Multiple Myeloma

THERAVIA - Multiple Myeloma

Multiple myeloma is a type of blood cancer that affects plasma cells, a type of white blood cells found mainly in the bone marrow. Normally, plasma cells produce antibodies to help fight infections. However, in multiple myeloma, a group of abnormal plasma cells (called myeloma cells) change and no longer grow or behave normally. They multiply and accumulate in the bone marrow making it hard for other blood cells to develop and work normally. Excessive plasma cells may eventually mass together to form a tumor or tumors in various sites of the body, especially the bone marrow. If only a single tumor is present, the term solitary plasmacytoma is used. When multiple tumors are present or the bone marrow has greater than 10% plasma cells, the term multiple myeloma is used.

What are the symptoms?

The four most common clinical and laboratory signs of multiple myeloma can be recalled using the mnemonic C.R.A.B.:

  • Calcium (abnormal increase in calcium blood levels)

  • Renal failure (deterioration of kidney function),

  • Anemia (decreased red blood cells),

  • Bone damage, lesions in the tissue constituting the bones (often bone pain and/or spontaneous fractures).

The onset of symptoms is usually related to disease progression. Multiple myeloma can however also be discovered in asymptomatic patients, particularly during a health check.

It is important to note that these clinical and laboratory signs are not specific to multiple myeloma and are not sufficient for a diagnosis to be made.

  • Low blood count: the overgrowth of plasma cells in the bone marrow can crowd out normal blood forming cells leading to low blood counts. This can cause anemia (shortage of red blood cells) leading to fatigue, an increased risk of infections due to leukopenia (shortage of normal white blood cells) and increased risk of bleeding and bruising due to thrombocytopenia (shortage of blood platelets count).

  • Bone damage: myeloma cells interfere with cells that keep bones strong. They produce a substance that leads to bone damage and high levels of calcium in the blood. The old bone is broken down without new bone to replace it, making the bones weak and easy to break. Bone pain and fractures is a major problem for patients with multiple myeloma.

  • Kidney problems: The excess production of abnormal antibodies by myeloma cells can damage the kidney, potentially leading to kidney failure.

  • Hypercalcemia: the bone breakdown releases calcium into the bloodstream, leading to high levels of calcium. It can cause extreme thirst, need to urinate often, dehydration, kidney problems, severe constipation, abdominal pain, loss of appetite, weakness, confusion, nausea, vomiting or lethargy.

Theravia - Multiple Myeloma Schema

How is the disease diagnosed?

Various in-depth examinations are required to confirm the disease, its nature and its extent to best adapt the choice of treatments to each patient’s needs:

  • A clinical examination, to assess the general state of health of the person and the presence of possible symptoms,

  • Blood and urine tests, to check for abnormal results and assess kidney function,

  • Bone marrow biopsies, to confirm the diagnosis,

  • An imaging assessment, to locate any bone lesions.

How is it managed?

While there is currently no cure for multiple myeloma, treatments such as chemotherapy, targeted therapy, stem cell transplants, and radiation can help manage the disease, reduce symptoms, slow the progression of the disease and put the disease in remission. Remission for multiple myeloma is when most or all signs and symptoms of the disease disappear. Advances in treatment have significantly improved the prognosis of patients with this condition.

Many types of supportive care can help people meet the physical, practical, emotional and spiritual challenges of multiple myeloma and maintain their lifestyle. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones. It may include physical therapy, nutritional counseling, exercise programs, relaxation techniques, emotional health support.

Useful associations and groups:

References