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Multiple myeloma

Plasma cell dyscrasia; Plasma cell myeloma; Malignant plasmacytoma; Plasmacytoma of bone; Myeloma - multiple

Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bones. It helps make blood cells.

Plasma cells help your body fight infection by producing proteins called antibodies. With multiple myeloma, plasma cells grow out of control in the bone marrow and form tumors in the areas of solid bone. The growth of these bone tumors weakens the solid bones. It also makes it harder for the bone marrow to make healthy blood cells and platelets.

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Cryoglobulinemia - of the fingers
Immune system structures
Antibodies

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Causes

The cause of multiple myeloma is unknown. Past treatment with radiation therapy increases the risk for this type of cancer. Multiple myeloma mainly affects older adults.

Symptoms

Multiple myeloma most commonly causes:

As the cancer cells grow in the bone marrow, you may have bone pain, most often in the ribs or back.

The cancer cells can weaken bones. As a result:

Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.

Blood tests can help diagnose this disease. These tests include:

Bone x-rays may show fractures or hollowed out areas of bone. If your provider suspects this type of cancer, a bone marrow biopsy will be performed.

Bone density testing may show bone loss.

If tests show that you have multiple myeloma, more tests will be done to see how far the cancer has spread. This is called staging. Staging helps guide treatment and follow-up.

Treatment

People who have mild disease or in whom the diagnosis is not certain are usually closely monitored. Some people have a form of multiple myeloma that grows slowly (smoldering myeloma), which takes years to cause symptoms.

Various types of medicines are used to treat multiple myeloma. They are most often given to prevent complications such as bone fractures and kidney damage.

Radiation therapy may be used to relieve bone pain or to shrink a tumor that is pushing on the spinal cord.

bone marrow transplant may be recommended:

You and your provider may need to manage other concerns during your treatment, including:

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Outlook depends on the person's age and the stage of disease. In some cases, the disease progresses very rapidly. In other cases, it takes years for symptoms to appear.

In general, multiple myeloma is treatable, but only in rare cases can it be cured.

Possible Complications

Kidney failure is a frequent complication. Others may include:

When to Contact a Medical Professional

Call your provider if you have multiple myeloma and you develop an infection, or numbness, loss of movement, or loss of sensation.

Related Information

Cancer
Platelet count
Anemia
Numbness and tingling
Muscle function loss
Acute kidney failure
Pneumonia - adults (community acquired)
Spinal cord trauma
Bone marrow transplant
Bone marrow transplant - discharge

References

National Cancer Institute website. PDQ plasma cell neoplasms (including multiple myeloma) treatment. www.cancer.gov/cancertopics/pdq/treatment/myeloma/healthprofessional. Updated August 10, 2017. Accessed September 29, 2017.

National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology: multiple myeloma. Version 1.2018. www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf. Updated September 15, 2017. Accessed September 29, 2017.

Rajkumar SV, Dispenzieri A. Multiple myeloma and related disorders. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 104.

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Review Date: 8/14/2017  

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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