Multiple Myeloma: Risk Factors, Symptoms and Treatments

Multiple myeloma is an uncommon cancer of white blood cells, called plasma cells, that develops in the bone marrow. 

Plasma cells typically are found in bone marrow and help produce antibodies, called immunoglobulins, to fight infections. With multiple myeloma, the plasma cells release too many immunoglobulins in the bones and blood, which can cause organ damage. The overgrowth of plasma cells can take over normal blood-forming cells, which can lead to bone loss, low blood count, infections, kidney problems and fractures.

What are the risk factors?

There is no clear cause of myeloma. But there are factors that may increase your risk of developing multiple myeloma. Those include:

• Age: Most people are diagnosed in their mid-60s
• Sex: Men are more likely to develop myeloma than woman
• Race: African Americans are twice as likely to develop myeloma than any other race
• Family history: Multiple myeloma seems to run in some families. If you have a sibling or parent with myeloma, you are more likely to get it than someone who does not have a family history. However, most patients have no affected relatives.
• Personal history of a monoclonal gammopathy of undetermined significance (MGUS): People with MGUS have a higher risk of getting multiple myeloma

Multiple myeloma symptoms

Early in the disease, there can be no symptoms. As the cancer progresses, symptoms may occur. Those include:

• Bone pain
• Nausea
• Fatigue
• Weakness
• Weight Loss
• Constipation
• Loss of appetite
• Infections
• Tingling or numbness in hands or feet

How is multiple myeloma diagnosed?

Multiple myeloma can be diagnosed through blood tests, urine tests, a bone marrow biopsy test or an imaging test such as an X-ray, MRI, CT scan or PET scan.

If you have too much calcium, low red blood cells and high protein in your blood, your healthcare provider can order additional blood tests to check for multiple myeloma. Your doctor may also want to perform a bone marrow biopsy to check your number of plasma cells.

Multiple myeloma treatment options

If you have symptoms, your physician will come up with a treatment plan catered for you. Possible treatments include:

• Chemotherapy drugs
• Corticosteroids
• Targeted therapy drugs, which target proteins, genes or tissues to prevent myeloma from spreading
• Stem cell transplant
• Radiation therapy
• Novel therapies like CAR T-cell, bi-specific antibodies, antibody drug conjugates (known as ADCs)
• Treatment on a clinical trial

Are monoclonal antibodies used to treat multiple myeloma?

Monoclonal antibodies are a type of therapy used to treat multiple myeloma. They are given to a patient by infusion or injection.

Monoclonal antibodies are made in a lab. They are designed attach to a specific target on cancer cells, mainly an antigen called CD 38 on myeloma cells.

The antibodies kill cancer cells, block their growth or keep them from growing. They are usually used in addition to chemotherapy.

There are a different class of antibodies called bi-specific antibodies or BiTEs that use your body’s immune system to kill cancer cells. These antibodies bind to a target on the myeloma cell and to another target on a normal white blood cell called lymphocyte, and then kill the myeloma cells.

Are plasmacytoma, POEMS syndrome and AL amyloidosis the same as multiple myeloma?

Plasmacytoma is a type of cancer that begins in plasma cells, the white blood cells that produce antibodies. A plasmacytoma refers to a single tumor while multiple myeloma refers to multiple tumors in the white blood cells.

POEMS syndrome is a rare autoimmune related blood disorder that damages your nerves and can affect other parts of the body. It is related to myeloma, but is not the same disease.

While multiple myeloma affects plasma cells, POEMS syndrome refers to the symptoms that result from abnormal plasma cells and too much M-protein. The acronym stands for the signs of the disease. Those include:

• Polyneuropathy: Numbness, tingling and weakness in your legs.
• Organomegaly: Enlarged spleen, liver or lymph nodes.
• Endocrinopathy: Abnormal hormone levels that can result in hypothyroidism, diabetes, fatigue, swelling in your limbs, problems with metabolism and other essential functions.
• Monoclonal plasma-proliferative disorder: This occurs when abnormal plasma cells produce a monoclonal protein, or M-protein, that is found in the bloodstream.
• Skin changes: More color than normal on your skin, possibly thicker skin and increased facial or leg hair.

AL amyloidosis is also related to myeloma. It is caused by a bone marrow disorder and affects many parts of the body.