What is Multiple Myeloma?

Multiple myeloma is a cancer of plasma cells, a type of white blood cell found in the bone marrow. Abnormal plasma cells can crowd out healthy blood cells and produce proteins that affect the kidneys, bones and immune system.

Some people first have a precursor condition that requires monitoring rather than immediate treatment. Active multiple myeloma is diagnosed when the abnormal cells cause specific organ damage or meet defined high-risk criteria.

Possible symptoms

Symptoms may include persistent bone pain, fractures, tiredness, weakness, breathlessness, repeated infections, weight loss, nausea, constipation, thirst or confusion. These can result from bone damage, anaemia, kidney problems or high calcium levels.

Not everyone has obvious symptoms, and similar symptoms can have other causes.

Tests used to diagnose myeloma

Assessment may include a full blood count, kidney and calcium tests, serum protein electrophoresis, immunofixation, free light-chain testing and urine tests.

A bone marrow biopsy measures abnormal plasma cells. Whole-body low-dose CT, PET-CT, MRI or other imaging can identify bone lesions and disease outside the marrow.

How is multiple myeloma treated?

Treatment usually combines several medicines that attack myeloma in different ways. These may include proteasome inhibitors, immunomodulatory medicines, steroids, antibody treatment, chemotherapy and other targeted therapies.

Eligible patients may undergo an autologous stem cell transplant after initial treatment. Supportive care may include bone-strengthening treatment, infection prevention, pain control, radiotherapy, transfusions and management of kidney or calcium problems.

Monitoring and relapse

Blood and urine tests are repeated to measure response. Imaging or bone marrow tests are used when clinically indicated. Maintenance treatment may help keep the disease controlled.

Myeloma can return after a period of response. If this happens, the next treatment is chosen according to previous therapy, duration of response, disease features and current health.

When to seek medical advice

Severe new back pain with leg weakness, numbness or loss of bladder or bowel control may indicate spinal cord compression and is a medical emergency. Fever, confusion or marked weakness also need prompt assessment.

Speak to a clinical haematologist

Ray of Hope Haematology provides specialist assessment and personalised care for blood disorders at Netcare Olivedale Hospital in Randburg. Contact the practice to request a consultation.

This article provides general information and does not replace medical advice, diagnosis or treatment from a qualified healthcare professional.