Myeloma: Causes, Symptoms, Development & Treatment

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What is Myeloma?

Myeloma, also known as multiple myeloma, is a cancer arising from plasma cells, a type of white blood cell which is made in the bone marrow.  Bone marrow is the ‘spongy’ material found in the centre of the larger bones in the body. The bone marrow is where all blood cells are made.

Plasma cells form part of your immune system. Normal plasma cells produce antibodies, also called immunoglobulins, to help fight infection.

In myeloma, these plasma cells become abnormal, multiply uncontrollably and release only one type of antibody known as paraprotein – which has no useful function. It is often through the measurement of this paraprotein that myeloma is diagnosed and monitored.

Is a type of cancer that begins in the bone marrow. It is a cancer of plasma cells, which are a type ofwhite blood cells (also called plasma B cells).

The disease belongs to a spectrum of disorders referred to as “plasma cell dyscrasias.”

Has several forms:

  • Multiple myeloma – most common form: More than 90 percent of people with myeloma have this type. Multiple myeloma affects several different areas of the body.
  • Plasmacytoma – only one site of myeloma cells evident in the body, such as a tumor in the bone, skin, muscle, or lung.
  • Localized myeloma – found in one site with exposure to neighboring sites.
  • Extramedullary myeloma – involvement of tissue other than the marrow, such as the skin, muscles or lungs.

Doctors divide myeloma into groups that describe how rapidly or slowly the disease is progressing:

  • Asymptomatic or smoldering myeloma progresses slowly and has no symptoms even though the patient has the disease.
  • Symptomatic myeloma has related symptoms such as anemia, kidney damage and bone disease.

Symptoms of Myeloma

The symptoms of myeloma depend on how advanced the disease is. In the earliest stages there may be no symptoms and myeloma may be detected by coincidence during a routine blood test.

Common symptoms include:

  • Anaemia, tiredness, fatigue, weakness and dizziness
  • Increased bleeding or bruising
  • Bone pain
  • Elevated blood calcium level
  • Frequent or repeated infections

It is not known why a plasma cell becomes cancerous. Factors such as infection, or chemicals, or other environmental factors may play a part in damaging cells and causing cancers such as myeloma. However, no factor has been proven as a cause for myeloma. It is not a hereditary disease.

How Does Myeloma Develop?

Myeloma develops when a plasma cell is changed (mutated).

  • Plasma cells are made from B lymphocytes (B cells), a type of white blood cell that is found in thebone marrow. Healthy plasma cells are part of the immune system and make proteins called “antibodies,” which help fight infection.

The mutated plasma cell (myeloma cell) multiplies, and, if untreated, these cells continue to grow in themarrow. They crowd out the healthy plasma cells and the normal stem cells in the bone marrow that form the white blood cells, red blood cells and platelets. If not treated, the cancerous cells can:

  • Crowd out functioning white cells, and the immune system can’t guard against infection effectively
  • Secrete high levels of protein in the blood and urine, which can lead to kidney damage
  • Build up in bone, causing it to weaken, which can lead to bone pain and fractures.

Myeloma Risk Factors?

Signs and symptoms of myeloma include the following:

  • Hypercalcemia (excessive calcium in the blood)
  • Anemia (shortage or reduced function of red blood cells)
  • Renal damage (kidney failure)
  • Susceptibility to infection
  • Osteoporosis, bone pain, bone swelling or fracture
  • High protein levels in the blood and/or urine
  • Weight loss

Myeloma occurs more frequently in the following populations:

  • African-American
  • Over the age of 50
  • Male
  • Obese
  • Exposed to radiation
  • Work in petroleum-related industries

How is myeloma treated?

Treatment for myeloma is aimed at disease control, relieving the complications and symptoms it causes, and extending and improving the quality of patients’ lives.

Myeloma treatment is almost always with a combination of drugs over periods of time known as cycles. Cycles may last from weeks to months.

Treatment combinations are usually made up of two or three different types of drugs which work well together and can include chemotherapy drugs, steroids and other types of anti-myeloma drugs.

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