Multiple Myeloma: Symptoms, Diagnosis and Treatment
Multiple myeloma is a type of blood cancer that develops from plasma cells in the bone marrow.
Because the disease can affect bones, kidneys, blood counts and the immune system, its symptoms can appear very different from one patient to another.
What Are Plasma Cells?
Plasma cells are part of the immune system. Their normal role is to produce antibodies that help the body fight infection.
In multiple myeloma, abnormal plasma cells multiply excessively and may produce an abnormal protein known as monoclonal protein or M-protein.
What Are the Symptoms of Multiple Myeloma?
Possible symptoms include:
- Persistent back or bone pain
- Bone fractures
- Fatigue
- Anaemia
- Repeated infections
- Kidney problems
- High calcium levels
- Weakness
- Easy bruising or bleeding in some patients
What Does CRAB Mean in Multiple Myeloma?
The term CRAB is commonly used to remember some of the important organ-related problems associated with active myeloma.
- C – Calcium: High calcium levels
- R – Renal: Kidney impairment
- A – Anaemia: Reduced red blood cells
- B – Bone: Bone lesions or damage
Doctors now use additional diagnostic criteria as well, so CRAB features are only part of the complete assessment.
How Is Multiple Myeloma Diagnosed?
Investigations may include:
- Complete blood count
- Kidney-function tests
- Blood calcium measurement
- Serum protein electrophoresis
- Immunofixation
- Serum free light-chain tests
- Urine tests
- Bone marrow aspiration or biopsy
- CT, MRI or PET-CT
What Is M-Protein?
M-protein is an abnormal monoclonal protein produced by abnormal plasma cells in many patients with myeloma.
The amount and type of this protein can provide important diagnostic and monitoring information.
What Is MGUS?
Monoclonal Gammopathy of Undetermined Significance, or MGUS, is a condition in which an abnormal monoclonal protein is present without the features required for active multiple myeloma.
MGUS usually does not require immediate cancer treatment but does require appropriate medical monitoring.
What Is Smouldering Multiple Myeloma?
Smouldering myeloma is an intermediate condition in which abnormal plasma-cell activity is higher than in MGUS but the patient does not yet have the defining features of active myeloma requiring treatment.
Regular monitoring is important because progression risk varies between patients.
How Is Multiple Myeloma Treated?
Treatment may include combinations of several types of medicines, such as:
- Proteasome inhibitors
- Immunomodulatory medicines
- Monoclonal antibodies
- Corticosteroids
- Other targeted therapies
- Newer immune-based treatments
The exact treatment combination depends on age, overall fitness, kidney function, disease characteristics and previous treatments.
What Is the Role of Stem Cell Transplant?
Selected patients may undergo an autologous stem cell transplant.
The patient’s own stem cells are collected and stored. High-dose treatment is then given, after which the stem cells are returned to help restore blood-cell production.
Can Multiple Myeloma Be Completely Cured?
Multiple myeloma is generally considered a treatable but currently not reliably curable disease with standard therapy.
However, modern treatment can produce deep and prolonged responses, and many patients are able to live with the disease under long-term medical management.
Conclusion
Multiple myeloma can affect several parts of the body and may initially present as bone pain, anaemia, kidney dysfunction or abnormal blood proteins.
Diagnosis and treatment should therefore be planned by a haematology or oncology team experienced in plasma-cell disorders.
This content is intended for general patient education and does not replace medical advice.
