Understanding Plasma Cell Cancer: Multiple Myeloma Overview

Plasma cell cancer

Known medically as multiple myeloma, this condition involves the uncontrolled growth of plasma cells in the bone marrow. Typically, these white blood cells produce normal antibodies, but in this disease, abnormal plasma cells proliferate, leading to issues such as bone pain, anemia, bleeding, infections, and amyloidosis. Many patients experience relapse even after remission. Causes are not fully understood but factors like genetic predisposition, obesity, alcohol consumption, radiation exposure, and chemicals may contribute. Malignant plasma cells produce irregular antibodies, thickening blood and damaging kidneys.

This disease forms tumor masses within the soft tissue of bone marrow. Multiple tumors define multiple myeloma. Diagnosis includes blood and urine tests for abnormal antibody levels, bone marrow biopsies, imaging for bone damage, and elevated blood calcium. Although treatable, it remains incurable with potential relapses. Treatments like steroids, thalidomide, chemotherapy, stem cell transplants, and lenalidomide can prolong life, averaging an additional five years. However, in the US, over 11,000 deaths occur annually due to multiple myeloma or its recurrence.

Relapse happens when initial therapies fail, or the disease progresses without response, challenging ongoing management. The disease impacts various organs, with symptoms such as renal failure, anemia, bone damage, weight loss, and infections like pneumonia. Common symptoms include:

• Bone pain affecting 70% of patients, especially in spine and ribs, worsening with activity, possibly indicating fractures.
• Anemia resulting from marrow infiltration, reducing red blood cell production.
• High levels of abnormal proteins or antibodies secreted by malignant cells, harming kidneys.
• Infections like pneumonia, particularly risky before chemotherapy, with symptoms including fatigue, confusion, neurological issues, and numbness in extremities.

Risk factors include monoclonal gammopathy, hidden multiple myeloma, obesity, genetic predisposition, and inherited protein hyperphosphorylation, more common in African Americans. Resistance and relapse depend on tumor diversity and past treatments, with options including treatment modification, stem cell transplants, and new therapies like bortezomib, thalidomide, and pomalidomide. Kidney complications may require dialysis. Oral medications such as ixazomib and daratumumab are also used. Palliative care plays a crucial role in managing symptoms and side effects. Overall survival has increased, with a five-year survival rate of around 35%, though prognosis varies by age and disease aggressiveness. Genetic testing at specialized centers helps assess individual risk. Ongoing research focuses on personalized treatments based on genetic variations to improve outcomes.