Multiple Myeloma

Image 1: Cartoon Myeloma Cells

Image 2: Development of Multiple Myeloma Cells

What is

Multiple Myeloma?

Multiple Myeloma is a type of cancer that forms in a group of white blood cells called plasma cells. The plasma cells are a cell found in the bone marrow that helps our bodies fight infection by producing antibodies that identify and attack germs.

When a person has Multiple Myeloma the mutated Myeloma cells begin to accumulate in the bone marrow and crowd out the healthy red blood cells, platelets and other white blood cells. The crowding caused by the Myeloma cells can cause problems such as anemia, fatigue, bleeding easily and getting infections easily. The Myeloma cells then produce abnormal proteins that cause complications such as bone damage, high levels of calcium in the blood and kidney problems.

Signs and Symptoms

The largest or most commonly known symptom of Multiple Myeloma is the bone damage it causes. The myeloma cells cause the bones in the body to breakdown faster than they are able to rebuild themselves. This causes the bones to be weaker and thinner which leads to lesions and/or broken bones. Multiple Myeloma affects multiple bones (hence the name) in different areas of the body but the most common bones affect are:

Spine (vertebrae)
Ribs
Breastbone (sternum)
Hips
Shoulder blade (scapula)
Skull
Upper arm bone (humerus)
Upper leg bone (femur)

The most common signs and symptoms of Multiple Myeloma can be referred to with the adjective CRAB. This stands for Hypercalcemia, renal (kidney) problems, anemia and bone disease. These symptoms paired with blood testing in which the abnormal myeloma protein (M -protein) and a shortage of other cells can be detected is a large part in how multiple myeloma can be diagnosed. Other forms of diagnosis for this disease include X-rays, MRI scans, biopsies, PET scans and a urinalysis (testing of urine).

Skull Image (Case courtesy of Dr Jennie Roberts, Radiopaedia.org, rID: 17909)

Pelvis Image (Case courtesy of Dr Saikat Sarkar, Radiopaedia.org, rID: 54702)

CRAB Image (from

crab_symptoms_for_active_myeloma_1_web_2

Spine Image (Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 7682)

Full Body Image: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 16464

Risk Factors

The risk of developing this disease is increased by age, most people are diagnosed in their mid-60s

Increasing Age

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Multiple Myeloma appears more commonly in overweight individuals then in those with a healthy weight.

Obesity and Overweight

Image From: (https://twitter.com/powerfm987/status/1019548369453240320)

Research has shown that people of African Ancestry are about twice as likely to develop multiple myeloma.

People of African Ancestery

Image from: (https://www.gograph.com/vector-clip-art/big-brother_3.html)

Individuals with weakened immune systems such as HIV or Aids or organ transplant recipients have a higher risk.

People with Weakened Immune Systems

Image From: (https://www.mifarmaciamecuida.es/blog/gripe-o-resfriado-diferencias.html)

Multiple Myeloma is more commonly seen in the male population.

Male Sex

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Monoclonal Gammopathy of Undetermined Significance or MGUS is when there is an abnormal protein known as the M protein present in your blood. MGUS can progress and become Multiple Myeloma.

Personal History of MGUS

Image From: (https://blood-cancer.com/living/coping-myeloma-open-eyes/)

Risk is four times greater for an person when a parent or sibling has multiple myeloma but most people have no family history of the disease

Family History of Multiple Myeloma

Image From: (https://www.pinterest.ca/pin/576038608579392587/?lp=true)

Studies show that people involved in farming have a higher risk of developing the disease (suggestions that it is connected some pesticides)

Individuals involved in Farming

Image From: (https://www.pinterest.ru/pin/561613016030177658/?autologin=true)

Treatment Options

Targeted Therapy

The use of a drug that targets a specific molecule, normally targeting the molecules that cause the cancer cells to grow and spread so that the drug can stop the growth.

Image From: (https://www.vix.com/es/actualidad/175099/un-asunto-de-vida-o-muerte-victimas-uruguayas-del-cancer-deciden-viajar-a-san-pablo)

Chemotherapy

The use of a number of drugs that kill the cancerous cells in the body. Targeted therapy and chemotherapy are commonly used together.

Image From: (https://boredomtherapy.com/?p=257988)

Stem Cell Transplant and Chemotherapy

To prepare for the autologous stem cell transplant (ASCT), the number of myeloma cells is reduced by using chemotherapy to destroy the cancer cells and blood producing cells in the bone marrow. The stem cells are the collected, frozen and stored until it is time for them to be reinfused. Once the stem cells are reinfused they can begin producing new blood cells.

IMage from: (https://www.quora.com/How-are-bone-marrow-transplants-performed)

Radiation Therapy

A form of high-energy radiation that is used to damage the myeloma cells and prevent them from growing. Radiation therapy is typically used on specific parts of the body, and is commonly combined with chemotherapy.

Image From: (https://www.pinterest.ca/pin/45247171242128911/?lp=true?

Clinical Trials

Research studies involve Multiple Myeloma patients and new experimental drugs that are used to look at new ways to treat the cancer as well as gather information on the drug’s dose, effectiveness and safety in humans. There is a wide variety of different clinical trials that vary in size, protocol, location and patient requirements.

Image From: (https://floridanownews.com/2017/06/27/tapimmune-reaches-50-patient-enrollment-benchmark-in-phase-2-study-of-novel-t-cell-vaccine-targeting-triple-negative-breast-cancer/)

Surgery

Is used to treat the bone damage that occurs.

Image From: (http://ngockhanhclinic.com.vn/chi-tiet/ho-van-dong-mach-chu,-nhung-thong-tin-quan-trong-can-nam-ro-c5191.html)

Supportive Therapy

Patients may also be prescribed other supportive treatments to help prevent and/or manage potential side effects of treatment combinations as well as treat the symptoms and complications of myeloma, such as pain, bone disease, anemia, etc.

Image From: (http://caringminds.co.in/old-age-supportive-therapy/)

*Some of the information used on this page from Cancer.ca and mayoclinic.org and myelomacanada.ca!

*This information is for educational and awareness purposes only and should not be constructed or used as medical advice.

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