A space where you’ll find clear explanations about what myeloma is, how it may affect your body, what to expect after diagnosis, and answers to questions that many patients ask.
What is
Multiple Myeloma?
How it
Develops
Disease
Characteristics
Progression and
Variability
What is Multiple Myeloma?
Multiple myeloma is a type of cancer that affects plasma cells, a type of white blood cell produced in the bone marrow. Plasma cells are essential for the immune system because they generate antibodies, which are proteins that help the body recognize and fight infections. In multiple myeloma, these plasma cells undergo malignant transformation, meaning they become cancerous and start multiplying uncontrollably.
How Multiple Myeloma Develops
Malignant Plasma Cells
Normal Function: Plasma cells are normally responsible for producing antibodies to fight infections. They originate from B cells, another type of immune cell, which mature into plasma cells in the bone marrow.
Cancerous Change: In multiple myeloma, a small number of these plasma cells undergo genetic mutations or other changes that make them cancerous (malignant). These malignant plasma cells start to grow and divide uncontrollably.
Effects of Accumulation of Malignant Plasma Cells
Bone Marrow Infiltration: The malignant plasma cells (also called “myeloma cells”) accumulate in the bone marrow, which is the spongy tissue inside bones where blood cells are produced. This buildup disrupts the normal production of red blood cells, white blood cells, and platelets.
Abnormal Proteins: The cancerous plasma cells usually produce an abnormal protein known as a monoclonal protein or M protein. These proteins do not function like normal antibodies. Instead, they can accumulate in the blood and urine, sometimes leading to problems like kidney damage. The monoclonal protein level can also serve as a tumour marker to monitor the disease activity by using serial blood or urine tests.
Disease Characteristics
Disruption of Normal Blood Cell Production
Anemia: The reduction in normal red blood cells can cause anemia, leading to fatigue, weakness, and pallor (paleness of the skin).
Increased Risk of Infections: With fewer normal white blood cells and abnormal antibodies, the body’s ability to fight infections is weakened.
Bleeding Issues: Low platelet counts can result in problems with blood clotting, causing easy bruising and bleeding.
Bone Damage
Bone Lesions: The malignant plasma cells can produce substances that activate certain cells in the bone marrow called osteoclasts; osteoclasts can break down bone. This results in bone loss (osteoporosis) and local areas of damage called “lesions”, leading to pain pain and an increased risk of fractures.
Hypercalcemia: Since bone contains a great deal of calcium, its the breakdown of bone releases calcium into the bloodstream, causing high levels of calcium (hypercalcemia), which can lead to various symptoms such as nausea, confusion, and increased thirst.
Kidney Damage
The excess M protein can overwhelm the kidneys, causing damage and in severe cases, to kidney failure. This can be indicated by elevated levels of protein in the urine and abnormal blood tests that reveal decreased kidney function.
Progression and Variability
Disease Stages
(Smoldering) Myeloma: In some patient, the early stages of, the disease might be asymptomatic or cause only mild symptoms. This is known as smoldering myeloma and is usually monitored closely.
Active Myeloma: As the disease progresses, symptoms become more apparent, and the impact on normal blood cell production, bones and organ function becomes more significant.
Advanced Myeloma: In advanced stages, multiple myeloma can cause severe complications and affect multiple organs, requiring more aggressive treatment.
Complexity and Individual Variability
Genetic Diversity: Multiple myeloma is a heterogeneous disease, meaning it can present differently in each person. The genetic and molecular characteristics of the cancer cells can vary widely, influencing how the disease progresses and how it responds to treatment.
Ongoing Research: Scientists are continually studying the genetic mutations, cellular mechanisms, and molecular pathways involved in multiple myeloma. This research is essential for developing targeted therapies and personalized treatments to improve patient outcomes.