Multiple Myeloma

Multiple myeloma is a cancer that begins in the plasma cells (a type of white blood cell) of the bone marrow. Plasma cells are responsible for making antibodies that help fight infections.
Multiple myeloma is a bone marrow cancer, not a bone cancer. Bone cancer begins in bone cells and is diagnosed and treated differently from multiple myeloma. However, multiple myeloma does destroy bone. The disease can also affect the immune system, kidneys and red blood cell count.

Symptoms of Multiple Myeloma

The early stages of multiple myeloma cancer may cause no symptoms or only vague symptoms, such as fatigue, recurring infections or back pain. Sometimes, the condition is discovered during a routine exam where blood or urine tests show the presence of abnormal proteins. To make a multiple myeloma diagnosis, your healthcare provider is likely to do lab tests, imaging tests and bone marrow tests.
A complication of multiple myeloma is a high level of calcium in the blood due to the breakdown of bone. High calcium can cause the following symptoms:
  • Constipation
  • Excessive thirst and urination
  • Loss of appetite
  • Mental confusion
  • Nausea.
Other signs and symptoms that can occur with multiple myeloma include:
  • Anemia (low red blood cell count) as myeloma cells replace the red blood cells in the bone marrow
  • Bone fractures due to weak bone
  • Repeated infections
  • Weakness or numbness in the legs
  • Weight loss.

Multiple Myeloma Cancer Treatment

If you do not have multiple myeloma symptoms, your healthcare providers may monitor your condition without treatment. Although multiple myeloma has no cure, treatment can let you lead a near-normal life. Treatment will depend on factors such as:
  • Prognostic indicators (such as an identified chromosome mutation)
  • Stage of your disease
  • Symptoms and complications you are experiencing
  • Types of previous treatments
  • Your age and general health.
Drugs, often used in combination, are a standard treatment. These drugs include bortezomib (Velcade®), thalidomide (Thalomid®), lenalidomide (Revlimid®), melphalan and prednisone.
If you're not a candidate for a stem cell transplant, your initial therapy is likely to be a combination of melphalan, prednisone and thalidomide (MPT) or melphalan, prednisone and bortezomib (MPV). If you cannot tolerate the side effects of these combinations, other combinations are possible. This therapy usually lasts for about 12 to 18 months.
If you are a candidate for a stem cell transplant, your initial therapy will likely exclude melphalan because it can have a toxic effect on stem cells.
Relapses of multiple myeloma are common, so it's important to work with your doctor to determine the best course of treatment for you.

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