What is Multiple Myeloma?

Multiple myeloma is a cancer that affects plasma cells, a type of white blood cell responsible for fighting infections. These cells are produced in the bone marrow, the soft centre of our bones.

In Multiple myeloma, the bone marrow produces an excessive amount of plasma cells, which hinders the production of other essential blood cells.

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Symptoms of Multiple Myeloma

Multiple myeloma can manifest in a variety of ways, often stemming from the overproduction of plasma cells. Common symptoms include:

  • Bone-related: Bone pain, fractures, brittle bones with increased risk of fractures
  • General discomfort: Nausea, vomiting, confusion, excessive thirst
  • Fatigue and weakness: Feeling unusually tired, breathlessness, lethargy 
  • Anaemia: Low red blood cell count
  • Vision problems: Blurred vision
  • Neurological issues: Numbness, tingling, or weakness in the chest, lower back, or legs
  • Weakened immune system: Increased susceptibility to infections
  • Unexplained weight loss

It’s important to remember that these symptoms can also indicate other health conditions. However, it’s crucial to consult your doctor if you experience any of these, as early detection is key.

Certain symptoms require immediate medical attention, as they could signal a serious complication where myeloma cells or bone fragments are pressing on the spinal cord:

  • Severe back pain
  • Weakness, numbness, or tingling in the legs
  • Sudden loss of bladder or bowel control

Diagnosing Multiple Myeloma

There are a series of tests needed to diagnose multiple myeloma. Your healthcare provider will conduct a physical examination and order specific tests, which may include:

  • Laboratory tests: Analysing blood and urine samples to look for abnormalities.
  • Bone marrow biopsy: A small sample of bone marrow is extracted and examined under a microscope for the presence of cancer cells.
  • Imaging tests: Techniques like CT scans, PET scans, and MRI scans create detailed images of the inside of your body, helping to assess the extent of the disease.

Treatment Options for Multiple Myeloma

People diagnosed with multiple myeloma often receive a combination of treatments tailored to their individual needs. These treatments aim to eliminate cancer cells, slow disease progression, and manage symptoms. Common treatment approaches include:

Medications

Various medications are used to target and eradicate myeloma cells:

  • Immunomodulators, proteasome inhibitors, and steroids: These drugs work through different mechanisms to hinder cancer cell growth and survival.
  • Chemotherapy: Powerful drugs that kill rapidly dividing cells, including cancer cells.
  • Antibodies: These specialised proteins, some naturally occurring and others lab-created, can recognise and target specific molecules on cancer cells, leading to their destruction.
  • Radiotherapy
  • Consolidation treatment after eradication of myeloma cells involves replacing damaged bone marrow with healthy bone marrow cells to prolong treatment-free survival.

Chimeric Antigen Receptor T Cell Therapy

This innovative immunotherapy harnesses the power of the patient’s own immune system:

  1. T cell harvest: T cells, a type of white blood cell, are collected from the patient’s blood.
  2. Genetic modification: In the laboratory, these T cells are genetically engineered to produce special receptors that recognise and bind to specific proteins on myeloma cells.
  3. Infusion: The modified T cells are multiplied and infused back into the patient, where they can effectively target and destroy cancer cells.

Supportive Care

In addition to directly targeting cancer cells, treatment plans often incorporate:

  • Bone-strengthening medications: To prevent fractures and manage bone pain.
  • Symptom management: Addressing specific symptoms, such as pain relief and infection control, to improve quality of life.

Follow-Up Care

After completing treatment for multiple myeloma, you will have regular check-ups to monitor for any signs of the cancer returning. While treatment may not completely cure the disease, it can effectively manage symptoms and extend lifespan. Follow-up appointments may involve various tests, including blood work, urine analysis, imaging scans, or bone marrow biopsies.

Managing Relapse

If the multiple myeloma returns, your doctor will discuss alternative treatment options with you. This may involve different combinations of medications, transplant, or participation in a clinical trial exploring new therapies.

Disclaimer:

The information on the Centre For Clinical Haematology website is intended for educational use. It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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