Multiple myeloma is cancer that starts in the plasma cells in bone marrow. Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells.
Plasma cells help your body fight infection by producing proteins called antibodies. In multiple myeloma, plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone.
The growth of these bone tumors makes it harder for the bone marrow to make healthy blood cells and platelets.
Multiple myeloma mainly affects older adults. Past treatment with radiation therapy raises your risk for this type of cancer.
Multiple myeloma causes a low red blood cell count (anemia). This makes you more likely to get infections and have abnormal bleeding.
As the cancer cells grow in the bone marrow, bone or back pain, most often in the ribs or back.
If the bones in the spine are affected, it can put pressure on the nerves, resulting in numbness or weakness of the arms or legs.
Other symptoms include:
Blood tests can help diagnose this disease. Some are:
This list is not all-inclusive.
Bone density testing may show bone loss.
People who have mild disease or where the diagnosis is not certain are often closely watched without treatment. Some people have a slow-developing form of multiple myeloma that takes years to cause symptoms.
Medications for the treatment of multiple myeloma include:
Two types of bone marrow transplantation may be tried:
People with multiple myeloma should drink plenty of fluids to prevent dehydration and help maintain proper kidney function. They should also be cautious when having x-ray tests that use contrast dye.
The stress of illness may be eased by joining a support group whose members share common experiences and problems. See: Cancer - support group
Survival of people with multiple myeloma depends on the patient's age and the stage of disease. Some cases are very aggressive, while others take years to get worse.
Chemotherapy and transplants rarely lead to a permanent cure.
Kidney failure is a frequent complication. Others may include:
Call your doctor if you have multiple myeloma and infection develops, or numbness, loss of movement, or loss of sensation develops.
Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multiple
National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Multiple Myeloma. 2012. Version 1.2012.
Rajkumar SV, Dispenzieri A. Multiple myeloma and related disorders. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 110.
Rajkumar SV. Plasma cell disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011: chap 193.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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