Jane Doe
What is Multiple Myeloma?
Multiple myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.
The immune system is composed of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. There are 2 major types of lymphocytes: T cells and B cells.
When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs. Lymphocytes can be found in many areas of the body, such as lymph nodes, the bone marrow, and the bloodstream. Plasma cells, however, are mainly found in the bone marrow. Bone marrow is the soft tissue inside some hollow bones.
When plasma cells become cancerous and grow out of control, they can produce a tumor called a plasmacytoma. These tumors generally develop in a bone, but they are also rarely found in other tissues. If there is only a single plasma cell tumor, it is called an isolated (or solitary) plasmacytoma. When there is more than one plasma cell tumor, it is called multiple myeloma.
In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out the normal blood-forming cells, leading to low blood counts. This can cause anemia — a shortage of red blood cells. Anemia causes people to become pale, weak, and fatigued. Multiple myeloma can also cause the level of platelets in the blood to become low (called thrombocytopenia). This can lead to increased bleeding and bruising. Another condition that can develop is leukopenia — a shortage of normal white blood cells. This can lead to problems fighting infections.
Myeloma cells also interfere with cells that help keep the bones strong. Bones are constantly being remade to keep them strong. Two major kinds of bone cells normally work together to keep bones healthy and strong. The cells that lay down new bone are called osteoblasts. The cells that break down old bone are called osteoclasts. Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. Since the osteoblasts do not get a signal to put down new bone, old bone is broken down without new bone to replace it. This makes the bones weak and they break easily. Fractured bones are a major problem in people with myeloma.
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Symptoms of Multiple Myeloma
Bone problems
Normally, the 2 major kinds of bone cells work together to keep bones healthy and strong. The cells that lay down new bone are called osteoblasts. The cells that break down old bone are called osteoclasts. Myeloma cells make a substance that tells the osteoclasts to speed up the dissolving of bone. The osteoblasts do not get a signal to put down new bone, so old bone is being broken down without new bone to replace it. This can cause areas of bone weakness that are painful.
Low blood counts
When myeloma cells replace normal blood-forming marrow cells, shortages of red blood cells, white blood cells, and blood platelets result. A reduced number of red blood cells, a condition called anemia, causes weakness, reduced ability to exercise, shortness of breath, and dizziness. Too few white blood cells (a condition called leukopenia) lowers resistance to infections such as pneumonia. When blood platelet counts are low (a condition called thrombocytopenia), even minor scrapes, cuts, or bruises may cause serious bleeding.
High blood calcium
When the myeloma cells dissolve bone, calcium is released. This can lead to high blood levels of calcium (called hypercalcemia). Symptoms include feeling very thirsty, drinking a lot of fluids, and urinating (peeing) a lot. This can cause dehydration and even kidney failure. High calcium can also cause severe constipation and loss of appetite. It can make people feel weak, drowsy, and confused. If the level of calcium gets high enough, it can even cause you to lapse into a coma
Nervous system symptoms
If myeloma weakens the bones in the spine, they can collapse and press on spinal nerves. This can cause sudden severe pain, numbness, and/or muscle weakness. This is a medical emergency and you should contact your doctor right away or go to the emergency room.
Sometimes, the abnormal proteins produced by myeloma cells can be toxic to the nerves. This damage can lead to weakness and numbness.
Kidney problems
Myeloma protein can damage the kidneys. Early on, this doesn't cause any symptoms, but can be found with a blood test. As the kidneys start to fail, they lose the ability to dispose of excess salt, fluid, and body waste products. This can lead to symptoms like weakness and leg swelling.
Infections
Myeloma patients are about 15 times more likely to get infections. This happens because the body is unable to make the antibodies that help fight infection. Often, once someone with myeloma gets an infection, it is slow to respond to treatment. That person may stay sick for a long time. Pneumonia is a common and serious infection seen in myeloma patient.
Treatments for Multiple Myeloma
Though there's no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity. You may wish to consider approved clinical trials as an option.
treatment options include:
Bortezomib (Velcade)
Bortezomib was the first approved drug in a new class of medications called proteasome inhibitors. It is administered intravenously. It causes cancer cells to die by blocking the action of proteasomes. It is approved for people with newly diagnosed and previously treated myeloma.
Thalidomide (Thalomid)
Thalidomide, a drug originally used as a sedative and to treat morning sickness during pregnancy in the 1950s, was removed from the market after it was found to cause severe birth defects. However, the drug received approval from the Food and Drug Administration (FDA) again in 1998, first as a treatment for skin lesions caused by leprosy. Today thalidomide is FDA approved for the treatment of newly diagnosed multiple myeloma. This drug is given orally.
Lenalidomide (Revlimid)
Lenalidomide is chemically similar to thalidomide, but because it appears to be more potent and cause fewer side effects, it is currently used more often than thalidomide. Lenalidomide is given orally. It is approved for people with previously treated myeloma, but is also often used in people with newly diagnosed disease.
Chemotherapy
Chemotherapy involves using medicines — taken orally as a pill or given through an intravenous (IV) injection — to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period. Often chemotherapy is discontinued during what is called a plateau phase or remission, during which your M protein level remains stable. You may need chemotherapy again if your M protein level begins to rise. Common chemotherapy drugs used to treat myeloma are melphalan (Alkeran), cyclophosphamide (Cytoxan), vincristine, doxorubicin (Adriamycin) and liposomal doxorubicin (Doxil).
Corticosteroids
Corticosteroids, such as prednisone and dexamethasone, have been used for decades to treat multiple myeloma. They are typically given in pill form.
Stem cell transplantation
This treatment involves using high-dose chemotherapy — usually high doses of melphalan — along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow.
Radiation therapy
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that's causing pain or destroying a bone.
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Lifestyle after Multiple Myeloma
The following tips may help you keep multiple myeloma under control:
Stay active
Exercise helps keep your bones stronger. If pain keeps you from being active, ask your doctor about ways to lessen the pain.
Drink fluids
Drinking fluids can help keep you from becoming dehydrated. And by drinking plenty of fluids, you help dilute the Bence Jones protein fragments in your urine, which may help prevent kidney damage.
Eat a balanced diet
One way to promote your overall health and cope with any form of cancer is to eat well. The amount of M protein in your system isn't affected by how much protein you eat, so there's no need to limit protein intake unless told otherwise by your doctor. Don't take vitamins, herbs or medications without your doctor's approval because they may interfere with your treatment.
.jpeg)
Multiple myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.
The immune system is composed of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. There are 2 major types of lymphocytes: T cells and B cells.
When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs. Lymphocytes can be found in many areas of the body, such as lymph nodes, the bone marrow, and the bloodstream. Plasma cells, however, are mainly found in the bone marrow. Bone marrow is the soft tissue inside some hollow bones.
When plasma cells become cancerous and grow out of control, they can produce a tumor called a plasmacytoma. These tumors generally develop in a bone, but they are also rarely found in other tissues. If there is only a single plasma cell tumor, it is called an isolated (or solitary) plasmacytoma. When there is more than one plasma cell tumor, it is called multiple myeloma.
In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out the normal blood-forming cells, leading to low blood counts. This can cause anemia — a shortage of red blood cells. Anemia causes people to become pale, weak, and fatigued. Multiple myeloma can also cause the level of platelets in the blood to become low (called thrombocytopenia). This can lead to increased bleeding and bruising. Another condition that can develop is leukopenia — a shortage of normal white blood cells. This can lead to problems fighting infections.
Myeloma cells also interfere with cells that help keep the bones strong. Bones are constantly being remade to keep them strong. Two major kinds of bone cells normally work together to keep bones healthy and strong. The cells that lay down new bone are called osteoblasts. The cells that break down old bone are called osteoclasts. Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. Since the osteoblasts do not get a signal to put down new bone, old bone is broken down without new bone to replace it. This makes the bones weak and they break easily. Fractured bones are a major problem in people with myeloma.
Causes of Multiple Myeloma
Scientists at hospitals, medical schools, and research laboratories across the country are studying multiple myeloma. At this time, we do not know what causes this disease or how to prevent it.
Although scientists cannot explain what causes one person gets multiple myeloma while another doesn't, we do know that most multiple myeloma patients are between 50 and 70 years old. This disease affects blacks more often than whites and men more often than women.
Some research suggests that there are certain multiple myeloma risk factors increase a person's chance of getting multiple myeloma. For example, a person's family background appears to affect the risk of developing multiple myeloma; children and brothers and sisters of patients who have this disease have a slightly increased risk. Farmers and petroleum workers exposed to certain chemicals also seem to have a higher-than-average chance of getting multiple myeloma. In addition, people exposed to large amounts of radiation (such as survivors of the atomic bomb explosions in Japan) have an increased risk for this disease. Scientists have some concern that smaller amounts of radiation (such as those radiologists and workers in nuclear plants are exposed to) also may increase the risk. At this time, however, scientists do not have clear evidence that large numbers of medical x-rays increase the risk for multiple myeloma. In fact, most people receive a fairly small number of x-rays, and scientists believe that the benefits of medical x-rays far outweigh the possible risk for multiple myeloma.
In most cases, people who develop multiple myeloma have no clear risk factors. The disease may be the result of several factors (known and/or unknown) acting together.
Symptoms of Multiple Myeloma
Bone problems
Normally, the 2 major kinds of bone cells work together to keep bones healthy and strong. The cells that lay down new bone are called osteoblasts. The cells that break down old bone are called osteoclasts. Myeloma cells make a substance that tells the osteoclasts to speed up the dissolving of bone. The osteoblasts do not get a signal to put down new bone, so old bone is being broken down without new bone to replace it. This can cause areas of bone weakness that are painful.
Low blood counts
When myeloma cells replace normal blood-forming marrow cells, shortages of red blood cells, white blood cells, and blood platelets result. A reduced number of red blood cells, a condition called anemia, causes weakness, reduced ability to exercise, shortness of breath, and dizziness. Too few white blood cells (a condition called leukopenia) lowers resistance to infections such as pneumonia. When blood platelet counts are low (a condition called thrombocytopenia), even minor scrapes, cuts, or bruises may cause serious bleeding.
High blood calcium
When the myeloma cells dissolve bone, calcium is released. This can lead to high blood levels of calcium (called hypercalcemia). Symptoms include feeling very thirsty, drinking a lot of fluids, and urinating (peeing) a lot. This can cause dehydration and even kidney failure. High calcium can also cause severe constipation and loss of appetite. It can make people feel weak, drowsy, and confused. If the level of calcium gets high enough, it can even cause you to lapse into a coma
Nervous system symptoms
If myeloma weakens the bones in the spine, they can collapse and press on spinal nerves. This can cause sudden severe pain, numbness, and/or muscle weakness. This is a medical emergency and you should contact your doctor right away or go to the emergency room.
Sometimes, the abnormal proteins produced by myeloma cells can be toxic to the nerves. This damage can lead to weakness and numbness.
Myeloma protein can damage the kidneys. Early on, this doesn't cause any symptoms, but can be found with a blood test. As the kidneys start to fail, they lose the ability to dispose of excess salt, fluid, and body waste products. This can lead to symptoms like weakness and leg swelling.
Infections
Myeloma patients are about 15 times more likely to get infections. This happens because the body is unable to make the antibodies that help fight infection. Often, once someone with myeloma gets an infection, it is slow to respond to treatment. That person may stay sick for a long time. Pneumonia is a common and serious infection seen in myeloma patient.
Treatments for Multiple Myeloma
Though there's no cure for multiple myeloma, with good treatment results you can usually return to near-normal activity. You may wish to consider approved clinical trials as an option.
treatment options include:
Bortezomib (Velcade)
Bortezomib was the first approved drug in a new class of medications called proteasome inhibitors. It is administered intravenously. It causes cancer cells to die by blocking the action of proteasomes. It is approved for people with newly diagnosed and previously treated myeloma.
Thalidomide (Thalomid)
Thalidomide, a drug originally used as a sedative and to treat morning sickness during pregnancy in the 1950s, was removed from the market after it was found to cause severe birth defects. However, the drug received approval from the Food and Drug Administration (FDA) again in 1998, first as a treatment for skin lesions caused by leprosy. Today thalidomide is FDA approved for the treatment of newly diagnosed multiple myeloma. This drug is given orally.
Lenalidomide (Revlimid)
Lenalidomide is chemically similar to thalidomide, but because it appears to be more potent and cause fewer side effects, it is currently used more often than thalidomide. Lenalidomide is given orally. It is approved for people with previously treated myeloma, but is also often used in people with newly diagnosed disease.
Chemotherapy
Chemotherapy involves using medicines — taken orally as a pill or given through an intravenous (IV) injection — to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period. Often chemotherapy is discontinued during what is called a plateau phase or remission, during which your M protein level remains stable. You may need chemotherapy again if your M protein level begins to rise. Common chemotherapy drugs used to treat myeloma are melphalan (Alkeran), cyclophosphamide (Cytoxan), vincristine, doxorubicin (Adriamycin) and liposomal doxorubicin (Doxil).
Corticosteroids
Corticosteroids, such as prednisone and dexamethasone, have been used for decades to treat multiple myeloma. They are typically given in pill form.
Stem cell transplantation
This treatment involves using high-dose chemotherapy — usually high doses of melphalan — along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow.
Radiation therapy
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that's causing pain or destroying a bone.
Lifestyle after Multiple Myeloma
The following tips may help you keep multiple myeloma under control:
Stay active
Exercise helps keep your bones stronger. If pain keeps you from being active, ask your doctor about ways to lessen the pain.
Drink fluids
Drinking fluids can help keep you from becoming dehydrated. And by drinking plenty of fluids, you help dilute the Bence Jones protein fragments in your urine, which may help prevent kidney damage.
Eat a balanced diet
One way to promote your overall health and cope with any form of cancer is to eat well. The amount of M protein in your system isn't affected by how much protein you eat, so there's no need to limit protein intake unless told otherwise by your doctor. Don't take vitamins, herbs or medications without your doctor's approval because they may interfere with your treatment.