Multiple Myeloma is a serious medical condition that occurs as a result of cancer of plasma cells.

Plasma cells are a type of white blood cells that are largely responsible for the production of antibodies.

The result is that that plasma cells become dysfunctional and they can accumulate in the bones.

The accumulation can result in bone lesions and interfere with production of normal blood cells.

Paraprotein can also be formed, this is an abnormal antibody that causes problems in the kidneys.

This disease does not have a cure – though it can be brought into remission by treatment.

 

Symptoms:

  • Kidney pain
  • Kidney failure
  • Fatigue
  • Bone Pain
  • Increased tendency for infections
  • Headaches
  • others

 

Diagnosis occurs with the following:

1.) Blood tests (protein electrophoresis, peripheral blood smear, CBC)

2.) Testing bone marrow through biopsy

3.) X-rays of bone – both intended and unintended radiographs

 

Staging:

Stage I

  • Hemeglobin – above 10
  • Normal Calcium
  • X-ray shows normal or single bone lesion or osteoporosis
  • Small amount of paraprotein

Stage II

  • When findings are above Stage I and not yet into Stage III

Stage III

  • Very high Calcium
  • Low Hemoglobin – below 8.5
  • X-ray shows 3 or more lytic bone lesions
  • Large amount of paraprotein

 

Treatment

Initial Treatment

* Depends on age – preferred to be under age 65

1.) Chemotherapy

  • Thalidomide dexamethasone
  • Bortezomib based regimens
  • Lenalidomide dexamethasone

2.) Autologous stem cell transplantation (ASCT)

* Transplant of own stem cells after chemotherapy

3.) Allogeneic stem cell transplantation

* Transplant of healthy person after chemotherapy
* Very rare

 

If over 65 – Transplantation – rare

1.) Standard treatment is Chemotherapy of Melphalan and Steroid Prednisone.

Maintenance Therapy

Younger patients – Thalidomide occasionally used

Relapse occurs often

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