Multiple myeloma is the second most common blood cancer (after non-Hodgkin lymphoma), but overall it is relatively rare, with about 33,000 cases diagnosed across the United States each year. The disease exists on a spectrum and can begin with less severe versions that may not need treatment, only monitoring.
Multiple myeloma affects plasma cells, a type of white blood cell that produces antibodies to attack germs and fight infections. Cancerous plasma cells crowd out and destroy healthy blood cells in bone marrow and produce abnormal proteins that can create a host of problems for the body - from anemia to weakened bones to complete kidney (renal) failure.
Improvements in treatment have made multiple myeloma much more manageable. A burst of new medications have been developed in recent years, including immunotherapies that stimulate the patient's immune system to fight the disease.
Broken Bones are a Common Red Flag
Multiple myeloma disrupts normal cells that help keep bones strong, leaving patients vulnerable to bone weakness, lesions, and breaks.
In fact, severe fatigue and frequent bone breaks are the symptoms that most often bring people in for blood tests, followed by a bone marrow biopsy, which can lead to a diagnosis of multiple myeloma.
The breakdown of bones by abnormal plasma cells can lead to high levels of calcium in the blood, creating another range of problems, including dehydration, changes in cognition, abdominal pain and kidney stones. High calcium levels can also affect the kidneys, which may already be weakened by abnormal protein production from myeloma cells. Signs of kidney damage are not always immediately apparent and are usually picked up by blood or urine tests.
Because multiple myeloma affects the production of normal antibodies, the disease can also weaken a patient’s ability to ward off infections. Patients may experience low blood counts, bruising, and bleeding. Other warning signs include:
- Mental fogginess or confusion
- Frequent infections
- Weakness or numbness in the legs
- Frothy urine
Promising Treatments Lengthen Survival
Multiple myeloma is not curable – yet – but treatment options developed over the past decade have boosted post-diagnosis survival rates from less than two years to about 10 years. Given that the median age of diagnosis is 67, this means that most patients with multiple myeloma have life expectancies that approach the national average.
Based on a patient’s age and condition, treatment usually consists of two or three medications, including chemotherapy, immunotherapy, and a steroid. If a patient is relatively young and robust, he or she may be referred for a stem cell transplant, which remains the best option for remission.
Chimeric antigen reception (CAR) T-cell therapy is a relatively new type of immunotherapy that engineers a patient’s own immune cells to recognize and attack cancerous cells. Clinical trials are ongoing nationwide to clarify their role in multiple myeloma.
Scientific advances have increased the length and quality of patients’ lives. There is optimism about ongoing new research and emerging treatment options that will yield a cure for multiple myeloma in the future.
Dr. Premkumar, is director of hematologic oncology at Holy Name’s Patricia Lynch Cancer Center, where a multi-disciplinary team of experienced and skilled oncologists, nurses, and support staff can diagnose, treat, and manage multiple myeloma. The center (201-541-5900) provides a unified and personalized approach to patients’ needs. Dr. Premkumar is an expert in treating blood disorders and cancer and has received grants for his research in blood cancers from the Conquer Cancer Foundation and the National Institutes of Health.
To make an appointment: 201-227-8008 or HolyName.org/Premkumar.