Multiple myeloma is a rare blood cancer characterized by the expansion of malignant plasma cells in the bone marrow associated with excessive production of monoclonal immunoglobulins in blood and urine. Individuals with multiple myeloma develop significant osteolytic bone lesions and have immunodeficiency that compromise their longevity and quality of life.
Pathophysiology and Epidemiology
Although the exact underlying cause of multiple myeloma is poorly understood, the specific symptoms of the condition result from abnormal and excessive growth of plasma cells in the bone marrow. These excess plasma cells form tumors in the bone, causing the bones to become weak and easily broken. These tumors also reduce the bone marrow’s ability to make healthy blood cells and platlets.
Signs and Symptoms
Symptoms will vary greatly in patients with multiple myeloma, but the most common symptom associated with multiple myeloma is bone pain and anemia.
Other common signs and symptoms of multiple myeloma include:
- Nausea
- Constipation
- Loss of appetite
- Frequent infections
- Weight loss
- Excessive thirst
- Weakness and/or numbness in the arms and legs
- Confusion
- Abnormal bleeding
- Weak bones that may break easily
- Difficulty breathing
Causes
There is not a clear cause of what causes multiple myeloma.
Diagnosis
A diagnosis of multiple myeloma may be suspected based on the presence of characteristic signs and symptoms. Additional testing can then be ordered to confirm the diagnosis. This may include:
- Specialized blood tests including immunoglobulin studies, complete blood count with differential, and blood chemistry studies
- Urine tests such as immunoglobulin studies and a twenty-four-hour urine test
- Bone marrow aspiration and biopsy
- Imaging studies such as an X-ray of the bones (skeletal bone survey), MRI, CT scan, and/or PET scan
Management and Treatment
Thierry Facon, MD: Brief History of Multiple Myeloma Treatment Options
The treatment of multiple myeloma varies based on many factors including the age and general health of the affected person; the associated signs and symptoms; and the severity of the condition. In general, one or more of the following interventions may be used:
- Chemotherapy
- Corticosteroid medications
- Targeted therapy
- Stem cell transplant
- Biological therapy
- Radiation therapy
- Surgery
- Watchful waiting
FDA approved treatments for multiple myeloma include:
- Melphalan (Brand name: Alkeran (injection))
- Daratumumab (Brand name: Darzalex)
- Doxorubicin HCL liposome injection (Brand name: Doxil (injection))
- Elotuzumab (Brand name: Empliciti)
- Carfilzomib (Brand name: Kyprolis)
- Ixazomib citrate (Brand name: Ninlaro)
- Pomalidomide (Brand name: Pomalyst)
- Lenalidomide (Brand name: Revlimid)
- Thalidomide (Brand name: Thalomid)
- Bortezomib (Brand name: Velcade)
Clinical Trials
For a full list of clinical trials relating to glioblastomas, go here.
Thierry Facon, MD: TOURMALINE-MM2 Study Results
Resources
International Myeloma Foundation
Multiple Myeloma Research Foundation
The National Coalition for Cancer Survivorship
To learn more about rare cancers, visit our Rare Cancers page
For more information about Multiple Myolema, visit the National Center for Advancing Translational Sciences’ Genetic and Rare
Diseases Information Center at https://rarediseases.info.nih.gov/diseases/7108/multiple-myeloma