with the right treatment and care. In this regard, here are a few tips to follow:

• Keeping a close eye on health through regular screenings
• Sticking to the recommended treatment plans
• Quickly tackling any complications by consulting the doctor
   

Moreover, ongoing research is bringing new hope for even better therapies down the line.