Multiple myeloma is a form of blood cancer characterized by uncontrolled division of plasma cells, which is one of the types of white blood cells. Myeloma is estimated at approximately 1% of all cancer cases and 10% of hematological malignancies.
In the Western world, about 40,000 new patients are diagnosed each year. Cancer often occurs in old age, with the average age of cancer onset being 67 years, although in recent years younger patients have also been diagnosed.
The dividing plasma cells produce and secrete into the blood and urine a pathogenic protein that can harm other organs; Therefore, its quantity in blood and urine is used as a measure of the development of the disease.
Symptoms of multiple myeloma
In the early stages, myeloma may not cause any symptoms, as it is often suspected or diagnosed only after a routine blood or urine test. Eventually, myeloma may cause a group of symptoms that include the following:
Persistent bone pain, usually in the back, ribs, or hips.
Fatigue, weakness and shortness of breath due to anemia.
High levels of calcium in the blood which may cause symptoms including:
Extreme thirst.
stomach pain.
The need to urinate frequently.
Constipation.
Confusion.
Weight loss
Blurred vision, dizziness, or headache due to increased blood density.
Recurrent infections.
Unusual bruising and bleeding, such as: frequent nosebleeds, bleeding gums, and heavy menstruation.
Weak bones that break easily. If this affects the spine, it may cause symptoms such as pins and needles, numbness and weakness in the legs and feet, and problems controlling the bladder and bowels.
Kidney problems
nausea.
holding.
Anorexia.
Mental confusion or disorientation.
Recurrent infections.
Weakness or numbness in your legs.
Extreme thirst.
Causes and risk factors of multiple myeloma
The following is an explanation of the most prominent causes and risk factors for developing multiple myeloma
1. Causes of multiple myeloma
The causes of myeloma are not clear. Doctors know that myeloma begins with a single abnormal plasma cell in the bone marrow, the soft, blood-producing tissue that fills the center of most of your bones. The abnormal cell then multiplies rapidly.
Because cancer cells do not mature and then die as normal cells do, they accumulate and eventually overwhelm the production of healthy cells. In the bone marrow, myeloma cells crowd out healthy blood cells, leading to fatigue and an inability to fight infection.
Myeloma cells continue to try to produce antibodies as healthy plasma cells do, but the myeloma cells produce abnormal antibodies that the body cannot use.
Instead, abnormal antibodies build up in the body and cause problems such as kidney damage. Cancer cells can also cause bone damage, increasing the risk of bone fractures.
2. Risk factors for multiple myeloma
The most prominent risk factors include the following:
Getting older
Your risk of developing multiple myeloma increases as you age, and most people are diagnosed in their mid-60s.
Sex
Men are more susceptible to the disease than women.
Race is black
Black people are more likely to develop multiple myeloma than people of other races.
Family history of multiple myeloma
If a brother, sister, or parent has multiple myeloma, your risk of developing the disease is increased.
Personal history of monoclonal gammopathy of undetermined significance
Multiple myeloma always begins as a monoclonal gammopathy of undetermined significance, so having this condition increases your risk.
Other factors
Other notable factors include the following:
Suffering from being overweight or obese.
Exposure to radiation.
Handling chemicals used in the rubber industry, woodworking, firefighting, or in herbicides.
Complications of multiple myeloma
The most common complications include:
1. Bone problems
Your bones can become weaker, leading to fractures.
2. Blood problems
You may develop anemia, which means your body doesn't have enough red blood cells. This can make you tired and emaciated and cause heart problems.
You may also have too few platelets, making your blood more difficult to clot.
3. Infections
When you have myeloma, your body produces too many weak antibodies that crowd out healthy ones, making it difficult for you to fight infections. A lack of white blood cells can also weaken your immune system.
4. Kidney damage
Myeloma can block your kidneys so they don't filter the way they should. This can lead to kidney failure.
Diagnosis of multiple myeloma
Multiple myeloma is sometimes diagnosed when your doctor accidentally finds it during a blood test for some other condition. It can also be diagnosed if your doctor suspects you may have multiple myeloma based on your signs and symptoms.
Tests and procedures used to diagnose multiple myeloma include:
1. Blood tests
Laboratory analysis of your blood may detect proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells called beta-2-microglobulin may be detected in your blood and give your doctor clues about how aggressive your myeloma is.
In addition, blood tests to check kidney function, blood cell counts, calcium levels, and folic acid levels can give your doctor clues about your diagnosis.
2. Urine tests
Urinalysis may show proteins referred to as Bence Jones proteins when detected in urine.
3. Bone marrow examination
Your doctor may take a sample of bone marrow for testing in a laboratory. The sample is collected with a long needle inserted into the bone
In the laboratory, the sample is examined for myeloma cells, where specialized tests, such as fluorescence in situ hybridization, and myeloma cells can be analyzed to identify genetic mutations.
4. Imaging tests
Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include X-rays, MRI, CT scan, or positron emission tomography.
Treatment of multiple myeloma
If you have multiple myeloma but don't have any symptoms, you may not need treatment right away. Immediate treatment may not be necessary for multiple myeloma that grows slowly and is at an early stage.
However, your doctor will monitor your condition regularly for signs that the disease is progressing, as this may include blood and urine tests. If you develop signs and symptoms, or if your multiple myeloma shows signs of progression, you and your doctor may decide to begin treatment. The most common treatment methods include the following:
1. Targeted therapy
Targeted drug therapies focus on specific weaknesses found within cancer cells by preventing these abnormalities, as targeted drug therapies can cause cancer cells to die.
2. Immunotherapy
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer; Because cancer cells produce proteins that help them hide from immune system cells, immunotherapy works by interfering with this process.
3. Chemotherapy
Chemotherapy uses drugs to kill cancer cells. The drugs kill fast-growing cells, including myeloma cells. High doses of chemotherapy drugs are used before a bone marrow transplant.
4. Corticosteroids
Corticosteroid medications regulate the immune system to control inflammation in the body, and they are also active against myeloma cells.
5. Bone marrow transplantation
Bone marrow transplant also known as stem cell transplant is a procedure to replace diseased bone marrow with healthy bone marrow.
Before a bone marrow transplant, hematopoietic stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy the diseased bone marrow. The stem cells are then injected into the body, where they travel to your bones and begin rebuilding the bone marrow.
6. Radiation therapy
Radiotherapy uses high-energy beams from sources such as:
Prevention of multiple myeloma
The disease cannot be prevented.
Symptoms of leukemia
Leukemia is a cancer that affects white blood cells. It often starts from the blood cells and then moves to the bone marrow. Symptoms of leukemia are the following:
General fatigue and emaciation.
shortness of breath.
Sweating during the night.
Body and bone pain.
Weight loss.
Unexplained bruises appear.
Enlarged lymph nodes.
Spleen swelling.
Continuous and frequent bleeding from small wounds.
Infections occur frequently.
High temperature.
Pale skin color.
Symptoms of lymphoma
Lymphoma may begin in the bone marrow or lymph nodes. Symptoms of lymphoma include:
Enlarged lymph nodes.
A lump under the armpit, in the thigh, leg, or neck.
Unexplained weight loss.
Numbness and tingling.
Feeling of fullness in the stomach.
General fatigue and emaciation.
Excessive sweating.
High temperature accompanied by chills.
Skin rash and itching.
Lower back, chest and nerve pain.
Diagnosing the symptoms of bone marrow cancer
Here are the methods for diagnosing the symptoms of bone marrow cancer:
Imaging tests
Imaging tests may help the doctor determine the extent to which the cancer has spread to other organs in the body. These tests are as follows:
Positron emission tomography.
Magnetic resonance imaging.
X ray.
Computed tomography.
Blood and urine tests
Blood and urine tests detect proteins in the circulation due to multiple myeloma, blood cell counts, and the effectiveness of kidney function.
Biopsy
A bone marrow biopsy is performed by removing a small piece of marrow using a large needle. The results of this procedure may help confirm bone marrow cancer and indicate the type of cancer it is.
Bone marrow aspiration
Doctors use the bone marrow aspiration technique to diagnose bone marrow cancer. A small sample of bone marrow is taken by anesthetizing the patient and then making a hole in one of the bones using a specialized needle. The doctor then examines the sample under a microscope to look for any cancer cells.
Treatment of bone marrow symptoms
The type of treatment for bone marrow cancer depends on many factors, including: the type of cancer, its severity, the age of the affected person, and his or her general health.
The following are common treatments for bone marrow symptoms:
Medicines: They attack certain types of cancer cells and prevent damage to healthy cells.
Chemotherapy: This can be done by drip or injection. This treatment method kills cancer cells and limits their reproduction.
Radiation therapy: Gamma rays and X-rays are used to kill cancer cells, relieve pain, and reduce the size of the tumor.
Bone marrow transplant: Damaged bone marrow is replaced with healthy marrow from a donor. The doctor may begin this treatment method after successful radiation therapy or chemotherapy.
